Is lamina propria matrix responsible for normal bladder compliance?
Immunohistochemistry using monoclonal and polyclonal antibodies to extracellular matrix proteins is a highly sensitive tool for the characterization of matrix components. For the first time in the normal and noncompliant human bladder we have used antibodies to collagen types I, III and IV, and elastin to provide morphological correlation with mechanical properties noted clinically. In the normal bladder elastin and collagen types I and III showed intense localization in the lamina propria with modest localization in the detrusor layer. In contrast, lamina propria staining in the noncompliant bladder was essentially unchanged, while there was intense localization within the detrusor layer. Significantly, this intense localization consisted of collagen type III and elastin with little increase in type I. Type IV collagen is associated with basement membranes and individual smooth muscle cells, and shows commensurate increase in specimens with muscle hypertrophy and/or hyperplasia. These observations suggest that in the normal bladder the lamina propria may be a major structural capacitance layer with the smooth muscle covering it. The collagen fibers of the lamina propria may gradually unfold during filling, thus, accounting for normal compliance while in the noncompliant bladder the capacitance layer shifts outward to the infiltrated smooth muscle, thus, preventing the normal expansion of the lamina propria. The smooth muscle infiltration consists of a deposition of collagen type III and elastin with little increase of collagen type I, and it results in a loss of compliance. The pattern of localization would suggest that the smooth muscle is responsible for this accumulation.
Ewalt
D H
DH
Division of Urology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia.
Howard
P S
PS
Blyth
B
B
Snyder
H M
HM
Duckett
J W
JW
Levin
R M
RM
Macarak
E J
EJ
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003094:Collagen / Q000032:analysis; D003187:Compliance; D003238:Connective Tissue / Q000737:chemistry / Q000473:pathology; D004549:Elastin / Q000032:analysis; D004848:Epithelium / Q000737:chemistry; D005109:Extracellular Matrix / Q000737:chemistry; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D009130:Muscle, Smooth / Q000737:chemistry / Q000473:pathology; D001743:Urinary Bladder / Q000737:chemistry / Q000473:pathology / Q000503:physiopathology*; D014570:Urologic Diseases / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology
D003094:Collagen; D004549:Elastin