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. 2021 Jun;39(6):2197-2204.
doi: 10.1007/s00345-020-03365-y. Epub 2020 Jul 21.

The effect of botulinum toxin on ureteral inflammation

Kevin Krughoff  1 , Faith L Anderson  2 , Scott Palisoul  3 , Alison L Young  2 , Jason R Pettus  3 , Karen L Moodie  4 , Christopher Ogomo  5 , Steven S Tau  2 , Rachel A Moses  6 , Matthew C Havrda  2 , David R Chavez  6
Affiliations

The effect of botulinum toxin on ureteral inflammation

Kevin Krughoff et al. World J Urol. 2021 Jun.

Abstract

Purpose: The impact of onabotulinum toxin type A (BoNT-A) on bladder afferent nerve pathways and chemosensory functions is an active area of investigation. There may be a role for BoNT-A in disorders of the ureter; however, no histologic studies have assessed the effects of BoNT-A on ureteral tissue. Our objective was to develop an animal model of ureteral inflammation and determine the impact of ureteral BoNT-A instillation on known mechanisms of inflammation.

Methods: The safety and feasibility of a novel animal model of ureteral inflammation was assessed. Through open cystotomy, the effect of ureteral BoNT-A instillation on inflammation was determined through H&E, masson's trichrome, Ki-67 stain, and prostaglandin E (PGE) synthase expression, a known marker of pain and inflammation in ureteral tissue. Urothelial microstructure was assessed using electron microscopy and standard histologic techniques.

Results: All experiments were carried to completion, and no systemic signs of botulinum toxicity were seen. BoNT-A exposure was associated with a decrease in PGE synthase expression in a dose-dependent fashion. BoNT-A exposure was not found to impact collagen deposition or cell proliferation. Disruption of tight junctions between urothelial cells was observed under conditions of inflammation.

Conclusion: We describe the feasibility of a novel in vivo model of ureteral inflammation and report the first histologic study of the effects of BoNT-A on the ureter. Preliminary findings show that BoNT-A attenuates ureteral PGE synthase expression under conditions of inflammation. The application of BoNT-A may provide anti-inflammatory and analgesic effects in the context of ureteral disorders.

Keywords: Botulinum toxin; Histology; Inflammation; Prostaglandin; Ureter.

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