Splenic B1 B Cells Acquire a Proliferative and Anti-Inflamatory Profile During Pregnancy in Mice

B cells are a heterogeneous cell population with differential ontogeny, anatomical location, and functions. B1 B cells are a distinct subpopulation characterized by their unique capacity of self-renewal, the production of large quantities of IL-10, and the ability to secrete protective, anti-inflammatory natural antibodies (NAbs), presumably upon down-regulation of CD1d expression. Although natural antibodies are thought to be protective, due to their polyreactivity, their participation in certain autoimmune diseases has been suggested. In the context of pregnancy, the role of B1 B cells has been discussed controversially. While in human pregnancies B1 B cells and natural/polyreactive antibodies they produce are involved in the development of preeclampsia, in mice they promote healthy gestation and fetal protection. In this work, we aimed to functionally characterize the splenic B1 B cell population during pregnancy in mice. Functional enrichment analysis using only up-regulated transcripts from a transcriptomic profile performed on total splenic B cells from pregnant compared to non-pregnant mice showed augmented cell cycle and DNA replication pathways. Proliferation studies by flow cytometry showed augmented Ki-67 proliferation marker expression and percentages of B1 B cells. Furthermore, B1 B cells produced higher levels of IL-10 and lower levels of TNF-α leading to an increased IL-10/TNF-α ratio and showing an immunoregulatory phenotype. Finally, we observed lower expression of CD1d on B1 B cells, suggesting a higher capacity to produce NAbs in the context of pregnancy. In summary, our results showed not only an expanded and proliferative splenic B1 B cell population during pregnancy but also the acquisition of immunomodulatory capacities suggesting its critical role in the intricate process of pregnancy tolerance

Triple therapy in refractory detrusor overactivity: a preliminary study

To evaluate in a prospective study the impact of the 'three-drug therapy' (antimuscarinic, alpha-blocker and tricyclic antidepressants) on the treatment of refractory detrusor overactivity (DO). Data from 27 consented patients with refractory DO were available for study. They were asked to complete a daily urinary chart and underwent urodynamic evaluation (UD) before and 60 days after treatment. Response to treatment was considered the presence of one or less involuntary detrusor contractions (IDC) on post-treatment UD. Statistical analysis was performed with Fisher and Mann-Whitney tests, besides Spearman's correlation. P values < 0.05 were considered significant. The mean follow-up was 15 months. The comparison of the daily urinary chart before and after treatment showed significant increase on bladder capacity and decreases on urgency, urge-incontinence and frequency. Objective data from UD showed that the mean maximum bladder capacity (MBC) ranged from 200 to 300 mL (P < 0.001) with treatment. The same trend was observed with the other UD variables. When compared to baseline, the questionnaire OAB-v8 showed significant improvement (P < 0.01). Main side effects comprised dry mouth and constipation (40%), with average scores of 5.16 and 3.08, respectively (visual scale from 0 to 10). Triple therapy may be an effective, easily employed and well-tolerated option to refractory DO treatment. More studies are necessary to achieve more consistent data on the matter.281798

Comparative Study Among Autologous And Synthetic Slings In The Treatment Of Stress Urinary Incontinence [studio Comparativo Tra Sling Autologhe E Sintetiche Nel Trattamento Dell'incontinenza Urinaria Da Sforzo]

Aim. Procedures to correct stress urinary incontinence (SUI) are designed to restore support of the urethrovescical junction and, in cases of intrinsic sphinteric dysfunction, improve the coaptation of the urethra. Voiding dysfunction and urinary retention are frequent complications of both urethropexy and urethral sling. Guatelli et al. reported a 8.5% obstruction rate following autologous sling procedure, while the obstruction rate after polypropylene sling meshes procedures was 3.7%. The aim of this study was to compare the success and bladder outlet obstruction (BOO) rates following sling procedure for SUI with two different mesh materials, synthetic versus autologous. Methods. A prospective study was carried out between July 1995 and December 1995 at the Department of Urology, University of Campinas Medical Center. Results. The median time between the anti-incontinence procedure and the diagnosis of BOO was nine months (3-96 months). All obstructed patients suffered from refractory urgency/frequency syndrome with varying postvoid residual volume. Our experience showed that autologous pubovaginal slings were statistically more obstructive than synthetic ones. Conclusion. Autologous and synthetic slings presented comparable success rates in treating SUI. However, BOO was more frequent among patients who underwent autologous sling procedure.606469473Petros, P., Ulmsten, U., An integral theory and its method for the diagnosis and management of female urinary incontinence (1993) Scand J Urol Nephrol, 153, pp. 1-93Ulmsten, U., Petros, P., Intravaginal slingplasty (IVS): An ambulatory surgical procedure for treatment of female urinary incontinence (1995) Scand J Urol Nephrol, 29, pp. 75-82Ward, K., Hilton, P., United Kingdom and Ireland Tension-free Vaginal Tape Trial Group. Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence (2002) BMJ, 325, p. 67Wadie, B.S., Edwan, A., Nabeeh, A.M., Autologous fascial sling vs polypropylene tape at short term follow-up: A prospective randomized study (2005) J Urol, 174, pp. 990-993Guatelli, S., Dall'Oglio, B., Schiavon, L., Luciano, M., Parma, P., Galletta, V., Pubo-vaginal sling (2004) Arch Ital Urol Androl, 76, pp. 46-48Kuo, H.C., Long-term surgical results of pubovaginal sling procedure using polypropylene mesh in the treatment of stress urinary incontinence (2005) Urol Int, 74, pp. 147-152Ulmsten, U., Henriksson, L., Johnson, P., Varhos, G., An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence (1996) Int Urogynecol J Pelvic Floor Dysfunct, 7, pp. 81-85Boustead, G.B., The tension-free vaginal tape for treating female stress urinary incontinence (2002) BJU Int, 89, pp. 687-693Klutke, C., Siegel, S., Carlin, B., Paszkiewicz, E., Kirkemo, A., Klutke, J., Urinary retention after tension-free vaginal tape procedure: Incidence and treatment (2001) Urology, 58, pp. 697-701Kuo, H.C., The surgical results of the pubovaginal sling procedure using polypropylene mesh for stress urinary incontinence (2001) BJU International, 88, pp. 884-888The Urinary Incontinence Treatment Network. Burch colposuspension versus fascial sling to reduce urinary stress incontinence (2007) N Engl J Med, 356, pp. 21-24Ostergard, D.R., Primary slings for everyone with genuine stress incontinence? The argument against (1997) Int Urogynecol J Pelvic Floor Dysfunct, 8, pp. 321-322Wilson, T.S., Lemack, G.E., Zimmern, P.E., Management of intrinsic sphincteric deficiency in women (2003) J Urol, 169, pp. 1662-1669Clemens, J.Q., DeLancey, J.O., Faerber, G.J., Westney, O.L., Mcguire, E.J., Urinary tract erosions after synthetic pubovaginal slings: Diagnosis and management strategy (2000) Urology, 56, pp. 589-594Nilsson, C.G., Kuuva, N., The tension-free vaginal tape procedure is successful in the majority of women with indications for surgical treatment of urinary stress incontinence (2001) Br J Obstet Gynaecol, 108, pp. 414-419Debodinance, P., Delporte, P., Engrand, J.B., Boulogne, M., Tension-free vaginal tape (TVT) in the treatment of urinary stress incontinence: 3 years experience involving 256 operations (2002) Eur J Obstet Gynecol Reprod Biol, 105, pp. 49-58Abouassaly, R., Steinberg, J.R., Lemieux, M., Marois, C., Gilchrist, L.I., Bourque, J.L., Complications of tension-free vaginal tape surgery: A multi-institutional review (2004) BJU Int, 94, pp. 110-113Deffieux, X., Bonnet, K., Chevalier, N., Gervaise, A., Frydman, R., Fernandez, H., Complications urinaires des soutènements sous-urétraux. (2005) J Gynecol Obstet Biol Reprod, 34, pp. 745-756Palma, P.C.R., Dambros, M., Riccetto, C.L.Z., Thiel, M., Netto Jr., N.R., Uretrolisis transvaginal tras cirugía correctora de la incontinencia urinaria de esfuerzo. (2005) Actas Urol Esp, 29, pp. 207-211Thiel, M., Rodrigues Palma, P.C., Riccetto, C.L., Dambros, M., Netto Jr, N.R., A stereological analysis of fibrosis and inflammatory reaction induced four different synthetic slings (2005) BJU Inter, 95, pp. 833-837Palma, P.C.R., Ikari, O., D'Ancona, C.A.L., Netto Jr., N.R., Alça pubovaginal sintética no tratamento da da incontinência urinária de esforço (1992) J Bras Urol, pp. 18202-18204Palma, P.C.R., Riccetto, C.L.Z., Herrmann, V., Dambros, M., Thiel, M., Bandiera, S., Transobturator SAFYRE sling is as effective as the transvaginal procedure (2005) Int Urogynecol J, 16, pp. 487-49