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Departments of 1 Surgery and 3 Medicine and Therapeutics, Mater Misericordiea Hospital, Conway Institute of Biomolecular and Biomedical Research, University College, Dublin 7, Ireland; and 2 Department of Reproductive and Surgical Sciences, Royal Victoria Infirmary, University of Newcastle, Newcastle-upon-Tyne NE2 4HH, United Kingdom
Our understanding of the pathophysiology
of the overactive bladder is poor. It has been proposed that localized
contractions result in the abnormal stretching of bladder smooth
muscle. We hypothesize that stretch regulates the cellular processes
that determine tissue size. The purpose of this study was to
investigate the effect of stretch on apoptosis, proliferation,
cell hypertrophy, and growth factor production in human bladder smooth
muscle cells in vitro. Normal human detrusor muscle was obtained from
patients undergoing radical cystectomy for invasive bladder cancer, and primary cultures were established. Cells were mechanically stretched on
flexible plates at a range of pressures and times. Apoptosis was assessed by propidium iodide incorporation and flow cytometry. Radiolabeled thymidine and amino acid incorporation were used to assess
proliferation and cell hypertrophy. ELISA and RT-PCR were used to
assess growth factor production. Mechanical stretch inhibits
apoptosis in a time- and dose-dependent manner and was associated with increases in the antiapoptotic proteins heat shock protein-70 and cIAP-1. Stretch also increases smooth muscle cell proliferation and hypertrophy, but hypertrophy is the more dominant response. These changes were associated with increases in IGF-1 and
basic FGF and a decrease in transforming growth factor-
1. Mechanical
stretch regulates apoptosis, proliferation, and cell hypertrophy in human bladder smooth muscle cells.
overactive bladder; apoptosis; heat shock proteins; hypertrophy
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