DEFECTS OF MUSCULAR INNERVATION IN NEUROGENIC BLADDER

神经源性膀胱肌肉神经支配缺陷

• 批准号: 3117105
• 负责人: AHMAD ELBADAWI
• 金额: $ 10.07万
• 依托单位: UPSTATE MEDICAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1985
• 资助国家: 美国
• 起止时间: 1985-09-30 至 1990-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3117105
• 关键词: biopsy; denervation; disease /disorder model; electron microscopy; histochemistry /cytochemistry; innervation; interneurons; neural transmission; neuroanatomy; neurochemistry; neurogenic urinary bladder disorder; neuromuscular junction; parasympathetic nervous system; sympathetic nervous system; tissue /cell preparation; urinary tract disorder diagnosis; urinary tract motility /pressure

Neurogenic bladder dysfunction (NBD) is a significant public health problem, and a challenging area of urologic diagnosis and management. Two issues central to the problem are: (1) the lack of detailed information on the nature of intrinsic defects of muscular innervation in the dysfunctional bladder and urethra; (2) the very limited knowledge of mechanisms of neurotransmission in the vesicourethral musculature. This study addresses both of the above issues by a multimodal morphologic approach that has not been applied previously for this purpose. Short- and long-term changes in the neurohistochemistry and ultrastructure of muscular innervation in the detrusor, internal sphincter and rhabdosphincter (external urethral sphincter), in 6 experimental models of parasympathetic lower motoneuron-type NBD, will be analyzed both qualitatively and quantitatively, as a prelude to future morphologic study of human NBD. Correlation of the findings with a parallel analysis of innervation parameters in normal musculature using the same multimodal approach will provide new information relative to the first issue, namely, the nature of intrinsic defects of muscular innervation in the dysfunctional bladder and urethra. A subsequent correlative analysis of all morphologic data with available physiopharmacologic observations on normal and abnormal micturition will provide further new information relative to the second issue, namely, the structural basis of neurotransmission in the vesicourethral musculature. The results of the proposed study will thus fill important gaps in our knowledge of the neuromuscular basis of normal and abnormal micturition, and provide the hitherto lacking data base for the long-term objective, namely, the clinical morphologic study of muscular innervation in NBD in man, including that due to spinal cord injury. Such a study would eventually lead to the introduction of: (1) a clinical biopsy tissue test as an aid to diagnosis, treatment planning and follow-up; and (2) drug therapy options that are more selective, effective and predictable than has so far been available.

神经源性膀胱功能障碍（NBD）是一个重要的公共卫生问题， 泌尿科诊断和管理的一个具有挑战性的领域。 两个核心问题 问题是：（1）缺乏关于 功能障碍性膀胱中肌肉神经支配的内在缺陷， 尿道;（2）对神经传递机制的认识非常有限， 膀胱尿道肌肉组织 本研究通过多模态形态学方法解决了上述两个问题。 这种方法以前没有用于此目的。 短期和 肌纤维神经组织化学和超微结构的长期变化 逼尿肌、内括约肌和横纹括约肌（外括约肌）的神经支配 尿道括约肌），在6个实验模型的副交感神经低 运动神经元型NBD，将进行定性和定量分析， 这是人类NBD未来形态学研究的前奏。 调查结果的相关性 与正常肌肉组织中神经支配参数的平行分析， 相同的多模式方法将提供相对于第一种方法的新信息， 问题，即，肌肉神经支配的内在缺陷的性质， 膀胱和尿道功能障碍 随后对所有数据进行相关分析， 形态学数据以及正常和 异常排尿将提供相对于第二次排尿的进一步的新信息。 问题，即膀胱尿道神经传递的结构基础 肌肉组织 因此，拟议研究的结果将填补我们知识中的重要空白 正常和异常排尿的神经肌肉基础，并提供 长期目标缺乏数据基础，即临床 人类NBD中肌肉神经支配的形态学研究，包括由于 脊髓损伤 这项研究最终将导致采用： (1)临床活检组织测试作为辅助诊断，治疗计划和 随访;（2）更具选择性、有效性和 比迄今为止所能预测的要多。