title: Intravesical hyaluronic acid treatment improves bacterial cystitis and reduces cystitis-induced hypercontractility in rats.
abstract: OBJECTIVE
  To investigate the effect of intravesical hyaluronic acid on Escherichia coli-induced cystitis and cystitis-induced hypercontractility in rats.
  
  
  METHODS
  Bacterial cystitis was induced in Wistar female rats by intravesical inoculation of E. coli. Isotonic saline was instilled in the control group (n = 6). The rats were either non-treated, treated with gentamycin (4 mg/kg, 5 days) or treated intravesically with hyaluronic acid (0.5 mL, 0.5%). On the eighth day, the bladder tissues were excised for histological examination, and the measurements of myeloperoxidase, superoxide dismutase and catalase activities. Contraction/relaxation responses to carbachol, isoprotrenol and papaverine were studied.
  
  
  RESULTS
  Tissue myeloperoxidase activity was increased, but superoxide dismutase and catalase activities were decreased in bacterial cystitis, while hyaluronic acid treatment reversed these changes. In the hyaluronic acid-treated group, healing of the uroepithelium was observed, while decreased inflammatory cell infiltration was obvious in gentamycin-treated group. E. coli-induced cystitis in all rats resulted in increased contraction responses to carbachol compared with controls (P < 0.01). Treatment with hyaluronic acid, but not gentamycin, significantly (P < 0.05) depressed hypercontractility at maximum carbachol concentrations. In all rats with cystitis, papaverine-induced relaxation was increased, whereas isoproterenol-induced relaxation curves were not different between the studied groups.
  
  
  CONCLUSIONS
  Gentamycin treatment, despite its ameliorative effect on inflammation, had no impact on the contractile dysfunction of the injured bladder. Intravesical hyaluronic acid, in addition to its supportive role in the healing of the epithelium, seems to lower the increased threshold for contraction and to reduce oxidative stress. These findings support a potential role for hyaluronic acid in the treatment of bacterial cystitis.
authors: Department of Pediatric Nephrology, Marmara University School of Medicine, Istanbul, Turkey.
authors: Nurdan
authors: http://orcid.org/0000-0001-6805-5313
authors: N
authors: Yıldız
authors: Department of Pediatric Nephrology, Marmara University School of Medicine, Istanbul, Turkey.
authors: Harika
authors: H
authors: Alpay
authors: Department of Pediatric Surgery, Marmara University School of Medicine, Istanbul, Turkey.
authors: Halil
authors: H
authors: Tuğtepe
authors: Department of Physiology, Marmara University School of Medicine, Istanbul, Turkey.
authors: Zarife Nigar
authors: ZN
authors: Özdemir Kumral
authors: Department of Histology and Embryology, Marmara University School of Medicine, Istanbul, Turkey.
authors: Dilek
authors: D
authors: Akakın
authors: Department of Microbiology, Marmara University School of Medicine, Istanbul, Turkey.
authors: Arzu
authors: A
authors: İlki
authors: Department of Pharmacology, Marmara University School of Pharmacy, Istanbul, Turkey.
authors: Göksel
authors: G
authors: Şener
authors: Department of Physiology, Marmara University School of Medicine, Istanbul, Turkey.
authors: Berrak
authors: B
authors: Ç Yeğen
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000283:Administration, Intravesical; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002374:Catalase / Q000378:metabolism; D003556:Cystitis / Q000188:drug therapy* / Q000201:enzymology / Q000382:microbiology / Q000473:pathology; D004926:Escherichia coli; D004927:Escherichia coli Infections / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D009119:Muscle Contraction / Q000187:drug effects*; D009126:Muscle Relaxation / Q000187:drug effects*; D009195:Peroxidase / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D013482:Superoxide Dismutase / Q000378:metabolism; D001743:Urinary Bladder / Q000187:drug effects* / Q000201:enzymology; D064804:Urological Agents / Q000494:pharmacology
chemical_list: D000276:Adjuvants, Immunologic; D000900:Anti-Bacterial Agents; D064804:Urological Agents; D006820:Hyaluronic Acid; D002374:Catalase; D009195:Peroxidase; D013482:Superoxide Dismutase
keywords: cystitis; detrusor hypercontractility; hyaluronic acid; inflammation; rats