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Publication : Neuroepithelial control of mucosal inflammation in acute cystitis.

First Author  Butler DSC Year  2018
Journal  Sci Rep Volume  8
Issue  1 Pages  11015
PubMed ID  30030504 Mgi Jnum  J:269659
Mgi Id  MGI:6271480 Doi  10.1038/s41598-018-28634-0
Citation  Butler DSC, et al. (2018) Neuroepithelial control of mucosal inflammation in acute cystitis. Sci Rep 8(1):11015
abstractText  The nervous system is engaged by infection, indirectly through inflammatory cascades or directly, by bacterial attack on nerve cells. Here we identify a neuro-epithelial activation loop that participates in the control of mucosal inflammation and pain in acute cystitis. We show that infection activates Neurokinin-1 receptor (NK1R) and Substance P (SP) expression in nerve cells and bladder epithelial cells in vitro and in vivo in the urinary bladder mucosa. Specific innate immune response genes regulated this mucosal response, and single gene deletions resulted either in protection (Tlr4(-/-) and Il1b(-/-) mice) or in accentuated bladder pathology (Asc(-/-) and Nlrp3(-/-) mice), compared to controls. NK1R/SP expression was lower in Tlr4(-/-) and Il1b(-/-) mice than in C56BL/6WT controls but in Asc(-/-) and Nlrp3(-/-) mice, NK1R over-activation accompanied the exaggerated disease phenotype, due, in part to transcriptional de-repression of Tacr1. Pharmacologic NK1R inhibitors attenuated acute cystitis in susceptible mice, supporting a role in disease pathogenesis. Clinical relevance was suggested by elevated urine SP levels in patients with acute cystitis, compared to patients with asymptomatic bacteriuria identifying NK1R/SP as potential therapeutic targets. We propose that NK1R and SP influence the severity of acute cystitis through a neuro-epithelial activation loop that controls pain and mucosal inflammation.
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