Michal Pokusa, Alžbeta Trančíková, Ján Švihra, Marián Kollárik, Róbert Dušenka, Ján Ľupták, Miloš Tatár
Objective: Expression of neurotrophic factors and receptors in the afferent bladder nerve is significantly increased in spinal
cord injury. OnabotulinumtoxinA reduces bladder overactivity and therefore will reduce the increased expression of
neurotrophic factors and receptors following spinal cord injury.
Material and Methods: The prospective study included patients with neurogenic bladder following complete spinal cord
lesion and control group without the neurogenic bladder. Follow-up was performed over three months, in patients with
neurogenic bleeding after detrusor injection of 200 U onabotulinumtoxinA. Urine samples were obtained by spraying or
spontaneous micturition. Samples were centrifuged for 10 minutes at 3000 rpm in a table centrifuge. The supernatant
was divided into aliquots and frozen at -80° C until the analysis was performed. Determination of the concentration of
the selected growth factors was determined by colorimetry using the ELISA method in the form of commercially available
kits (RayBiotech, USA). Values obtained by measurement were normalised to creatinine concentrations (Enzo Life
Sciences, USA) in individual patients.
Results: The study included 9 patients and 7 control healthy probands at an average age of 43.8 years (standard deviation
11.3). Growth factors were investigated: Glioma Neurotrophic Factor (GDNF), Nerve Growth Factor (NGF), Brain Neurotrophic
Factor (BDNF), Artemin (ARTN). All growth factor’s values have not changed in the control patients. Patients with
the neurogenic bladder had a statistically significant changes in GDNF from 0.242 (0.081) to 0.157 (0.035); NGF from 0.245
(0.082) to 0.197 (0.022); BDNF from 0.005 (0.001) to 0.004 (0.001) and ARTN from 0.170 (0.068) to 0.152 (0.032).
Conclusions: The value of urinary growth factors was influenced by neurogenic bladder following complete spinal cord
lesion. Intradetrusor injection of onabotulinumtoxinA reduced values of all growth factors.