title: Increased serum nerve growth factor levels in patients with overactive bladder syndrome refractory to antimuscarinic therapy.
abstract: OBJECTIVE
  To investigate the serum nerve growth factor (NGF) and urinary NGF levels in patients with overactive bladder syndrome (OAB) refractory to antimuscarinic therapy.
  
  
  METHODS
  Thirty-four patients with OAB (17 OAB-dry and 17 OAB-wet) and 31 normal subjects were enrolled. The patients were diagnosed to have OAB based on symptoms of urgency with/without urgency incontinence and 3-day voiding diary. All OAB patients had been treated with previous antimuscarinic therapy for at least 3 months but had failed. Serum and urine were collected at baseline and after solifenacin treatment for 3 months. The serum NGF and urinary NGF levels were compared between OAB-dry and OAB-wet and between baseline and after solifenacin treatment.
  
  
  RESULTS
  Serum NGF levels were significantly elevated in OAB (median and interquartile range, 7.367  pg/ml, 0-57.66) compared to the controls (0.0728  pg/ml, 0-0.234, P < 0.001). Urinary NGF/Cr levels were significantly elevated in patients with OAB (0.685 pg/mg, 0.08-1.94) compared to the controls (0.005  pg/mg, 0-0.0275, P < 0.001). Serum NGF levels were significantly correlated with urinary NGF (P = 0.002) and NGF/Cr levels (P < 0.001) in OAB patients. There was no significant difference of serum NGF levels between OAB-dry and OAB-wet. The serum and urinary NGF levels remained unchanged (P = 0.504 and 0.414, respectively) in OAB patients after solifenacin therapy. The serum NGF levels were highly correlated between baseline and after solifenacin treatment (R(2)  = 0.83, P < 0.001).
  
  
  CONCLUSIONS
  Increased serum and urinary NGF levels in patients with OAB refractory to antimuscarinic treatment suggest these bladder disorders might be caused by chronic inflammation.
authors.affiliation: Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
authors.forename: Hsin-Tzu
authors.initials: HT
authors.lastname: Liu
authors.forename: Heng
authors.initials: H
authors.lastname: Lin
authors.forename: Hann-Chorng
authors.initials: HC
authors.lastname: Kuo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016022:Case-Control Studies; D003404:Creatinine / Q000652:urine; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D020932:Nerve Growth Factor / Q000097:blood* / Q000652:urine; D011812:Quinuclidines / Q000627:therapeutic use*; D000069464:Solifenacin Succinate; D013577:Syndrome; D013624:Taiwan; D044005:Tetrahydroisoquinolines / Q000627:therapeutic use*; D013997:Time Factors; D017211:Treatment Failure; D015854:Up-Regulation; D001743:Urinary Bladder / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018727:Muscarinic Antagonists; C502240:NGF protein, human; D011812:Quinuclidines; D044005:Tetrahydroisoquinolines; D020932:Nerve Growth Factor; D003404:Creatinine; D000069464:Solifenacin Succinate