title: Microarray analysis of exstrophic human bladder smooth muscle.
abstract: OBJECTIVE
  To compare the genetic profiles of 'healthy' bladder smooth muscle cells (SMCs) and exstrophic SMCs (ESMCs) to identify genes that are over- and under-expressed in ESMCs, thus providing a molecular evaluation of the quality and therapeutic potential of ESMC tissue.
  
  
  METHODS
  Classical bladder exstrophy is a rare disorder, occurring in 1 in 30,000 live births. Studies have shown that exstrophic bladders are developmentally immature at birth. After surgical closure, the bladder typically undergoes abnormal remodelling (such as over-expression of collagen III) throughout early development. We hypothesized that the predominant genetic differences between normal SMCs and ESMCs are in the developmental genes. This hypothesis was tested by the use of microarray analysis. Bladder SM biopsies were taken from 'healthy' subjects undergoing bladder surgeries for other conditions (for example, urinary reflux) and patients with bladder exstrophy. Cells were expanded in vitro, and total RNA was isolated and hybridized to the Affymetrix U133A GeneChip (Affymetrix Inc., Santa Clara, CA, USA) by the Wake Forest University School of Medicine Affymetrix core facility, using standard protocols.
  
  
  RESULTS
  We created a genetic signature consisting of 961 genes that are over-expressed and 432 genes that are under-expressed in ESMCs. Analysis of these signatures identified an over-expression of inflammatory genes and an under-expression of developmental genes.
  
  
  CONCLUSIONS
  Our data is in concordance with previous studies and histological data showing that ESMCs are developmentally immature relative to healthy bladder SM. The clinical implication of the ESMC genetic signature is that it provides a list of targets that can be (i) manipulated ex vivo and/or in vivo to induce differentiation (the completion of development) and (ii) used as biomarkers to explain the variability of the clinical symptoms after surgical closure.
authors.affiliation: Department of Urology, Wake Forest Institute for Regenerative Medicine, Wake Forest University, Winston-Salem, NC 27157, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Hipp
authors.forename: Karl-Erik
authors.initials: KE
authors.lastname: Andersson
authors.forename: Tae Gyun
authors.initials: TG
authors.lastname: Kwon
authors.forename: Eun Kyoung
authors.initials: EK
authors.lastname: Kwak
authors.forename: James
authors.initials: J
authors.lastname: Yoo
authors.forename: Anthony
authors.initials: A
authors.lastname: Atala
mesh_terms: D001746:Bladder Exstrophy / Q000235:genetics* / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D015870:Gene Expression / Q000235:genetics; D020869:Gene Expression Profiling; D006801:Humans; D007150:Immunohistochemistry; D007231:Infant, Newborn; D008297:Male; D032389:Myocytes, Smooth Muscle / Q000473:pathology*; D020411:Oligonucleotide Array Sequence Analysis