von Brunn's Nests and Follicular Cystitis Following Intradetrusor OnabotulinumtoxinA Injections for Overactive Bladder

Nekkanti, Silpa; Doering, Andrew; Zynger, Debra L.; Hundley, Andrew F.

doi:10.1016/j.eucr.2017.06.008

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…The condition is well‐recognized but incompletely understood in humans and has been sporadically described in dogs, cattle, and buffaloes 1,4,5 . Current evidence suggests that formation of TLSs in the urinary bladder occurs secondary to chronic inflammation in response to infection, bladder neoplasia, or chemical irritants allowing a highly localized immune response 6‐9 . TLSs are transient and can disappear after elimination of the antigenic stimulation 3,6 …”

Section: Introductionmentioning

confidence: 99%

“…1,4,5 Current evidence suggests that formation of TLSs in the urinary bladder occurs secondary to chronic inflammation in response to infection, bladder neoplasia, or chemical irritants allowing a highly localized immune response. [6][7][8][9] TLSs are transient and can disappear after elimination of the antigenic stimulation. 3,6 Dogs and humans share the commonality of high incidence of UTIs often resulting in recurrent or chronic cystitis.…”

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confidence: 99%

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Escherichia coli‐associated follicular cystitis in dogs: Clinical and pathologic characterization

Viitanen,

Tuomisto,

Salonen

et al. 2023

Veterinary Internal Medicne

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Background Follicular cystitis is an uncommon inflammatory change in the urinary bladder wall characterized by the formation of tertiary lymphoid structures (TLSs) in the submucosa. Objectives To characterize clinical and pathologic features of follicular cystitis in dogs and to explore in situ distribution and possible role of Escherichia coli as an associated cause. Animals Eight dogs diagnosed with follicular cystitis and 2 control dogs. Methods Retrospective descriptive study. Dogs diagnosed with follicular cystitis (macroscopic follicular lesions in the urinary bladder mucosa and histopathologic detection of TLSs in bladder wall biopsies) were identified from medical records. Paraffin embedded bladder wall biopsies were subject to in situ hybridization for E. coli 16SrRNA identification. Results Follicular cystitis was diagnosed in large breed (median weight 24.9 kg, interquartile range [IQR] 18.8‐35.4 kg) female dogs with a history of chronic recurrent urinary tract infections (UTIs; median duration of clinical signs 7 months, IQR 3‐17 months; median number of previous UTIs 5, IQR 4‐6). Positive E. coli 16SrRNA signal was detected within developing, immature and mature TLSs in 7/8 dogs, through submucosal stroma in 8/8 dogs and within the urothelium in 3/8 dogs. Conclusions and Clinical Importance Chronic inflammation associated with an intramural E. coli infection in the urinary bladder wall represents a possible triggering factor for the development of follicular cystitis.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Escherichia coli‐associated follicular cystitis in dogs: Clinical and pathologic characterization

Viitanen,

Tuomisto,

Salonen

et al. 2023

Veterinary Internal Medicne

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“…The presence of a muscularis propria invasion is a key distinguishing feature. This may not be present in early lesions, and the bland cytology of this tumor can prove challenging when only lamina propria invasion is present [1,8].…”

Section: Discussionmentioning

confidence: 99%

Von Brunn’s Nest in an Incidental Bladder Mass Found during Holmium Laser Enucleation of the Prostate

Lee

2020

Urogenit Tract Infect

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“…Small clinical case series occasionally report lymphoid aggregates or follicles in the 147 bladder (35)(36)(37), but their relation to aging and outcome of chronic bladder inflammation remains 148 unknown. Small, raised, reddish-yellow nodules can be grossly visualized by bladder endoscopy 149 (cystoscopy) in some women with chronic bladder inflammation ( Fig.…”

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Tertiary lymphoid tissue develops during normal aging in mice and humans

Ligon

Wang

Jennings

et al. 2019

Preprint

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One Sentence Summary: Mice develop bladder tertiary lymphoid tissue (bTLT) during aging that is dependent on TNF and independent of urinary tract infection.ABSTRACT 1 Aging has multifaceted effects on the immune system in the context of systemic responses 2 to specific vaccines and pathogens, but how aging affects tissue-specific immunity is not well-3 defined. Chronic bladder inflammation is highly prevalent in older women, but mechanisms by 4 which aging promotes these pathologies remain unknown. Here we report distinct, age-5 associated changes to the immune compartment in the otherwise normal female (but not in male) 6 mouse urinary bladder and parallel changes in older women with chronic bladder inflammation. 7 In aged mice, the bladder epithelium became more permeable, and the homeostatic immune 8 landscape shifted from a limited, innate immune-predominant surveillance to an inflammatory, 9 adaptive immune-predominant environment. Strikingly, lymphoid cells were organized into tertiary 10 lymphoid tissues, hereafter named bladder tertiary lymphoid tissue (bTLT). Analogous bTLTs 11 were found in older women, many of whom had a history of recurrent urinary tract infection (UTI). 12Aged mice responded poorly to experimental UTI, experiencing spontaneous recurrences at 13 higher rates than young mice. However, bTLT formation was dependent on aging and 14 independent of infection. Furthermore, bTLTs in aged mice played a role in de novo antibody 15 responses and urinary IgA production by recruitment of naive B cells that form germinal centers 16 and mature into IgA-secreting plasma cells. Finally, TNF was a key driver of bTLT formation, as 17 aged TNF -/mice lacked bTLTs. Both aged TNF -/and wild type mice exhibited increased 18 bladder permeability, suggesting that epithelial dysfunction may be an upstream mediator of 19 chronic, age-associated bladder inflammation. Thus, bTLTs arise as a function of age and may 20 underlie chronic, age-associated bladder inflammation. Our model establishes a platform for 21 further investigation of age-association tissue inflammation and translation to new treatment 22 strategies. 24Immune dysfunction during aging is characterized by chronic, low-grade inflammation 25 coupled with ineffective responses to pathogens. Aging is also the strongest risk-factor for 26 numerous chronic diseases, including cardiovascular disease, neurodegeneration, osteoarthritis, 27 and cancers. While these diseases are all linked by chronic inflammation, immune responses vary 28 by tissue, resulting in tissue-specific inflammation and dysfunction. Older women (50+) are highly 29 susceptible to bladder disorders including overactive bladder/urge incontinence (OAB), interstitial 30 cystitis/bladder pain syndrome (IC/BPS), and recurrent urinary tract infections (rUTIs) (1-5). 31These disorders all have a chronic inflammatory component as well as overlapping symptoms, 32 known as lower urinary tract symptoms (6, 7). How and why bladder disorders and bladder 33 inflammation become more prevalent with ...

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von Brunn's Nests and Follicular Cystitis Following Intradetrusor OnabotulinumtoxinA Injections for Overactive Bladder

Cited by 6 publications

References 5 publications

Escherichia coli‐associated follicular cystitis in dogs: Clinical and pathologic characterization

Escherichia coli‐associated follicular cystitis in dogs: Clinical and pathologic characterization

Von Brunn’s Nest in an Incidental Bladder Mass Found during Holmium Laser Enucleation of the Prostate

Tertiary lymphoid tissue develops during normal aging in mice and humans

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