A pilot study to investigate the associations of urinary concentrations of NO, ATP and derivatives with overactive bladder symptom severity
A pilot study to investigate the associations of urinary concentrations of NO, ATP and derivatives with overactive bladder symptom severity
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DOI：
10.1113/ep088450
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发表时间：
2020-04-18
影响因子：
2.7
通讯作者：
Young, John S.
中科院分区：
文献类型：
--
作者：
Firouzmand, Sepinoud;Young, John S.
新发现这项研究的中心问题是什么？尿中一氧化氮和三磷酸腺苷及其代谢产物的浓度与膀胱过动症的严重程度有关吗？主要发现是什么及其重要性？尿比值[ATP/NO]、[ADP/NO]及其组合[ATP/Cr*ADP/Cr]/[NO/Cr]与OAB整体症状严重程度相关，后者的组合还与尿频和尿急症状的严重程度相关。总之，这些数据揭示了尿路上皮信号的变化伴随着从生理到病理的转变。膀胱过动症（OAB）是一种非常普遍的症状，其特征是尿急、尿频增加和尿空（夜尿症），伴或不伴急迫性尿失禁，没有证实感染或其他明显病理。特发性OAB的潜在病理生理机制尚不清楚，并且存在几种表型。目前的诊断方法是基于不一致的措施，遭受主观性和无法检测提出的OAB表型。一氧化氮、三磷酸腺苷及其代谢物先前已被证明是膀胱充溢感的基础，它们的释放改变了病理上的尿急感。因此，在这项研究中，我们评估了从普通人群中招募的113名同意参与者尿液中NO、ATP和相关代谢物的浓度。招募的参与者完成了一份调查问卷，以测量与oab相关的泌尿系统症状的严重程度，并提供了一份中游尿液样本。经微生物学和显微镜鉴定感染和血尿后，95份标本进行NO、NO2-、NO3-、ATP、ADP和肌酐（Cr）测定。[no /Cr]、[NO2-/Cr]、[NO3-/Cr]与OAB整体症状严重程度无相关性。[ATP/NO]、[ADP/NO]及其组合[ATP/Cr*ADP/Cr]/[NO/Cr]与OAB症状严重程度相关，[ATP/Cr*ADP/Cr]/[NO/Cr]与尿频严重程度和尿急程度相关。这项研究增加了越来越多的文献，证明了尿液生物标志物的潜力，并为更大规模的纵向研究提供了基础。
New FindingsWhat is the central question of this study? Are the urinary concentrations of NO and ATP, and their metabolites, associated with the severity of symptoms of overactive bladder?What is the main finding and its importance? The urinary ratios of [ATP/NO], [ADP/NO] and a combination of these, [ATP/Cr*ADP/Cr]/[NO/Cr], were correlated with overall OAB symptom severity, with the latter combination also being correlated with the severity of urinary frequency and urgency symptoms individually. Together, these data reveal changes in urothelial signalling that accompany the transition from physiology to pathology.Overactive bladder (OAB) is a highly prevalent symptom complex characterized by symptoms of urinary urgency and increased frequency and waking to void (nocturia), with or without urge incontinence and in the absence of proven infection or other obvious pathology. The underlying pathophysiology of idiopathic OAB is not clearly known, and the existence of several phenotypes has been proposed. Current diagnostic approaches are based on discordant measures, suffer from subjectivity and are incapable of detecting the proposed OAB phenotypes. Nitric oxide, ATP and their metabolites have previously been shown to underlie the perception of bladder fullness, with their release modifying the pathological perception of urgency. Therefore, in this study we assessed the concentrations of NO, ATP and associated metabolites in the urine of 113 consenting participants recruited from the general population. Recruited participants completed a questionnaire to measure the severity of OAB-associated urinary symptoms and provided a mid-stream urine sample. After identification of infection and haematuria using microbiology and microscopy, 95 samples were subjected to assays to measure NO, NO2-, NO3-, ATP, ADP and creatinine (Cr). There was no correlation between [NO/Cr], [NO2-/Cr] or [NO3-/Cr] and overall OAB symptom severity. In contrast, [ATP/NO], [ADP/NO] and a combination of these, [ATP/Cr*ADP/Cr]/[NO/Cr], were correlated with OAB symptom severity, and [ATP/Cr*ADP/Cr]/[NO/Cr] was also correlated with the severity of urinary frequency and urgency. This study adds to a growing literature that demonstrates the potential of urinary biomarkers and provides a foundation for a larger, longitudinal study.