EXPERIMENTAL CYSTOPLASTY--IN-VIVO AND IN-VITRO STUDIES

实验性膀胱成形术——体内和体外研究

• 批准号: 3240937
• 负责人: Michael Raymond Ruggieri
• 金额: $ 15.88万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-07-16 至 1995-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3240937
• 关键词: alpha adrenergic receptor; gastrointestinal transplantation; hypertrophy; ileum; immunocytochemistry; immunoprecipitation; in situ hybridization; innervation; laboratory rabbit; muscarinic receptor; muscle contraction; neural plasticity; tissue /cell culture; urinary bladder; urinary incontinence; urine; western blottings

Bladder augmentation or substitution with bowel segments are surgical procedures intended to provide a high capacity, low pressure urine reservoir for patients with small, hypertrophied, low compliance, high pressure bladders. Preliminary studies have indicated that experimental, ileocystoplasty in rabbits shifts the muscarinic, alpha adrenergic and purinergic response of the ileum towards that of the bladder. This effect is important as a manifestation of the functional plasticity of visceral smooth muscle. The major goal of the proposed studies is to determine what physiological signal or signals induce this change. Of the many possibilities, 5 of the most obvious are: 1)- the different environmental input (i.e. periodic inflation and deflation), 2) exposure to urine, 3) reinnervation of the intestinal segment by bladder nerves, 4) overgrowth of intestinal muscle by bladder muscle, and 5) replacement of intestinal muscle by newly formed bladder muscle. The initial approach will be to compare cystoplasty with alternative surgical models which include: 1) Cystoplasty with and without continence, 2) Tubular vs. detubulirized cystoplasty, 3) Ileal pouch with and without periodic filling (with either saline or urine). By comparing the contractile pharmacology of ileal segments from the above models, it will be determined whether the observed smooth muscle plasticity is related to the filling cycle of the bladder, the presence of urine, physical contact with gladder muscle, or a combination of factors. The long term objectives are to understand the mechanism whereby intestinal smooth muscle becomes similar to bladder smooth muscle following cytoplasty. Armed with this knowledge, novel treatment strategies will be developed which may induce the neoreservoir to perform the bladder emptying function thus avoiding complications that intermittent catheterization imposes. In addition, these studies will provide a significant contribution to understanding the functional plasticity of visceral smooth mechanisms of smooth muscle and could lead to insights into mechanisms of smooth muscle excitation contraction coupling.

膀胱膨胀或用肠细分替换为手术 旨在提供高容量低压尿液的程序 小型，肥厚，低依从性的患者储层 压力膀胱。 初步研究表明，实验性， 兔子中的回肠囊肿术转移毒蕈碱，α肾上腺素和 回肠对膀胱的嘌呤能反应。 这个效果 重要的是内脏功能可塑性的表现 平滑肌。 拟议研究的主要目标是确定什么生理 信号或信号会引起这种变化。 在许多可能性中，有5个 最明显的是：1） - 不同的环境输入（即周期性 通货膨胀和放气），2）暴露于尿液，3）重新支配 膀胱神经的肠片段，4）肠道肌肉过度生长 膀胱肌肉和5）用新形成的肠肌肉代替 膀胱肌肉。 最初的方法是将膀胱成形术与 替代手术模型，其中包括：1）有或没有的膀胱成形术 连续性，2）管状与持续的膀胱成形术，3）带有带有 并且没有定期填充（用盐水或尿液）。 通过比较 上述模型的回肠段的收缩药理学， 将确定观察到的平滑肌可塑性是否相关 到膀胱的填充周期，尿液的存在，物理 与Gladder肌肉接触或多种因素。 长期目标是了解肠道的机制 平滑肌变得与膀胱平滑肌相似 细胞置换术。 有了这些知识，新颖的治疗策略将是 开发的可能会诱导Neoreservoir进行膀胱排空 功能因此避免了间歇性导管插入的并发症 强加。 此外，这些研究将提供重要的 理解内脏光滑的功能可塑性的贡献 平滑肌的机制，可能导致对机制的见解 平滑肌激发收缩耦合。