Use permanent link to share in social media Share with a friend Please login to send this document by krónikus prosztatagyulladás kezelése gyógynövényekkel To explain why bladder instillations of chondroitin sulphate are beneficial for the treatment of cystitis, it is important to understand the pathophysiology of radio- therapy- and chemotherapy-associated cystitis.
Radio- therapy and chemotherapy can damage the GAG layer of the bladder, which leads to a loss of urothelial barrier function [ 1415 ]. The GAG layer consists of negatively charged sulphated polysaccharides, which are coupled to a negatively charged anchor protein [ 16 ].
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- Intravesical Glycosaminoglycan Replacement with Chondroitin__Article_ | HBS
When the integrity of the GAG layer and urothelial cells is dis- rupted, the permeability for aggressive components in the urine potassium ions, proteases, calcium crystals, etc.
This can increase the stimulation of sub- urothelial pain fibres. In addition, these generated signals are amplified within the suburothelial networks [ 17 ], which explains the clinical symptoms of pain, pollak- isuria and urinary urgency seen with cystitis.
Finally, damage to the GAG layer can lead to development of a chronic transmural inflammatory process and promotion of bacterial adhesion, causing patients to have recurrent urinary tract infections [ 18 ]. The late stage of radio- therapy-associated cystitis is characterized by an alter- ation of the bladder wall, with angiopathy and interstitial fibrosis Fig.
The consecutive decrease in bladder compliance and anatomical capacity can ultimately lead to a complete loss psa reduced after antibiotics bladder function, and sometimes the only possible therapeutic option remaining is a cys- tectomy.
"Как такое могло произойти?" - повторял Ричард, качая головой. Потом экраны вдруг погасли. - Мы выбрали сорок восемь отрывков, - проговорила Верховный Оптимизатор, - чтобы показать вам, что все они сделаны в Новом Эдеме за последние восемь дней. Оптимизатор - вы зовете его Арчи - располагает каталогом отрывков, в котором приводится время, место и описание событий.
Therefore, a crucial aspect for the success of GAG replacement therapy is a urothelium that can still be regenerated and is treated before ulceration and wall fibrosis occur. An available treatment that addresses the cause of chronic cystitis is intravesical instillation of substances that replace the GAG layer—a regimen that was successfully introduced in the s.
While this treatment regimen can now be regarded as established in the therapy of interstitial cystitis, it is rarely used in radiotherapy- and chemother- apy-associated cystitis. Of the different substances that are used in GAG replacement therapy, chondroitin sulphate is particularly suitable.
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Chondroitin sulphate is the GAG, which is located mainly on the luminal side of the urothelium and contributes to maintaining transepithelial resistance [ 19 ]. Data from animal studies show that instillation of chondroitin sulphate leads to restoration of the permeability barrier [ 20 ]; thus, in the suburothelium, the number of inflammatory cells decreases [ 12 ].
Further- more, for intravesical chondroitin sulphate, it has been proven that the GAG molecules selectively attach apically to damaged areas of mucosa and do not penetrate into deeper layers of the bladder wall [ 21 ]. As a result, reduc- tions in clinical symptoms, particularly episodes of urinary urgency, bladder pain and pollakisuria, have been observed with chondroitin sulphate treatment in patients with inter- stitial cystitis, overactive bladder, radiogenic cystitis and recurrent urinary tract infections with corresponding GAG layer defects [ 13 ], and in psa reduced after antibiotics patients with overactive bladder [ 22 ].
To our knowledge, only one other study has specifically investigated the use of 0. In that pilot study, Hazewinkel and colleagues showed that prophylactic intravesical administration of Fig. III pilot study of dose escalation using conformal radiotherapy in prostate cancer: PSA control and side effects. Br J Cancer.
Vitaprost cystitis Hogyan kell szedni a furadonin 50 mg-ot cystitis felülvizsgálatokhoz Active substance of the drug vitaprost is a complex of water-soluble biologically active peptides isolated from bovine prostatic gland.
Phase II study of the American Brachytherapy Society guidelines for the use of high-dose rate brachytherapy in the treatment of cervical carcinoma: is 45— Int J Gynecol Cancer.
Practical treatment approach of radiation induced cystitis.
Gyakran ismételt kérdések (GYIK)
Actas Urol Esp. Intravesical bacillus Calmette-Guerin is superior to mitomycin C in reducing tumour recurrence in high-risk superficial bladder cancer: a meta-analysis of randomized trials.
BJU Int. Management of radiation cystitis.
Nat Rev Urol. Berkey FJ. Managing the adverse effects of radiation therapy. Am Fam Physician.
Guidelines for the diagnosis, prevention and management of chemical- and radiation-induced cystitis. J Clin Urol.
А вот это, - проговорил Макс, махнув рукой в сторону котлов и фабрики, - чистая жуть. Знай я заранее, что придется увидеть машины, которые умнее людей, не стал бы записываться в колонию. - Ричард, Ричард.
GAG layer replenishment therapy for chronic forms of cystitis with intravesical glycosaminoglycans—a review. Neurourol Urodyn. The care situation of patients with interstitial cystitis in Germany: results of a survey of patients.