IS LAMINA PROPRIA MATRIX RESPONSIBLE FOR NORMAL BLADDER COMPLIANCE
IS LAMINA PROPRIA MATRIX RESPONSIBLE FOR NORMAL BLADDER COMPLIANCE
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DOI：
10.1016/s0022-5347(17)36650-8
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发表时间：
1992-08-01
影响因子：
6.6
通讯作者：
MACARAK, EJ
中科院分区：
文献类型：
--
作者：
EWALT, DH;HOWARD, PS;MACARAK, EJ
使用细胞外基质蛋白的单抗和多克隆抗体的免疫组织化学是表征基质成分的一种高度敏感的工具。我们首次在正常和不合规的人膀胱中使用了I型、III型和IV型胶原的抗体和弹性蛋白，以提供与临床上注意到的机械特性的形态相关性。在正常膀胱中，I型和III型弹性蛋白和胶原蛋白在固有层有较强的定位，在逼尿肌层有中等的定位。相反，不顺应性膀胱的固有层染色基本上没有变化，而逼尿肌层内有强烈的定位。值得注意的是，这种强烈的定位由III型胶原和弹性蛋白组成，而I型胶原的增加很少。IV型胶原与基底膜和单个平滑肌细胞有关，在肌肉肥大和/或增生的标本中显示出相应的增加。这些观察结果表明，在正常膀胱中，固有层可能是一个主要的结构电容层，其上覆盖着平滑的肌肉。固有层的胶原纤维在充盈过程中可能逐渐展开，从而解释了正常的顺应性，而在不顺应性的膀胱中，电容层向外移位到浸润性的平滑肌，从而阻止了固有层的正常扩张。肌层内有III型胶原和弹性蛋白沉积，I型胶原少量增加，导致顺应性丧失。定位的模式表明，这种堆积是由平滑肌负责的。
Immunohistochemistry using monoclonal and polyclonal antibodies to extracellular matrix proteins is a highly sensitive tool for the characterization of matrix components. For the first time in the normal and noncompliant human bladder we have used antibodies to collagen types I, III and IV, and elastin to provide morphological correlation with mechanical properties noted clinically. In the normal bladder elastin and collagen types I and III showed intense localization in the lamina propria with modest localization in the detrusor layer. In contrast, lamina propria staining in the noncompliant bladder was essentially unchanged, while there was intense localization within the detrusor layer. Significantly, this intense localization consisted of collagen type III and elastin with little increase in type I. Type IV collagen is associated with basement membranes and individual smooth muscle cells, and shows commensurate increase in specimens with muscle hypertrophy and/or hyperplasia. These observations suggest that in the normal bladder the lamina propria may be a major structural capacitance layer with the smooth muscle covering it. The collagen fibers of the lamina propria may gradually unfold during filling, thus, accounting for normal compliance while in the noncompliant bladder the capacitance layer shifts outward to the infiltrated smooth muscle, thus, preventing the normal expansion of the lamina propria. The smooth muscle infiltration consists of a deposition of collagen type III and elastin with little increase of collagen type I, and it results in a loss of compliance. The pattern of localization would suggest that the smooth muscle is responsible for this accumulation.