Evaluation of the relationship of cholinergic metabolites in urine and urgency urinary incontinence

Abstract

Introduction and hypothesis To investigate differences in urine cholinergic metabolites in women with urinary urgency incontinence (UUI) and responders (R) and non-responders (NR) to anti-cholinergic medications (AC). Methods Patients with UUI and age-matched controls were evaluated pre- and post-treatment using OABSS, UDI-6 and IIQ-7. Controls were defined as having a cumulative OABSS of zero. Patients with UUI were treated with AC and followed for 12 weeks. Responders were those with a > 50% decrease in the total OABSS score. Urine samples were collected from all participants for evaluation. Metabolite detection was accomplished using commercial assay kits. Wilcoxon-rank sum test and Fisher’s exact test were used to express differences between groups. Spearman’s rho correlation coefficient was used to determine the relationship between acetylcholine (Ach), choline (Ch), acetylcholinesterase (AchE) and questionnaire scores. Results We recruited 39 with UUI and 33 controls. We found concentrations of Ch [29.0 (IQR: 24.2–42.5) μmol vs. 15.2 (IQR: 7.5–24.1) μmol] and Ach [65.8 (IQR: 30.4–101.8) nmol and 33.1 (IQR: 11.9–43.8) nmol] were higher in the UUI group compared to controls ( p = 0.003 and p < 0.001, respectively] and no differences in AchE concentrations. In the UUI group, 43.6% responded to AC after 12 weeks of therapy. There were no differences in Ch or AchE levels between R and NR; Ach levels were higher in the R group [82.1 nmol (IQR: 54.8–118.1) vs. 50.3 nmol (IQR: 29.9–68.2), p = 0.007]. Ch and Ach were positively associated with pre-treatment OABSS parameters. Conclusions Urine Ach is higher in responders to anti-cholinergic therapy, and urine cholinergic metabolites were higher in the UUI patients compared to controls.

Determinants of Urinary Incontinence using IIQ-7 and UDI-6 in pregnant women: A case series in hospital setting in Kinshasa

“…were the UI risk factors. These findings are in accordance with those in the literature showing that parity, prepregnancy UI, overweight, vaginal delivery (compared to cesarean section) are pregnancyrelated risk factors of UI (16)(17)(18)(19)(20)(21)(22).…”

“…Med., vol. 16 According to the quality of life, the majority of women had moderate diability risk (53.7 %), followed by severe disability risk (35.7 %).…”

Assessment of acetylcholinesterase activity in CD9-positive exosomes from patients with Parkinson’s disease

“…Cholinergic dysfunction within the gastrointestinal tract has been implicated in explaining non-motor symptoms, including gastrointestinal dysmotility and constipation, in PD ( Tatyana et al, 2017 ). Similarly, urinary exosomes also exhibit strong CD9 expression ( Man Zhang et al, 2021 ), and the impairment of cholinergic function in the urinary system may be associated with urinary symptoms such as urgency, retention, and incontinence in PD ( Sheyn et al, 2022 ). Finally, although the presence of CD9 in exosomes released by cardiovascular cells has not been established, cholinergic dysfunction in the cardiovascular system can lead to autonomic dysfunction, including orthostatic hypotension, characterized by a drop in blood pressure ( Palma and Kaufmann, 2020 ).…”