May 28, 2002 ORLANDO, May 25 – Researchers from the University of Pittsburgh School of Medicine have found that, in animal models, autologous skeletal muscle derived cell (MDC) transplants offer a safer, more effective and longer lasting treatment for urinary incontinence than existing methods. In the procedure, muscle cells are taken from the individual, purified and cloned, and then reinjected into the bladder.
“In patients who need more advanced treatments for incontinence, we currently have the options of treating them through surgery or through the injection of bulking agents like collagen. Although collagen injections give good short-term results and are less invasive than surgery, there is a possibility of the collagen being reabsorbed or causing allergic reactions,” said Ryan J. Pruchnic, of the departments of urology and orthopaedic surgery, University of Pittsburgh School of Medicine and lead author of the study. “In our study, MDCs have the potential to offer a longer-term solution without the risk of rejection.”
Pruchnic and colleagues presented these findings today at the Centennial Celebration Annual Meeting of the American Urological Association (AUA). Results are published in abstract 131 in the AUA proceedings.
In the study, researchers obtained a mixed population of MDCs from a mouse skeletal muscle biopsy. The cells were purified to obtain a population that was purely myogenic – meaning that the cells were from muscle and capable of producing muscle. One cell from this population was then genetically engineered and cloned to form a large population. These cells were then injected into the bladder walls of mice.
The bladders of the mice were evaluated at one, four and eight weeks and 6 months. On evaluation, researchers noted the presence of myofibers, or differentiated muscle cells, throughout the smooth muscle layer, the number of which did not significantly decrease over time. Some of the myofibers expressed a-smooth muscle actin, suggesting differentiation of the cells into smooth muscle. Researchers also observed the presence of neuromuscular junctions, indicating that the muscle was supplied with nerves giving the muscle the ability to become functional tissue.
“These findings indicate that the use of MDCs may prove to be a very promising new therapy in the treatment of urinary incontinence. Essentially, we are giving the bladder muscles the ability to fix themselves by generating new muscle,” said Michael Chancellor, M.D., professor of urology and gynecology at the University of Pittsburgh School of Medicine. “In future studies we hope this will turn into a long lasting, if not permanent, solution for our patients.”
Urinary incontinence affects 13 million Americans and is typified by the inability to control the flow of urine. Incontinence can be caused by a number of different anatomic, physiologic, and pathologic factors and can be temporary or chronic. The ability to control bladder function relies on the combined function of the smooth muscle tissue of the urethra and bladder, skeletal muscle and the nervous system.
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