title: Brain-derived neurotrophic factor in urinary continence and incontinence.
abstract: Urinary incontinence adversely affects quality of life and results in an increased financial burden for the elderly. Accumulating evidence suggests a connection between neurotrophins, such as brain-derived neurotrophic factor (BDNF), and lower urinary tract function, particularly with regard to normal physiological function and the pathophysiological mechanisms of stress urinary incontinence (SUI) and bladder pain syndrome/interstitial cystitis (BPS/IC). The interaction between BDNF and glutamate receptors affects both bladder and external urethral sphincter function during micturition. Clinical findings indicate reduced BDNF levels in antepartum and postpartum women, potentially correlating with postpartum SUI. Experiments with animal models demonstrate that BDNF is decreased after simulated childbirth injury, thereby impeding the recovery of injured nerves and the restoration of continence. Treatment with exogenous BDNF facilitates neural recovery and the restoration of continence. Serotonin and noradrenaline reuptake inhibitors, used to treat both depression and SUI, result in enhanced BDNF levels. Understanding the neurophysiological roles of BDNF in maintaining normal urinary function and in the pathogenesis of SUI and BPS/IC could lead to future therapies based on these mechanisms.
authors.affiliation: Department of Urology, Changhai Hospital, Shanghai, PR China.
authors.forename: Qi-Xiang
authors.initials: QX
authors.lastname: Song
authors.affiliation: Department of Urology, University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA 15261, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Chermansky
authors.affiliation: Department of Medicine, University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA 15261, USA.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Birder
authors.affiliation: Department of Urology, Second Affiliated Hospital of TMMU, Chongqing, PR China.
authors.forename: Longkun
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Biomedical Engineering, The Cleveland Clinic, 9500 Euclid Avenue ND20, Cleveland, OH 44195, USA.
authors.forename: Margot S
authors.initials: MS
authors.lastname: Damaser
mesh_terms: D000818:Animals; D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use; D019208:Brain-Derived Neurotrophic Factor / Q000187:drug effects / Q000378:metabolism* / Q000502:physiology; D018856:Cystitis, Interstitial / Q000378:metabolism; D005260:Female; D006801:Humans; D011788:Quality of Life; D017470:Receptors, Glutamate / Q000378:metabolism; D014521:Urethra / Q000378:metabolism* / Q000502:physiology / Q000503:physiopathology; D001743:Urinary Bladder / Q000378:metabolism* / Q000502:physiology / Q000503:physiopathology; D014549:Urinary Incontinence / Q000378:metabolism / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology; D014551:Urinary Tract / Q000378:metabolism / Q000503:physiopathology; D014554:Urination / Q000502:physiology
chemical_list: D000928:Antidepressive Agents; D019208:Brain-Derived Neurotrophic Factor; D017470:Receptors, Glutamate