The effects of cyclical oestrogen on bladder and urethral structure and function
The effects of cyclical oestrogen on bladder and urethral structure and function
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DOI：
10.1111/j.1464-410x.2007.06532.x
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发表时间：
2007-01-01
影响因子：
4.5
通讯作者：
Levin, Robert M.
中科院分区：
文献类型：
--
作者：
Palmieri, Katherine;Mannikarottu, Anita S.;Levin, Robert M.
目的探讨雌激素循环对家兔的影响，因为雌激素对雌性泌尿生殖道的生理维持和完整性至关重要。材料与方法循环雌激素的改变对实验动物膀胱有明显影响，卵巢切除术（Ovx）诱导膀胱平滑肌（ISM）和粘膜萎缩，胶原合成和沉积增加，收缩功能、粘膜和SM血流量降低；雌激素逆转了这些作用，增加膀胱质量和SM密度，主要是通过刺激血管生成和增加血流量。将20只成年雌性新西兰大白兔分成5组；1组为对照组，2 ~ 5组为双侧卵巢。第二组不使用雌二醇，在Ovx后2周进行评估；3-5组在Ovx治疗2周后给予17- β雌二醇皮下缓释片，并持续2周。第三组在雌二醇治疗2周后进行评估。第4组和第5组停用雌二醇片2周，第4组在停用雌二醇后进行评估。然后，第5组接受了新的雌二醇片，并将其放置2周。结果两组（3、5组）患者膀胱重量均显著高于对照组和2组。SM的体积分数与膀胱重量呈平行关系，表明雌激素增加了SM的体积分数，而Ovx和低雌激素降低了SM的体积分数。第3组和第5组的尿道横截面明显比对照组和第1组宽，这也与雌激素的结构作用相一致。在所有组中，动脉注射苯肾上腺素使尿道压力升高到相似的水平。动脉内乙酰胆碱对尿道压力的反应由对照组的收缩转变为雌激素治疗组的松弛。卵细胞导致较低的血管密度，而雌激素导致血管密度显著增加（血管生成）。结论周期性雌激素具有明显的结构和药理作用。低雌激素降低了SM的体积分数，增加了胶原蛋白，减少了脉管系统，而雌激素介导了SM成分的显著肥大，减少了胶原成分，刺激了血管生成。周期性雌激素对动脉内乙酰胆碱的反应也有显著影响，使反应从收缩转变为松弛。
OBJECTIVE To determine the effects of cycling oestrogen in rabbits, as oestrogen is essential for physiological maintenance and integrity of the female urogenital tract.MATERIALS AND METHODS Changes in circulating oestrogen have marked effects on the bladder of experimental animals, with ovariectomy (Ovx) inducing smooth muscle ISM) and mucosal atrophy, increasing Collagen synthesis and deposition, decreasing contractile function, mucosal and SM blood flow; oestrogen reverses these effects and increases bladder mass and SM density, primarily by stimulating angiogenesis and increasing blood flow. Twenty adult female New Zealand White rabbits were divided into five equal groups; group 1 served as the control group, and groups 2-5 had a bilateral Ovx. Group 2 received no oestradiol and was assessed 2 weeks after Ovx; groups 3-5 received 17-beta oestradiol from a subcutaneous slow-release tablet 2 weeks after Ovx, which remained in place for a subsequent 2-week period. Group 3 was then assessed after the 2 weeks on oestradiol. Groups 4 and 5 then had their oestradiol tablets removed for 2 weeks and group 4 was assessed after this period off oestradiol. Group 5 then received a new oestradiol tablet that was left in place for an additional 2 weeks.RESULTS Both groups receiving oestrogen (3 and 5) had a statistically significantly greater bladder weight than both the control group and group 2. The volume fraction of SM paralleled the bladder weight, showing that oestrogen increased the volume fraction of SM whereas Ovx and low oestrogen decreased the SM fraction. The cross-sections of the urethra from groups 3 and 5 were significantly wider than those of either the control or group 1, also being consistent with the structural effects of oestrogen. Intra-arterial phenylephrine increased urethral pressure to a similar level in all groups. The urethral pressure response to intra-arterial acetylcholine shifted from contraction in the control to relaxation in the oestrogen-treated groups. Ovx resulted in a lower vascular density, whereas oestrogen resulted in a significant increase in vascular density (angiogenesis).CONCLUSIONS Cyclical oestrogen had pronounced structural and pharmacological effects. Low oestrogen decreased the volume fraction of SM, increased Collagen, and decreased vasculature, whereas oestrogen mediated a marked hypertrophy of the SM components, decreased the Collagen component, and stimulated angiogenesis. Cyclical oestrogen also had marked effects on the responses to intra-arterial acetylcholine, shifting the response from contraction to relaxation.