Early life stressful events induce chronic bladder pain in adulthood – involvement of TRPV1.

Matos R1, Cruz F2, Charrua A3

Research Type

Pure and Applied Science / Translational

Abstract Category

Pelvic Pain Syndromes / Sexual Dysfunction

Abstract 442
Pain Mediators and Interventions
Scientific Podium Short Oral Session 21
Thursday 5th September 2019
14:15 - 14:22
Hall G1
Pain, other Painful Bladder Syndrome/Interstitial Cystitis (IC) Pathophysiology
1.Faculty of Medicine of University of Porto, 2.FMUP, IBMC-I3S and CHSJ, 3.FMUP, IBMC-I3S

Francisco Cruz



Hypothesis / aims of study
Stressful events occurring early in life may have a role in the development of BPS/IC later in adulthood.  We used the maternal deprivation model (MDM) to study such link, by characterizing for the first time bladder changes in the MDM model.
Study design, materials and methods
MDM was induced on female C57BL/6 by separating pups from mother and from littermates, for 1h, from P2 to P15 (MDM WT). Each separated animal was maintained on a heat blancket. Experiments were performed at P156. Non separated pups (wildtype, WT) were used as controls. 
Mechanical pain threshold was analysed at P156. Briefly, animals were placed in individual chambers (23.0 × 17.0 × 14.0 cm3) with a wire mesh floor and allowed to acclimate. This test was performed in the lower abdomen and consists in touching this region with one of a series of Von Frey monofilaments (rated at 0.008, 0.02, 0.04, 0.07, 0.16 g, 0.40 g). Filaments were applied perpendicularly with enough strength to cause the monofilament to slightly bend. Each monofilament was tested five times, 5 s interval between each application. It was considered a positive response when the animal reacted to the filament (abdomen retraction or jump) in at least three of the five filament applications. In case of no response to the filament, the next-stronger monofilament was applied within an interval of 30 s.
At P157, animals were anaesthetised with urethane (1.2g/kg body weight) laid on a heating pad with a rectal probe underneath their body to measure body temperature in order to maintain it at 37 ºC. The bladder was then exposed through a low abdominal incision. A needle was inserted in the bladder dome and saline was infused (1.8 ml/h).  After a stabilization period of 30 minutes, the cystometrograms were recorded for 10 minutes. Cystometrograms were analysed and bladder reflex activity was expressed as the number of bladder contractions per minute.
Afterwards, the bladders were harvested, fixed, dehydrated, embedded in paraffin and sectioned at 10 micrometres. Bladder sections were stained with Hematoxylin-eosin to analyse urothelium integrity and with Toluidine blue to analyse mast cell presence.
MDM was repeated on female TRPV1 knockout (KO) mice (MDM TRPV1 KO) to investigate the role of TRPV1 nociceptors in this model. Non separated TRPV1 KO pups (TRPV1 KO) were used as controls.
Wildtype (WT) mice had a lower abdominal pain threshold of 0.08±0.01g. MDM WT animals had a decrease in their threshold to 0.02±0.01 (P=0.0002). TRPV1 KO and MDM TRPV1 KO mice had similar lower abdominal pain threshold (0.13±0.18g and 0.28±0.14g respectively; P=0.2).
WT mice presented 0.48±0.15 bladder contractions/minute while MDM WT had 1.05±0.35 contractions/minute (P=0.04). TRPV1 KO presented 0.50±0.12 bladder contractions/minute and MDM TRPV1 KO mice had 0.50±0.08 bladder contractions/minute.
The bladder of WT, TRPV1 KO and MDM TRPV1 KO mice presented normal urothelium. However, MDM WT animals presented urothelial disruption in 7% of the urothelial surface.
In the present experiment, the bladder wall of WT, MDM, TRPV1 KO and MDM TRPV1 KO mice did not present mastocystosis.
Interpretation of results
The results of the present work showed that MDM is a good model to study some aspects of BPS/IC, as MDM WT mice showed some of the bladder changes observed in BPS/IC, such as pain signs, increase number of voiding contractions and a mild urothelial disruption.

Also, since MDM TRPV1 KO mice did not present the changes observed in MDM WT mice, the results indicated a role for TRPV1-expressing nociceptive fibres in the development of the observed pain and bladder changes.
Concluding message
We conclude that MDM model may be useful to investigate the consequences of early in life stressful events, in particular mechanism leading to the development of chronic bladder pain in adulthood.
Funding This work has received support from the EU/EFPIA/Innovative Medicines Initiative [2] Joint Undertaking (IMI-PAINCARE) grant n° 777500. Clinical Trial No Subjects Animal Species mice Ethics Committee ORBEA and DGAV
25/09/2021 12:02:57