The Effect of Alpha-Blocker Treatment on Bladder Hypoxia Inducible Factor-1 Alpha Regulation during Lower Urinary Tract Obstruction

作者：Koritsiadis George; Tyritzis Stavros I^*; Koutalellis George; Lazaris Andreas C; Stravodimos Konstantinos

来源：International Brazilian Journal of Urology, 2010, 36(1): 86-93.

DOI：10.1590/S1677-55382010000100013

• bladder
• bladder outlet obstruction
• hypoxia inducible factor-1
• ischemia
• alpha-blockers

Aims: To determine whether alpha 1-blocker treatment, in chronic bladder outlet obstruction (BOO), influences bladder tissue ischemia.
Materials and Methods: This prospective study included 60 patients with BOO, of which 40 were under alpha 1-blocker medication and 20 without treatment. Patients underwent transurethral resection of the prostate (TURF) or suprapubic prostatectomy (SPP). Ten patients with non-muscle invasive bladder cancer underwent transurethral resection of the bladder tumor and served as the control group. Tissue specimens were immunohistochemically stained for hypoxia inducible factor-1 alpha (HIF-1 alpha).
Results: Bladder tissue from obstructed subjects showed high immunoreactivity to HIF-1 alpha. The specimens from the control group, showed no or weak, mainly cytoplasmic immunoreactivity to HIF-1 alpha. Patients under alpha -blocker treatment did not differ in the number of HIF-1 alpha positive cells compared to subjects with no treatment (median number 86.8 [20-150] and 88.6 [0-175], respectively) (p > 0.05). The lowest bladder pressure at which H1F-1 alpha was up regulated, was detected at detnisor pressure Qmax (PdetQmax) = 60 cm H2O.
Conclusions: Treatment with alpha-blockers in obstructed patients considered as non-responders, does not result in HIF-1 alpha down regulation, thus bladder continues to be under chronic stress.

• 出版日期2010-2