目的:尽管间质性膀胱炎(IC)和子宫内膜异位症(ENDO)的发生率很高,这种共现的确切病理生理学尚不清楚.从相关结构到相同神经元中心的输入收敛可能表明神经元过度兴奋是这种共存的机制。
方法:本研究旨在调查IC和ENDO之间的关联,通过使用c-fos免疫组织化学研究ENDO和环磷酰胺(CYP)诱导的IC大鼠模型中脑干对膀胱测压反应的变化。
结果:膀胱测压后,仅ENDO中c-fos表达显着增加的脑干区域包括:导水管周围灰色(PAG)核,中缝背侧核,中缝暗暗核,kolliker-保险丝区,和后期地区。然而,在ENDO和CYP治疗的动物中,c-fos表达显着增加的脑干区域包括:大细胞核,侧耳旁细胞核,尾腹外侧核,rostroventrolateral/caudoventrolateralnucleus,外侧网状核,蓝斑,横向PAG,中缝苍白核,中缝马格核,rostroventrateralnucleus,迷走神经背侧运动核,和孤束核。而在单独的CYP处理的动物中,仅外侧臂旁核显示c-fos表达显著增加。
结论:本研究的结果表明,在ENDO和IC条件下,膀胱兴奋的脑干核重叠。脑干核的过度兴奋模式可能有助于低估IC和ENDO病症的病理生理学。
OBJECTIVE: Although the co-occurrence of interstitial cystitis (IC) and endometriosis (ENDO) is remarkably high, the exact pathophysiology for this co-occurrence is unknown. The convergence of the inputs from the involved structures to the same neuronal centers may suggest neuronal hyperexcitability as a mechanism for this co-occurrence.
METHODS: The present
study aimed to investigate the association between IC and ENDO, by studying the changes in brainstem responses to cystometry in a rat model of ENDO and cyclophosphamide (CYP)-induced IC using c-fos immunohistochemistry.
RESULTS: Following cystometry the brainstem areas that had significant increase in c-fos expression in ENDO alone included: periaqueductal gray (PAG) nuclei, dorsal raphe nucleus, raphe obscurus nucleus, kolliker- Fuse areas, and area postrema. However, the brainstem areas that had increased significantly in the c-fos expression in the ENDO and CYP treated animals included: gigantocellular nucleus, lateral paragigantocellular nucleus, caudoventrolateral nucleus, rostroventrolateral/caudoventrolateral nucleus, lateral reticular nucleus, locus coeruleus, lateral PAG, raphe pallidus nucleus, raphe magnus nucleus, rostroventrolateral nucleus, dorsal motor nucleus of vagus, and solitary tract nucleus. Whereas only lateral parabrachial nucleus showed significant increase in c-fos expression in CYP treated animals alone.
CONCLUSIONS: The results of the present
study demonstrate the overlap of brainstem nuclei that are excited by urinary bladder under ENDO and IC conditions. The pattern of hyperexcitability of the brainstem nuclei may help in understating the pathophysiology of IC and ENDO conditions.