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Targeting neurotrophin and nitric oxide signaling to promote recovery and ameliorate neurogenic bladder dysfunction following spinal cord injury – Mechanistic concepts and clinical implications

Kanai, A. J. ; Andersson, K. E. LU orcid ; Fry, C. H. and Yoshimura, N. (2023) In Continence 6.
Abstract

This review summarizes the presentations made to a workshop entitled “Targeting Neurotrophin and Nitric Oxide Signaling to Promote Recovery and Ameliorate Neurogenic Bladder Dysfunction following Spinal Cord Injury – Mechanistic Concepts and Clinical Implications” at the International Continence Society (ICS) 2022 Vienna Meeting. Spinal cord injury (SCI; T8-T9 contusion/transection) causes impaired mobility, neurogenic detrusor overactivity (NDO), detrusor sphincter dyssynergia (DSD) and subsequent decreased quality of life. This workshop discussed the potential of future therapeutic agents that manage the lesion and its consequences, in particular possibilities to reduce the lesion itself and manage pathophysiological changes to the... (More)

This review summarizes the presentations made to a workshop entitled “Targeting Neurotrophin and Nitric Oxide Signaling to Promote Recovery and Ameliorate Neurogenic Bladder Dysfunction following Spinal Cord Injury – Mechanistic Concepts and Clinical Implications” at the International Continence Society (ICS) 2022 Vienna Meeting. Spinal cord injury (SCI; T8-T9 contusion/transection) causes impaired mobility, neurogenic detrusor overactivity (NDO), detrusor sphincter dyssynergia (DSD) and subsequent decreased quality of life. This workshop discussed the potential of future therapeutic agents that manage the lesion and its consequences, in particular possibilities to reduce the lesion itself and manage pathophysiological changes to the lower urinary tract (LUT). Attenuation of the spinal cord lesion itself was discussed with respect to the potential of a trio of agents: LM11A-3, a p75 neurotrophin receptor modulator to counter activation of local apoptotic pathways; LM22B-10 to promote neuronal growth by targeting tropomyosin-related kinase (Trk) receptors; and cinaciguat, a soluble guanylate cyclase (sGC) activator as an agent promoting angiogenesis at the injury site. The workshop also discussed targets on the bladder to block selectivity sites associated with detrusor overactivity and poor urinary filling profiles, such as purinergic pathways controlling excess contractile activity and afferent signaling, as well as excess fibrosis. Finally, the importance of increased mechanosensitive signaling as a contributor to DSD was considered, as well as potential drug targets. Overall, an emphasis was placed on targets that help restore function and reduce pathological LUT consequences, rather than downregulate normal function.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bladder wall metabolism, Detrusor sphincter dyssynergia (DSD), Mechanosensitive afferents, Neural cord repair, Neurogenic detrusor overactivity (NDO), Spinal cord injury (SCI)
in
Continence
volume
6
article number
100703
publisher
Elsevier
external identifiers
  • pmid:37389025
  • scopus:85173956346
ISSN
2772-9737
DOI
10.1016/j.cont.2023.100703
language
English
LU publication?
yes
id
b30f21a7-bd52-495c-9ed8-bb684149befe
date added to LUP
2023-12-12 13:34:18
date last changed
2024-04-25 07:05:42
@article{b30f21a7-bd52-495c-9ed8-bb684149befe,
  abstract     = {{<p>This review summarizes the presentations made to a workshop entitled “Targeting Neurotrophin and Nitric Oxide Signaling to Promote Recovery and Ameliorate Neurogenic Bladder Dysfunction following Spinal Cord Injury – Mechanistic Concepts and Clinical Implications” at the International Continence Society (ICS) 2022 Vienna Meeting. Spinal cord injury (SCI; T8-T9 contusion/transection) causes impaired mobility, neurogenic detrusor overactivity (NDO), detrusor sphincter dyssynergia (DSD) and subsequent decreased quality of life. This workshop discussed the potential of future therapeutic agents that manage the lesion and its consequences, in particular possibilities to reduce the lesion itself and manage pathophysiological changes to the lower urinary tract (LUT). Attenuation of the spinal cord lesion itself was discussed with respect to the potential of a trio of agents: LM11A-3, a p75 neurotrophin receptor modulator to counter activation of local apoptotic pathways; LM22B-10 to promote neuronal growth by targeting tropomyosin-related kinase (Trk) receptors; and cinaciguat, a soluble guanylate cyclase (sGC) activator as an agent promoting angiogenesis at the injury site. The workshop also discussed targets on the bladder to block selectivity sites associated with detrusor overactivity and poor urinary filling profiles, such as purinergic pathways controlling excess contractile activity and afferent signaling, as well as excess fibrosis. Finally, the importance of increased mechanosensitive signaling as a contributor to DSD was considered, as well as potential drug targets. Overall, an emphasis was placed on targets that help restore function and reduce pathological LUT consequences, rather than downregulate normal function.</p>}},
  author       = {{Kanai, A. J. and Andersson, K. E. and Fry, C. H. and Yoshimura, N.}},
  issn         = {{2772-9737}},
  keywords     = {{Bladder wall metabolism; Detrusor sphincter dyssynergia (DSD); Mechanosensitive afferents; Neural cord repair; Neurogenic detrusor overactivity (NDO); Spinal cord injury (SCI)}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Continence}},
  title        = {{Targeting neurotrophin and nitric oxide signaling to promote recovery and ameliorate neurogenic bladder dysfunction following spinal cord injury – Mechanistic concepts and clinical implications}},
  url          = {{http://dx.doi.org/10.1016/j.cont.2023.100703}},
  doi          = {{10.1016/j.cont.2023.100703}},
  volume       = {{6}},
  year         = {{2023}},
}