title: Distribution of neuropeptide Y-containing nerves in the neurogenic and non-neurogenic detrusor.
abstract: OBJECTIVE
  To evaluate the role of neuropeptide Y in the detrusor of patients with neurogenic detrusor overactivity (NDO), as it has an important role in the neural regulation of the lower urinary tract by exerting differential effects on the release of cholinergic and adrenergic transmitters via autoinhibition and heterosynaptic interactions.
  
  
  METHODS
  Detrusor biopsies were obtained from 38 patients; 31 had video-urodynamically verified NDO, caused by meningomyelocele in 17 or spinal cord injury in 14. Seven had stress urinary incontinence (SUI) and this group served as a control. All specimens were fixed, paraffin wax-embedded, sectioned and stained with a monoclonal antibody against neuropeptide Y and a general nerve marker protein-gene-product 9.5 (PGP 9.5). The number of PGP 9.5- and neuropeptide Y-containing nerves was quantified by a standardized evaluation using image-analysis software.
  
  
  RESULTS
  The median (range) number of neuropeptide Y-containing nerves in the neurogenic detrusor, at 0.273 (0.126-0.639) per muscle cell nucleus (MCN), was significantly lower (P = 0.014) than that in patients with SUI, at 0.383 (0.267-0.728). In the neurogenic detrusor the number of PGP 9.5-positive nerves, at 0.278 (0.054-0.641)/MCN was also lower (P = 0.111) than in patients with SUI, at 0.368 (0.258-0.497). The ratio of neuropeptide Y to PGP 9.5 counts per biopsy did not differ between the groups (P = 0.628).
  
  
  CONCLUSIONS
  The number of PGP 9.5-positive nerves was not significantly and the number of neuropeptide Y-containing nerves was significantly reduced in patients with NDO. This may have been caused by transynaptic nerve degeneration of the detrusor, as described by in patients with spinal cord injury. As neuropeptide Y inhibits the contractile response of the detrusor the reduction of neuropeptide Y-containing nerves may play a role in the development and persistence of DO.
authors.affiliation: Department of Urology, University of Heidelberg, Heidelberg, Germany. Axel_Haferkamp@med.uni-heidelberg.de
authors.forename: Axel
authors.initials: A
authors.lastname: Haferkamp
authors.forename: Thomas
authors.initials: T
authors.lastname: Freund
authors.forename: Nina
authors.initials: N
authors.lastname: Wagener
authors.forename: Andre
authors.initials: A
authors.lastname: Reitz
authors.forename: Brigitte
authors.initials: B
authors.lastname: Schurch
authors.forename: Joachim
authors.initials: J
authors.lastname: Doersam
authors.forename: Stefan
authors.initials: S
authors.lastname: Schumacher
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Bastian
authors.forename: Reinold J
authors.initials: RJ
authors.lastname: Buettner
authors.forename: Stefan C
authors.initials: SC
authors.lastname: Mueller
authors.forename: Markus
authors.initials: M
authors.lastname: Hohenfellner
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle / Q000379:methods; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008591:Meningomyelocele / Q000150:complications; D009130:Muscle, Smooth / Q000294:innervation* / Q000473:pathology; D009417:Nerve Tissue / Q000473:pathology; D009478:Neuropeptide Y / Q000378:metabolism*; D013119:Spinal Cord Injuries / Q000150:complications; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000473:pathology*
chemical_list: D009478:Neuropeptide Y