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Fibrosis and the bladder, implications for function ICI-RS 2017

Fry, Christopher H.; Kitney, Darry G.; Paniker, Jalesh; Drake, Marcus J.; Kanai, Anthony and Andersson, Karl Erik LU (2018) In Neurourology and Urodynamics 37. p.7-12
Abstract

Aims: Most benign bladder pathologies are associated with an increase of extracellular matrix (ECM—fibrosis) and may progress from formation of stiffer matrix to a more compliant structure. The aims were to summarize current knowledge of the origins of bladder fibrosis and consequences in bladder function. Methods: A meeting at the International Consultation on Incontinence Research Society 2017 congress discussed the above aims and considered paradigms to reduce the extent of fibrosis. Discussants based their arguments on the basis of their own expertise, supplemented by review of the literature through PubMed. Proposals for future work were derived from the discussion. Results: Altered urodynamic compliance when ECM deposition is... (More)

Aims: Most benign bladder pathologies are associated with an increase of extracellular matrix (ECM—fibrosis) and may progress from formation of stiffer matrix to a more compliant structure. The aims were to summarize current knowledge of the origins of bladder fibrosis and consequences in bladder function. Methods: A meeting at the International Consultation on Incontinence Research Society 2017 congress discussed the above aims and considered paradigms to reduce the extent of fibrosis. Discussants based their arguments on the basis of their own expertise, supplemented by review of the literature through PubMed. Proposals for future work were derived from the discussion. Results: Altered urodynamic compliance when ECM deposition is increased is mirrored by changes in the elastic modulus of isolated tissue, whether compliance is decreased or increased. No changes to compliance or fibrosis have been reported after botulinum toxin injections. Several paracrine and autocrine agents increase ECM deposition, the role of TGF-β was particularly emphasized. None of these agents has a net long-term effect on detrusor contractility and the reduction of contractile performance with increased ECM is due solely to a loss of detrusor mass. Several strategies to reduce fibrosis were described, ranging from potential therapeutic roles for vitamin-D or endostatin, manipulation of intracellular pathways that mediate myofibroblast differentiation and the potential role of the anti-fibrotic hormone relaxin. An understanding of epigenetic regulation of ECM deposition was also considered. Conclusions: The conclusion that reduced bladder contractile function with increased fibrosis is due largely to the replacement of detrusor with ECM offers a way forward for future research to consider approaches that will restore bladder function by reducing ECM deposition.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bladder, contraction, fibrosis
in
Neurourology and Urodynamics
volume
37
pages
7 - 12
publisher
John Wiley & Sons
external identifiers
  • scopus:85050792657
ISSN
0733-2467
DOI
10.1002/nau.23725
language
English
LU publication?
yes
id
8f84154c-97da-46f4-9875-65a8b98fba63
date added to LUP
2018-09-17 10:01:21
date last changed
2019-10-15 06:45:12
@article{8f84154c-97da-46f4-9875-65a8b98fba63,
  abstract     = {<p>Aims: Most benign bladder pathologies are associated with an increase of extracellular matrix (ECM—fibrosis) and may progress from formation of stiffer matrix to a more compliant structure. The aims were to summarize current knowledge of the origins of bladder fibrosis and consequences in bladder function. Methods: A meeting at the International Consultation on Incontinence Research Society 2017 congress discussed the above aims and considered paradigms to reduce the extent of fibrosis. Discussants based their arguments on the basis of their own expertise, supplemented by review of the literature through PubMed. Proposals for future work were derived from the discussion. Results: Altered urodynamic compliance when ECM deposition is increased is mirrored by changes in the elastic modulus of isolated tissue, whether compliance is decreased or increased. No changes to compliance or fibrosis have been reported after botulinum toxin injections. Several paracrine and autocrine agents increase ECM deposition, the role of TGF-β was particularly emphasized. None of these agents has a net long-term effect on detrusor contractility and the reduction of contractile performance with increased ECM is due solely to a loss of detrusor mass. Several strategies to reduce fibrosis were described, ranging from potential therapeutic roles for vitamin-D or endostatin, manipulation of intracellular pathways that mediate myofibroblast differentiation and the potential role of the anti-fibrotic hormone relaxin. An understanding of epigenetic regulation of ECM deposition was also considered. Conclusions: The conclusion that reduced bladder contractile function with increased fibrosis is due largely to the replacement of detrusor with ECM offers a way forward for future research to consider approaches that will restore bladder function by reducing ECM deposition.</p>},
  author       = {Fry, Christopher H. and Kitney, Darry G. and Paniker, Jalesh and Drake, Marcus J. and Kanai, Anthony and Andersson, Karl Erik},
  issn         = {0733-2467},
  keyword      = {bladder,contraction,fibrosis},
  language     = {eng},
  month        = {06},
  pages        = {7--12},
  publisher    = {John Wiley & Sons},
  series       = {Neurourology and Urodynamics},
  title        = {Fibrosis and the bladder, implications for function ICI-RS 2017},
  url          = {http://dx.doi.org/10.1002/nau.23725},
  volume       = {37},
  year         = {2018},
}