Activation of the mTOR dependent signaling pathway underlies ketamine‐induced uropathy

Lin, Chih-Chieh; Yang, An-Hang; Lin, Alex Tong‐Long

doi:10.1002/nau.23234

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…Additionally, ketamine leads to activation of the mTOR pathway resulting in fibroblast-specific expression (FSP-1) and subsequent ketamine-induced uropathy. 31,32 One study was conducted assessing 36 KIC patients and 9 controls for a mechanism involved in microvascular injury of the bladder. The subjects completed a questionnaire that had the O'Leary-Sant interstitial cystitis symptom complex (ICSI) along with the interstitial cystitis problem index ICPI.…”

Section: Pathophysiology Of Ketamine Induced Cystitismentioning

confidence: 99%

Ketamine-Induced Cystitis: A Comprehensive Review of the Urologic Effects of This Psychoactive Drug

Anderson

Zhou

Cao

et al. 2022

Health Psychology Research

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Ketamine is a common medical anesthetic and analgesic but is becoming more widely used as a recreational drug. Significant side effects on the urinary tract are associated with frequent recreational ketamine use most notably ketamine-induced cystitis (KIC). Regular ketamine consumption has been shown to increase the risk of cystitis symptoms by 3- to 4-fold, and cessation of ketamine use is usually associated with improvement of symptoms. Common KIC-related problems are urinary pain and discomfort, bladder epithelial barrier damage, reduced bladder storage and increased pressure, ureter stenosis, and kidney failure, all of which significantly impact patients’ quality of life. Furthermore, it becomes a vicious cycle when KIC patients attempt to manage their urinary pain with increased ketamine use. The precise pathophysiology of KIC is still unknown but several theories exist, most of which highlight the inflammatory signaling pathways leading to bladder epithelium damage due to presence of ketamine in the urine. Empirical treatment options for KIC are available and consist of ketamine cessation, noninvasive therapies, and surgery, and should be decided upon based on the time course and severity of the disease. Of note, cessation of use is strongly recommended for all KIC patients, and should be supplemented with motivational interviews and psychological and social support. It is crucial for clinicians to be familiar with KIC diagnosis and treatment, and to be prepared to have informed discussions with ketamine-using patients about the potential health consequences of ketamine.

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Section: Pathophysiology Of Ketamine Induced Cystitismentioning

confidence: 99%

Ketamine-Induced Cystitis: A Comprehensive Review of the Urologic Effects of This Psychoactive Drug

Anderson

Zhou

Cao

et al. 2022

Health Psychology Research

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“…These histological changes are associated with the upregulation of collagen genes, collagen I, collagen III, fibronectin, and transforming growth factor-β1 (TGF-β1) 35 and the downregulation of sonic hedgehog, WNT gene family, WNT2B , WNT5A , WNT10A , and WNT11 in the biopsy of non-Hunner-type IC/BPS patients 33 , 36 – 40 . Recent studies report the association of YKL-40 antigenic expression in detrusor mast cell granules and submucosal macrophages with detrusor fibrosis 34 and of the fibrosis in ketamine-induced 41 IC/BPS with the activation of mammalian target of rapamycin (mTOR).…”

Section: Current Understanding Of the Pathologymentioning

confidence: 99%

“…Fibrotic changes (collagen deposition) in the bladder wall are a well-known outcome of progressive IC/BPS 15 , 33 , 34 , 45 , ketamine abuse 41 , 116 , and obstruction 117 , 118 . The inability to non-invasively measure fibrosis represents a major gap in the care and investigation of IC/BPS and other voiding disorders.…”

Section: Potential Applications Of Imaging Tools In Interstitial Cystmentioning

confidence: 99%

Recent advances in imaging and understanding interstitial cystitis

et al. 2018

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Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating condition associated with intense pelvic pain and bladder storage symptoms. Since diagnosis is difficult, prevalence estimates vary with the methodology used. There is also a lack of proven imaging tools and biomarkers to assist in differentiation of IC/BPS from other urinary disorders (overactive bladder, vulvodynia, endometriosis, and prostatitis). Current uncertainty regarding the etiology and pathology of IC/BPS ultimately impacts its timely and successful treatment, as well as hampers future drug development. This review will cover recent developments in imaging methods, such as magnetic resonance imaging, that advance the understanding of IC/BPS and guide drug development.

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Mechanisms of Inhibition of Excessive Microglial Activation by Melatonin

Gao

Liu

et al. 2020

J Mol Neurosci

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Activation of the mTOR dependent signaling pathway underlies ketamine‐induced uropathy

Abstract: Ketamine induces activation of the mTOR pathway and subsequent mesenchymal phenotypic expression (FSP1) in HBdMECs.

Cited by 5 publications

References 23 publications

Ketamine-Induced Cystitis: A Comprehensive Review of the Urologic Effects of This Psychoactive Drug

Ketamine-Induced Cystitis: A Comprehensive Review of the Urologic Effects of This Psychoactive Drug

Recent advances in imaging and understanding interstitial cystitis

Mechanisms of Inhibition of Excessive Microglial Activation by Melatonin

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