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Wertigkeit des „nerve growth factor“ beim Syndrom der überaktiven Blase

Veränderungen nach Botulinumtoxin-Therapie

Value of nerve growth factor levels in overactive bladder syndrome

Alterations after botulinum toxin therapy

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Zusammenfassung

Hintergrund

Das Neutrophin „nerve growth factor“ (NGF) scheint eine relevante, wenn auch noch unklare Rolle bei der überaktiven Blase (OAB) zu spielen. Ziel dieser prospektiven Studie war es, die Wertigkeit von NGF im Serum (sNGF) vor und nach Botulinumtoxin-A- (BTX-A-)Therapie bei dem Krankheitsbild der idiopathischen OAB zu evaluieren.

Methodik

Der sNGF wurde bei 26 Patienten (66,5; 28–83 Jahre) mit idiopathischer OAB vor und 4 Wochen nach BTX-A-Injektion in den M. detrusor vesicae bestimmt; 32 gesunde Personen fungierten als Kontrollgruppe (41; 19–60 Jahre). sNGF wurde in Bezug auf die klinischen Daten und die Ausprägung der OAB (wet/dry) ausgewertet.

Ergebnisse

Patienten mit idiopathischer OAB zeigten im Vergleich zur Kontrollgruppe signifikant höhere sNGF-Spiegel (58,8 vs. 2,0 pg/ml; p<0,005). Patienten mit „wet OAB“ hatten signifikant höhere sNGF-Spiegel als Patienten mit „dry OAB“ (85,0 vs. 0,73 pg/ml; p<0,005). Bezogen auf das Lebensalter zeigten Patienten  >60 Jahre signifikant höhere sNGF-Spiegel als Patienten < 60 Jahre (77,2 vs. 8,9 pg/ml; p< 0,05). Vier Wochen nach BTX-A-Injektion sanken die sNGF-Spiegel signifikant ab (2,4 pg/ml; p<0,005).

Schlussfolgerung

Der NGF scheint in der Pathologie der OAB eine wichtige Rolle zu spielen. Der Einsatz als Biomarker sowohl im Rahmen der Diagnostik als auch zur Therapieerfolgskontrolle scheint vielversprechend. Inwieweit sNGF als Biomarker auch zum Therapiemonitoring sinnvoll sein kann, muss zukünftig an einem größeren Patientenkollektiv untersucht werden.

Abstract

Objectives

Several studies discussing the pathology of overactive bladder suggested changes in urinary proteins. The neurotrophin “nerve growth factor” (NGF) seems to be an important marker in overactive bladder syndrome (OAB). In this prospectively designed study we evaluated NGF blood levels (sNGF) initially and after injection of botulinum toxin type A (BTX-A) in the detrusor muscle in patients suffering from idiopathic OAB.

Materials and methods

Blood samples were obtained from 26 patients (66.5 years, 28–83) with idiopathic OAB. sNGF levels were measured before and 4 weeks after BTX-A treatment by enzyme-linked immunosorbent assay (ELISA). A group of 32 healthy persons with normal bladder function served as controls (41 years, 19–60). sNGF was evaluated in relation to clinical data and the severity of OAB (wet/dry).

Results

Significantly higher sNGF levels were detected in patients with OAB compared to the control group (58.8 vs 2.0 pg/ml, p<0.005). Further, sNGF levels were elevated in patients with wet OAB compared to patients with dry OAB (85.0 vs 0.73 pg/ml, p<0.005). Patients > 60 years showed significantly higher sNGF levels (77.2 vs 8.9 pg/ml, p<0.05) compared to younger OAB patients. After BTX-A therapy sNGF levels decreased significantly compared to baseline (p<0.005).

Conclusion

NGF appears to play a decisive role in OAB. Its use as a biomarker in both the diagnostics and follow-up after therapy seems promising. To what extent sNGF can be useful as a biomarker or in therapy monitoring needs to be examined prospectively in a larger population.

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Danksagung

Ein besonderer Dank gilt Frau E. Oplesch für Ihre Unterstützung.

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Der korrespondierende Autor erhält Unterstützungen für Forschungsprojekte von der Firma Ipsen Pharma GmbH.

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Authors and Affiliations

  1. Klinik für Urologie und Kinderurologie, Universitätsklinikum Gießen und Marburg GmbH – Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland

    S. Knippschild, C. Frohme, P. Olbert, R. Hofmann &  A. Hegele

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  1. S. Knippschild
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  2. C. Frohme
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  3. P. Olbert
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  4. R. Hofmann
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  5. A. Hegele
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Correspondence to A. Hegele.

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Knippschild, S., Frohme, C., Olbert, P. et al. Wertigkeit des „nerve growth factor“ beim Syndrom der überaktiven Blase. Urologe 51, 379–383 (2012). https://doi.org/10.1007/s00120-011-2726-0

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  • DOI: https://doi.org/10.1007/s00120-011-2726-0

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