Vascular Therapy for Radiation Cystitis
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2011-01-01
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Soler, Roberto 
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Purpose: the underlying pathology of radiation cystitis is cellular and vascular damage followed by increased fibrosis and inflammation. This study was to determine if neovascular- promoting therapy could reduce the pathological changes in the bladder wall associated with pelvic irradiation. Methods: Adult female Lewis inbred rats were irradiated with a single dose of 20 Gy directed at their bladder. Four weeks later, 30 rats were divided equally into one of three treatment groups for bladder wall injection of: (1) PBS (Control); (2) PBS containing 50 ng vascular endothelial growth factor (VEGF165); or (3) PBS containing 1 x 10(6) rat endothelial cells (EC). Age- matched non- irradiated rats (n 10) served as untreated controls. At either 1.5 or 3 months following radiation, bladders were analyzed for collagen deposition using Masson's Trichrome staining of collagen and muscle and vascularization using Von Willebrand factor staining of ECs. Quantitative- PCR was used to examine markers of angiogenesis, hypoxia, and fibrosis. Results: the collagen/ muscle ratio was doubled in the control group 3months post- irradiation (P < 0.05 vs. non- irradiated bladders). Both ECs and VEGF inhibited increases in collagen content (P < 0.05 vs. control). Similarly, irradiation reduced bladder wall vessel counts compared to non- irradiated controls (P < 0.05) and both ECs and VEGF maintained vessel counts similar to that of non- irradiated controls (P < 0.05). PCR analysis showed a higher expression of neovascular markers (CD31, KDR) in the EC and VEGF groups compared to non- irradiated controls (P < 0.05). Conclusions: Angiogenesis therapy may be useful in the prevention and/or treatment of the underlying pathology of radiation cystitis. Neurourol. Urodynam. 30: 428- 434, 2011. (C) 2010 Wiley-Liss, Inc.
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Neurourology and Urodynamics. Malden: Wiley-Blackwell, v. 30, n. 3, p. 428-434, 2011.