You are here

Home » Content

Mesane İçi Kemoterapötik İlaçların Mesane Fonksiyonu Üzerine Olan Etkileri

Investigation of Effects of Intravesical Chemotherapeutics on Bladder Functions

Journal Name:

  • Abant Tıp Dergisi

Publication Year:

  • 2012
DOI: 
http://dx.doi.org/10.5505/abantmedj.2012.85570

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Background: Transuretral resection is the gold standard method in superficial bladder uroepithelial tumor treatment. Intravesical chemo/immunotherapy is performed in order to prevent recurrence after transurethral resection regarding tumor level and grade, multiplicity, size and first or second time treatment. Lower urinary tract symptoms are seen in patients received intravesical chemo/immunotherapy. Mechanism and causes of these symptoms are unknown. The aim of this study is to investigate if Mitomycin C and Epirubicin, two intravesical chemotherapeutic agents, change in vitro cholinergic and purinergic responses of rat bladder smooth muscle. Method: : In this study 30 wistar albino rats were separated in three groups each consisting of Mitomycin C group, Epirubicin group and control group. Mitomycin C group received 1 mg/ml (0.1ml) intravesical Mitomycin C once a week for 8 weeks, Epirubicin group received 1 mg/ml (0.1ml) intravesical Epirubicin once a week for 8 weeks, control group received 0.1 cc % 0.9 NaCl intravesical once a week for 8 weeks. One week after therapy bladder shreds was examined in vitro. Carbachole, KCL, ATP, ADP and electrical field stimulation responses were evaluated. Results: There was no significant difference between Mitomycin C and Epirubicin groups with KCL, whereas Carbachole, ATP and ADP contraction responses were significantly decreased in Mitomycin C and Epirubicin groups as compred to control group. Electrical field stimulation contraction responses were not significantly different between Epirubicin and control groups. Contraction responses showed significant increase in Mitomycin C group with respect to control groups. Conclusion: While the decreased response to cholinergic agent and purinnergic, expected from the lack of decrease to response at contractıon alert that is obtained by the electric field warning.Increase the Mitomycin C group and the lack of change in the epirubicin group suggests that different mechanisms may play a role in this case. Further research is required on this object.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Yüzeyel mesane üroepitelyal tümörleri tedavisinde transüretral rezeksiyon altın standarttır. Transüretral rezeksiyon sonrası gelişebilecek nüks ve ilerlemenin önlenmesi amacıyla yüzeyel mesane tümörlerinin evresine, derecesine, tek veya çok odaklı olmasına, boyutuna ve ilk ya da ikincil tedavi edilmesi gibi ölçütlere bağlı olarak intravezikal kemo/ immunoterapi uygulanmaktadır. İntravezikal kemo/ immunoterapi alan hastalarda alt üriner sistem semptomları sık olarak görülmektedir. Bu semptomların ortaya çıkmasının sebebi ve mekanizması bilinmemektedir. Bu çalışmadaki amacımız Mitomycin C ve Epirubicin gibi intravezikal kemoterapötik ilaçların sıçan mesane kası şeritlerinin kolinerjik ve pürinerjik ajanlara verdiği in vitro yanıtları nasıl etkilediğini araştırmaktır. Yöntem: Bu çalışmada 30 adet Wistar Albino dişi sıçan; Mitomycin C grubu, Epirubicin ve kontrol grubu olmak üzere üçe ayrıldı. Mitomycin C grubuna 8 hafta 1 mg/mL (0.1 mL) intravezikal haftada 1 kez, Epirubicin grubuna 8 hafta 1 mg/mL (0.1 mL) intravezikal haftada 1 kez, kontrol grubuna 8 hafta 0.1 cc % 0.9 NaCl intravezikal haftada 1 kez uygulandı. Tedavinin bitiminden 1 hafta sonra tüm gruplardan alınan mesane şeritleri in vitro olarak değerlendirildi. Karbakol, KCL, ATP, ADP ve elektriksel alan uyarısı ile oluşan kasılma yanıtlarına bakıldı. Bulgular: Çalışma sonucunda mesane şeritlerinde in vitro olarak yapılan değerlendirmelerde kontrol grubu ile Mitomycin C ve Epirubicin grubunda KCL kasılma yanıtlarında anlamlı fark bulunmazken; Karbakol, ATP ve ADP kasılma yanıtlarında kontrole göre Mitomycin C ve Epirubicin grubunda anlamlı olarak azalmış bulundu. Elektriksel alan uyarısı ile elde edilen kasılma yanıtlarında kontrol ve Epirubicin grupları arasında anlamlı fark saptanmadı. Mitomycin C grubunda ise kontrole göre elektriksel alan uyarısı ile elde edilen kasılma yanıtlarında anlamlı artış saptandı. Sonuç: Kolinerjik ve pürinerjik ajanlara yanıt azalmış iken elektriksel alan uyarısı ile elde edilen kasılma yanıtlarında beklenebilecek azalmanın olmaması, Mitomycin C grubunda artış olması ve Epirubicin grubunda ise değişiklik olmaması, farklı mekanizmaların bu olayda rol oynayabileceğini düşündürmektedir. Bu konu ile ilgili ileri araştırmalara gerek vardır.
FULL TEXT (PDF): 
PDF icon arastirmax-mesane-ici-kemoterapotik-ilaclarin-mesane-fonksiyonu-uzerine-olan-etkileri.pdf
  • 3
115-119
  • Turkish

REFERENCES

References: 

1. Fleshner NE, Herr HW, Stewart AK, Murphy GP,
Mettlin C,Menck HR. The National Cancer Data Base
report on bladder carcinoma. The American College
of Surgeons Commission on Cancer and the American
Cancer Society. Cancer 1996;78: 1505–13.
2. Kılavuz ES, Tosun M, Uras AR. Adequacy of nucleer
matrix protein 22 to determine recurrences in patients
with bladder cancer. Abant Med J. 2012; 1: 18-
22.
3. Kirkali Z, Chan T, Manoharan M, et al. Bladder cancer:
epidemiology, staging and grading, and diagnosis.
Urology 2005;66: 4–34.
4. Babjuk M, Oosterlinck W, Sylvester R, Kaasinen E,
Böhle A, Palou J. European Association of Urology
guidelines on TaT1 (non-muscle invasive) bladder
cancer. Update 210. Arnhem, the Netherlands: European
Association of Urology; 2010.
5. National Comprehensive Cancer Network. Clinical
practice guidelines in oncology: bladder cancer including
upper tract tumours and urothelial carcinoma
of the prostate. Version 1. Jenkintown, PA: NCCN;
2007.
6. Sylvester RJ, van der Meijden AP, Witjes JA, et al. High
grade Ta urothelial carcinoma and carcinoma in situ
of the bladder. Urology 2005;66:90–107.
7. Heney NM, Koontz WW, Barton B, et al. Intravesical
thiotepa versus mitomycin C in patients with Ta, T1
and TIS transitional cell carcinoma of the bladder: a
phase III prospective randomized study. J Urol
1988;140:1390–3.
8. Christoper Fry, The physiology of micturition; Women’s
Health Medicine, 2005 (volume2) issue 6: 53-55.
9. Harriss DR, Marsh KA, Birrningham AT, et al: Expression
of muscarinic Mr receptors coupled to inositol
phospholipid hydrolysis in human detrusor smooth
muscle cells. J UroI1995;154:1241-8.
10. Burnstock G, Dumsday B, SymtheA: Atropine resistant
excitation of the urinary bladder: the possibility of
transmission via nerves releasing a pürine nucleotide.
Br J Pharmacol. 1972 Mar ;44(3):451-61.
11. Palea S, Artibani W, Ostardo E et al: Evidence for
purinergic neurotransmission in human urinary bladder
affected by interstitial cystitis. J Urol. 1993;
150:2007-12.
12. Michielsen D, Amy JJ, Coomans D, Storme
G,Wyndaele JJ, Mitomycin C and epirubicin: functional
bladder damage in rats after repeat intravesical instillations.
J.Urol.2005; 173:2166–70.
13. Post JG, te Poele JA, Oussoren Y,Stewart FA, Bladder
damage in mice after single and repeated intravesical
instillations of mitomycin C or doxorubicin. J Urol.
1993;150:1965-9.
14. Theobald, R. J., Jr. The effect of NG-monomethyl-Larginine
on bladder function. Eur. J. Pharmacol,
1996;311:73–78.
15. Yu Y and De Groat WC. Sensitization of pelvic afferent
nerves in the in vitro urinary bladder pelvic nerve
preparation of the rat by purinergic agonists or by
cyclophosphamide (CYP) pretreatment. Am J Physiol
Renal Physiol 2008{294}: 1146–56.
16. Patrik Aronsson, Michael Andersson, Therese Ericsson
and Daniel Giglio, Assessment and Characterization of
Purinergic Contractions and Relaxations in the Rat
Urinary Bladder. 2010 The Authors Journal compilation
2010 Nordic Pharmacological Society. Basic &
Clinical Pharmacology & Toxicology, 107, 603–13.
17. Ambache N, Zar MA. Non-cholinergic transmission by
post-ganglionic motor neurones in the mammalian
bladder. J Physiol 1970;210:761–83.
18. Somogyi GT, Zernova GV, Yoshiyama M, Yamamoto T,
de Groat WC. Frequency dependence of muscarinic
facilitation of transmitter release in urinary bladder
strips from neurally intact or chronic spinal cord transected
rats. Br J Pharmacol 1998;125:241–246.
19. Wibberley A, Chen Z, Hu E, Hieble PJ, Westfal TD.
Expression and functional role of ho-kinase in rat urinary
bladder smooth muscle. Br J Pharmacol
2003;138:757–66.
20. Darblade B, Behr-Rousel D, Oger S, Effects of potassium
channel modulators on human detrusor smooth
muscle myogenic phasic contractile activity: potential
therapeutic targets for overactive bladder. Urology,
2006;68: 442-8.

Thank you for copying data from http://www.arastirmax.com