Urinary biomarkers of inflammation and tissue remodeling may predict bladder dysfunction in patients with benign prostat
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UROLOGY - ORIGINAL PAPER
Urinary biomarkers of inflammation and tissue remodeling may predict bladder dysfunction in patients with benign prostatic hyperplasia Paulo Sajovic de Conti1 · João Arthur Brunhara Alves Barbosa1 · Sabrina Thalita Reis2 · Nayara I. Viana2 · Cristiano Mendes Gomes1 · Leonardo Borges1 · Marco Nunes2 · William C. Nahas1 · Miguel Srougi1 · Alberto Azoubel Antunes1,2 Received: 21 April 2020 / Accepted: 5 June 2020 © Springer Nature B.V. 2020
Abstract Purpose To evaluate the expression of urinary biomarkers of inflammation and tissue remodeling in patients with BPH undergoing surgery and evaluate the association of biomarkers with postoperative urodynamic outcomes Materials and methods We analyzed urine samples from 71 patients treated with TURP from 2011 to 2017. Urinary levels of epidermal growth factor (EGF), matrix-metalloproteinase-1 (MMP-1), interleukin-6 (IL-6), nerve growth factor (NGF) and monocyte-chemoattractant protein-1 (MCP-1) (by commercial ELISA kit) were measured, adjusted by urinary creatinine (Cr) and analyzed according to patients clinical and urodynamic characteristics (baseline and 12-month postoperative urodynamic) Results MMP-1/Cr levels were significantly higher among subjects with higher detrusor pressure on preoprative urodynamic. MCP-1/Cr levels were significantly higher amongs subjects with preoperative DO. Preoperative levels of NGF/Cr (0.13 vs 0.08, p = 0.005) and MMP-1/Cr (0.11 vs 0.04, p = 0.021) were predictors of persistent DO 12 months after surgery. The following factors were shown to be useful for predicting the persistence of DO in the postoperative period: NGF/Cr, with an AUC of 0.77 (95% CI 0.62–0.92) (p = 0.006), and MMP-1/Cr, with an AUC of 0.72 (95% CI 0.56–0.88) (p = 0.022). Conclusions MMP-1/Cr was associated with higher detrusor pressure and MCP-1/CR with DO. NGF/Cr and MMP-1/Cr were shown to be predictors of persistent postoperative DO. Keywords Urinary biomarkers · Benign prostatic hyperplasia · Bladder outlet obstruction · Overactive bladder
* João Arthur Brunhara Alves Barbosa [email protected]
William C. Nahas [email protected]
Paulo Sajovic de Conti [email protected]
Miguel Srougi [email protected]
Sabrina Thalita Reis [email protected]
Alberto Azoubel Antunes [email protected]
Nayara I. Viana [email protected]
1
Cristiano Mendes Gomes [email protected]
Division of Urology, University of São Paulo Medical School, São Paulo, Brazil
2
LIM 55‑Laboratory of Medical Investigation, Univerisity of São Paulo Medical School, São Paulo, Brazil
Leonardo Borges [email protected] Marco Nunes [email protected]
13
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Introduction Bladder outlet obstruction (BOO) caused by benign prostatic hyperplasia (BPH) may lead to secondary bladder dysfunctions, such as sensitivity changes, decreased compliance, detrusor overactivity (DO), and hypocontractility. DO is present in approximately 45–50% of men with BOO and is a major cause of LUTS in older men [1–3]. Even
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