Neuropathological Examination of the Alterations of the Intrinsic Innervation in Multiple Sclerosis Cystopathy (With 1 color plate)

Abstract

Morphometric analysis of the innervation pattern of the stromal layer of the urinary bladder was done on biopsies from 88 patients with definite multiple sclerosis (MS). The biopsies were stained for acetylcholinesterase and for S100 protein, and a semiquantitative score was assigned. Nearly 30% of the samples showed increased immunoreactivity for S100, indicating Schwann cell hyperplasia. In 16% a decreased S100 immunoreactivity was found, the significance of which is unclear. More than 90% had normal acetylcholinesterase activity. No correlation could be demonstrated for age, sex, severity and duration of the disease, the presence of cystitis and the type of detrusor dysfunction. The finding of altered S100 immunoreactivity in MS bladders could indicate that MS also affects the peripheral nervous system and is not limited to the central nervous system as classically described. This finding warrants further investigation.

Diabetic Cystopathy: Neuropathological Examination of Urinary Bladder Biopsies

“…For AChE all diabetic bladders showed low or definitely S100 protein, a calcium-binding protein, is consid ered as a marker of neuropathy: in the bladder it is exclu sively found in Schwann cells; they proliferate when axonal or myelin destruction occurs in order to enable regeneration [13]. The increase in SI00 immunoreactivity was described in multiple sclerosis bladder [14,15]. Only one study reports on the amount of SI00 in the peripheral nerves of diabetic rats, where no difference was found in the sciatic nerve as compared to a control group [16].…”

The effect of intravesical capsaicin on the suburothelial innervation in patients with detrusor hyper‐reflexia

“…Gu et al. [19] reported a convincing increase in S100‐staining structures in the neurogenic bladder, a finding confirmed in up to 30% of bladder biopsies from patients with multiple sclerosis (MS) [20]. The conventional histological assessment of bladder biopsies is not affected by this method of staining [21].…”