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Clinical Pathophysiology and Molecular Biology of the Urothelium and the GAG Layer

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Bladder Pain Syndrome

Abstract

The urothelium is a special, somehow unique, epithelium. Starting from its basic functions (impermeability and distensibility), it can generate “signaling molecules” which, through the “sensory web,” contribute to the regulation of the urinary function. The knowledge of its molecular basis is getting further details in disclosing its “complex mechanisms”; control of the latter, through a targeted therapy, represents an exciting challenge for basic research. Aim of this chapter is to define, through a molecular pathophysiological analysis, the actual role played by the urothelium in the “natural history” of disorders such as BPS/IC. In particular is described the molecular basis of impermeability and distensibility and selective impermeability of urothelial barriers. Are also discussed the role of dynamin in the regulation of vesicular traffic in the urothelium and centrality of the “uroplakin system.” The urothelium is lined by a soft, flexible coating (cell coat, glycocalix, fuzz), a constituent of the apical membrane of “umbrella cells.” The molecular composition and related functions are analyzed in detail. The relationship between cell populations and the urothelial pacemaker and the potential role of myofibroblasts as a conduction tissue are discussed. A “dysfunction” is the quantitative/qualitative alteration of a function (hyper- or hypofunction). However this generic pathophysiological term pretty well describes a complex of symptoms, from both clinical and molecular standpoint. Are finally evaluated the criteria to define the condition of urothelial dysfunction and the theoretical foundations of coating repair.

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Authors and Affiliations

  1. Department of Pharmaceutical and Biomedical Sciences (FARMABIOMED), University of Salerno, Salerno, Italy

    Gianfranco Tajana

  2. Viale Glorioso 13, 00153, Rome, Italy

    Mauro Cervigni

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  1. Gianfranco Tajana
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  2. Mauro Cervigni
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Correspondence to Mauro Cervigni .

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Editors and Affiliations

  1. University of Copenhagen, Department of Urology, Herlev Hospital, Herlev, 2730, Denmark

    Jørgen Nordling

  2. University Hospital Antwerp, Department of Urology, and Antwerp University, Edegem, 2650, Belgium

    Jean Jacques Wyndaele

  3. and Internal Medicine, Erasmus MC,, Departments of Immunology, University Medical Center Rotterdam, Rotterdam, 3141 XW, Netherlands

    Joop P. van de Merwe

  4. Koege Hospital, Department of Clinical Biochemistry, University of Copenhagen, Copenhagen, 4600, Denmark

    Pierre Bouchelouche

  5. Department Obstetrics and Gynecology, Department of Urogynecology S.Carlo-IDI, Catholic University, Rome, 00165, Italy

    Mauro Cervigni

  6. Institute of Clinical Sciences, Department of Urology, Sahlgrens Academy at University of Gothenburg, Göteborg, 41345, Sweden

    Magnus Fall

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Tajana, G., Cervigni, M. (2013). Clinical Pathophysiology and Molecular Biology of the Urothelium and the GAG Layer. In: Nordling, J., Wyndaele, J., van de Merwe, J., Bouchelouche, P., Cervigni, M., Fall, M. (eds) Bladder Pain Syndrome. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-6929-3_4

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