Therapeutic Effect of Platelet-Rich Plasma Improves Bladder Overactivity in the Pathogenesis of Ketamine-Induced Ulcerative Cystitis in a Rat Model

Chueh, Kuang-Shun; Huang, Kuan‐Hua; Lu, Jian‐He; Juan, Tai-Jui; Chuang, Sung-Kiang; Lin, Rong-Jyh; Lee, Yi‐Chen; Long, Cheng‐Yu; Shen, Mei-Chen; Sun, Ting-Wei; Juan, Yung‐Shun

doi:10.3390/ijms23105771

Cited by 9 publications

(10 citation statements)

References 92 publications

(133 reference statements)

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“…In our previous study, HA instillations promoted the repair of the damaged GAG layer and enhanced bladder re-epithelialization, proliferation and differentiation in the KIC rat model [33]. On the other hand, the therapeutic effect of PRP instillation decreased inflammatory fibrosis, attenuated oxidative stress, promoted regeneration of urothelial cells, enhanced angiogenesis and neurogenesis, and thereafter restored bladder dysfunction and improved bladder hyperactivity in KIC rats [64]. The present study showed that the immunoactivity of the HA receptors (CD44, RHAMM and TLR-4) was mainly expressed in the basal layer of UL and stroma cells as well as vessels of SL in the OVX group.…”

Section: Discussionmentioning

confidence: 85%

Effects of Therapeutic Platelet-Rich Plasma on Overactive Bladder via Modulating Hyaluronan Synthesis in Ovariectomized Rat

Chueh

Juan

et al. 2023

IJMS

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Postmenopausal women who have ovary hormone deficiency (OHD) may experience urological dysfunctions, such as overactive bladder (OAB) symptoms. This study used a female Sprague Dawley rat model that underwent bilateral ovariectomy (OVX) to simulate post-menopause in humans. The rats were treated with platelet-rich plasma (PRP) or platelet-poor plasma (PPP) after 12 months of OVX to investigate the therapeutic effects of PRP on OHD-induced OAB. The OVX-treated rats exhibited a decrease in the expression of urothelial barrier-associated proteins, altered hyaluronic acid (hyaluronan; HA) production, and exacerbated bladder pathological damage and interstitial fibrosis through NFƘB/COX-2 signaling pathways, which may contribute to OAB. In contrast, PRP instillation for four weeks regulated the inflammatory fibrotic biosynthesis, promoted cell proliferation and matrix synthesis of stroma, enhanced mucosal regeneration, and improved urothelial mucosa to alleviate OHD-induced bladder hyperactivity. PRP could release growth factors to promote angiogenic potential for bladder repair through laminin/integrin-α6 and VEGF/VEGF receptor signaling pathways in the pathogenesis of OHD-induced OAB. Furthermore, PRP enhanced the expression of HA receptors and hyaluronan synthases (HAS) enzymes, reduced hyaluronidases (HYALs), modulated the fibroblast-myofibroblast transition, and increased angiogenesis and matrix synthesis via the PI3K/AKT/m-TOR pathway, resulting in bladder remodeling and regeneration.

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Section: Discussionmentioning

confidence: 85%

Effects of Therapeutic Platelet-Rich Plasma on Overactive Bladder via Modulating Hyaluronan Synthesis in Ovariectomized Rat

Chueh

Juan

et al. 2023

IJMS

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“…25 In another study on the effects of PRP on ketamine-induced ulcerative cystitis, PRP intravesical treatment decreased inflammatory fibrotic biosynthesis and oxidative stress and promoted urothelial cell regeneration, angiogenesis, and neurogenesis. 26 This demonstrates that PRP treatment can recover the dysfunctional bladder and ameliorate bladder overactivity in a ketamine-induced cystitis rat model. In an animal study involving overactive bladder animal model of ovary hormone deficiency, PRP was demonstrated to enhance the expression of hyaluronan receptors and hyaluronan synthases, reduced hyaluronidases, modulated the fibroblast-myofibroblast transition, and increased angiogenesis and matrix synthesis via the PI3K/AKT/m-TOR pathway, resulting in bladder remodeling and regeneration.…”

Section: Prp Treatment For Bladder Inflammatory Conditionsmentioning

confidence: 83%

“…In another study on the effects of PRP on ketamine‐induced ulcerative cystitis, PRP intravesical treatment decreased inflammatory fibrotic biosynthesis and oxidative stress and promoted urothelial cell regeneration, angiogenesis, and neurogenesis 26 . This demonstrates that PRP treatment can recover the dysfunctional bladder and ameliorate bladder overactivity in a ketamine‐induced cystitis rat model.…”

Section: Prp Treatment For Bladder Inflammatory Conditionsmentioning

confidence: 87%

Intravesical injections of autologousplatelet‐richplasma for the treatment of refractory interstitial cystitis

Kuo

2023

LUTS

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The urothelium acts as a barrier for the urinary bladder that prevents the influx of urinary toxic substances, electrolytes, urea nitrogen, and pathogens into the circulation. Acute or chronic inflammation of the urinary bladder may impair the regenerative function of urothelial cells and thus urothelial cell differentiation. In an inflamed bladder wall, mature apical cells are defective, resulting in impaired barrier function and thus increased urothelial permeability. This is considered to be the potential mechanism of the symptom trigger in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Previous studies have revealed that increased bladder inflammation, impaired urothelial cell maturation, a defective umbrella cell barrier, and defective junction proteins are prominent in IC/BPS bladders. Platelet‐rich plasma (PRP) contains many growth factors and cytokines that are essential proteins for modulating inflammation and promoting tissue regeneration and thus wound healing. As such, PRP has been used as a regenerative therapy in many medical fields. Our preliminary studies have demonstrated that multiple intravesical PRP injections could improve symptoms in 70% of IC/BPS patients. Repeated PRP treatments also improve junctional protein, increase cytoskeleton protein expression, and decrease urinary inflammatory proteins. These preliminary results suggest that PRP injections might reduce bladder inflammation and improve urothelial cell regeneration in IC/BPS patients. This article reviews recently published clinical and basic research on the treatment potential of PRP for IC/BPS patients.

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“…Additionally, PRP treatment reversed the ketamine induced enhancement in detrusor muscle contractile in response to electrical field stimulation and chemical stimulation (i.e. carbachol and KCL) in KIC bladder strips 25 …”

Section: Treatment Of Ketamine Induced Cystitis In Animal Modelsmentioning

confidence: 92%

Current approaches for the treatment of ketamine‐induced cystitis

Zhou

Scott

Miab

et al. 2023

Neurourology and Urodynamics

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Aims Ketamine is a dissociative anesthetic, historically used in a clinical setting for the induction and maintenance of anesthesia. Ketamine usage can produce undesirable psychological manifestations including hallucinations and long‐term psychotomimetic effects. As a results of its fast onset and short period of action, ketamine is widely used as a recreational drug. Chronic abuse of ketamine can lead to significant urinary system complications including ketamine‐induced cystitis (KIC). Common side effects of chronic ketamine abuse are urinary pain and discomfort and decreased bladder compliance and voiding pressure. Cessation of ketamine use is associated with improvement of symptoms however the exact pathophysiology of KIC remains unknown, complicating the ability of clinicians to treat this condition. Method A literature search was performed using the National Center for Biotechnology Information (NCBI) Pubmed database up to May 2021. Results Animal models of KIC are necessary to further our understanding of KIC pathophysiology and explore potential treatment options. In all cases, cessation of ketamine use is the first line of treatment and is most effective in managing KIC. In addition to cessation, treatment plans must be tailored to the individual, based on the severity of symptoms and disease progression, and include options such as: oral anti‐inflammatories, intravesical treatment and in the most severe cases, surgical intervention. Conclusion KIC is a painful condition that currently lacks standardized treatment methods. Both animal models of KIC and clinical trials to further elucidate the mechanism of KIC pathophysiology must be explored to create targeted treatment plans.

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Therapeutic Effect of Platelet-Rich Plasma Improves Bladder Overactivity in the Pathogenesis of Ketamine-Induced Ulcerative Cystitis in a Rat Model

Cited by 9 publications

References 92 publications

Effects of Therapeutic Platelet-Rich Plasma on Overactive Bladder via Modulating Hyaluronan Synthesis in Ovariectomized Rat

Effects of Therapeutic Platelet-Rich Plasma on Overactive Bladder via Modulating Hyaluronan Synthesis in Ovariectomized Rat

Intravesical injections of autologousplatelet‐richplasma for the treatment of refractory interstitial cystitis

Current approaches for the treatment of ketamine‐induced cystitis

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