{"title":"膀胱内注射富血小板血浆在治疗因再生缺陷引起的下尿路疾病方面的治疗潜力。","authors":"Qian-Sheng Ke, Jia-Fong Jhang, Teng-Yi Lin, Han-Chen Ho, Yuan-Hong Jiang, Yuan-Hsiang Hsu, Hann-Chorng Kuo","doi":"10.4103/tcmj.tcmj_92_19","DOIUrl":null,"url":null,"abstract":"<p><p>The bladder urothelium plays an important role of barrier function to prevent influx of urinary toxic substance and bacteria. When there is insult to the urinary bladder, the urothelium will start to regenerate on injury. However, several factors might affect the regenerative function of bladder urothelium, including aging, chronic inflammation, and system diseases such as diabetes and chronic kidney diseases (CKDs). Impairment of bladder mucosal regenerative function might result in defective urothelial cell differentiation as well as barrier function, which might be the underlying pathophysiology of interstitial cystitis/bladder pain syndrome (IC/BPS) and recurrent bacterial cystitis. Our previous immunohistochemistry (IHC) study and electron microscopic study revealed that the loss of normal umbrella cells and defective junction proteins in IC/BPS and recurrent cystitis. Platelet-rich plasma (PRP) has been previously used in many medical aspects as regenerative medicine therapy. PRP is rich in many growth factors and cytokines which modulate the process of inflammation and regeneration in the wound healing process. Recent pilot studies have shown that intravesical PRP injections improve IC symptoms and yield a success rate of 70% at 3 months after treatment. The results highly suggest that PRP injection could improve urothelial regenerative function and reduce chronic inflammation in IC patients. This article reviews recently published researches on the urothelial dysfunction biomarkers, urothelial cell differentiation, and urinary regenerative and inflammatory proteins in patients with IC/BPS or recurrent bacterial cystitis. The pathophysiology of the insufficient urothelial regeneration and differentiation; and chronic inflammation may induce urothelial dysfunction and further affect the regenerative ability of the diseased bladder urothelium in IC/BPS and recurrent bacterial cystitis are discussed.</p>","PeriodicalId":72593,"journal":{"name":"Ci ji yi xue za zhi = Tzu-chi medical journal","volume":"31 3","pages":"135-143"},"PeriodicalIF":0.0000,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/bb/TCMJ-31-135.PMC6559029.pdf","citationCount":"0","resultStr":"{\"title\":\"Therapeutic potential of intravesical injections of platelet-rich plasma in the treatment of lower urinary tract disorders due to regenerative deficiency.\",\"authors\":\"Qian-Sheng Ke, Jia-Fong Jhang, Teng-Yi Lin, Han-Chen Ho, Yuan-Hong Jiang, Yuan-Hsiang Hsu, Hann-Chorng Kuo\",\"doi\":\"10.4103/tcmj.tcmj_92_19\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The bladder urothelium plays an important role of barrier function to prevent influx of urinary toxic substance and bacteria. 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PRP is rich in many growth factors and cytokines which modulate the process of inflammation and regeneration in the wound healing process. Recent pilot studies have shown that intravesical PRP injections improve IC symptoms and yield a success rate of 70% at 3 months after treatment. The results highly suggest that PRP injection could improve urothelial regenerative function and reduce chronic inflammation in IC patients. This article reviews recently published researches on the urothelial dysfunction biomarkers, urothelial cell differentiation, and urinary regenerative and inflammatory proteins in patients with IC/BPS or recurrent bacterial cystitis. 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引用次数: 0
摘要
膀胱尿路上皮起着重要的屏障作用,防止尿液中的有毒物质和细菌进入膀胱。当膀胱受到损伤时,尿路黏膜会开始再生。然而,多种因素可能会影响膀胱尿路上皮的再生功能,包括衰老、慢性炎症以及糖尿病和慢性肾病等系统疾病。膀胱粘膜再生功能受损可能导致尿路上皮细胞分化和屏障功能缺陷,这可能是间质性膀胱炎/膀胱疼痛综合征(IC/BPS)和复发性细菌性膀胱炎的潜在病理生理学原因。我们之前的免疫组化(IHC)研究和电子显微镜研究发现,IC/BPS 和复发性膀胱炎中存在正常伞状细胞丢失和交界蛋白缺陷。富血小板血浆(PRP)作为再生医学疗法已被广泛应用于医学领域。富血小板血浆富含多种生长因子和细胞因子,可调节伤口愈合过程中的炎症和再生过程。最近的试验研究表明,膀胱内注射 PRP 可改善 IC 症状,治疗 3 个月后的成功率达 70%。这些结果高度表明,PRP 注射可改善 IC 患者的尿道再生功能并减轻慢性炎症。本文回顾了近期发表的关于IC/BPS或复发性细菌性膀胱炎患者尿道功能障碍生物标志物、尿道细胞分化、尿再生蛋白和炎症蛋白的研究。讨论了 IC/BPS 和复发性细菌性膀胱炎患者尿路上皮再生和分化不足的病理生理学;慢性炎症可能诱发尿路上皮功能障碍,并进一步影响病变膀胱尿路上皮的再生能力。
Therapeutic potential of intravesical injections of platelet-rich plasma in the treatment of lower urinary tract disorders due to regenerative deficiency.
The bladder urothelium plays an important role of barrier function to prevent influx of urinary toxic substance and bacteria. When there is insult to the urinary bladder, the urothelium will start to regenerate on injury. However, several factors might affect the regenerative function of bladder urothelium, including aging, chronic inflammation, and system diseases such as diabetes and chronic kidney diseases (CKDs). Impairment of bladder mucosal regenerative function might result in defective urothelial cell differentiation as well as barrier function, which might be the underlying pathophysiology of interstitial cystitis/bladder pain syndrome (IC/BPS) and recurrent bacterial cystitis. Our previous immunohistochemistry (IHC) study and electron microscopic study revealed that the loss of normal umbrella cells and defective junction proteins in IC/BPS and recurrent cystitis. Platelet-rich plasma (PRP) has been previously used in many medical aspects as regenerative medicine therapy. PRP is rich in many growth factors and cytokines which modulate the process of inflammation and regeneration in the wound healing process. Recent pilot studies have shown that intravesical PRP injections improve IC symptoms and yield a success rate of 70% at 3 months after treatment. The results highly suggest that PRP injection could improve urothelial regenerative function and reduce chronic inflammation in IC patients. This article reviews recently published researches on the urothelial dysfunction biomarkers, urothelial cell differentiation, and urinary regenerative and inflammatory proteins in patients with IC/BPS or recurrent bacterial cystitis. The pathophysiology of the insufficient urothelial regeneration and differentiation; and chronic inflammation may induce urothelial dysfunction and further affect the regenerative ability of the diseased bladder urothelium in IC/BPS and recurrent bacterial cystitis are discussed.