The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia

Neurourol Urodyn. 2017 Sep;36(7):1896-1902. doi: 10.1002/nau.23207. Epub 2017 Jan 16.

Abstract

Aims: The aim of this study was to determine the value of urine nerve growth factor (NGF), transforming growth factor beta 1 (TGF-Beta-1), tissue inhibitor of matrix metalloproteinase 2 (TIMP-2) levels to predict the urodynamic profile before and after botulinum neurotoxin type A (BoNT-A) treatment in children with myelodysplasia.

Methods: This prospective study included 15 children with myelodysplasia who underwent intradetrusor BoNT-A injections due to neurogenic detrusor overactivity (NDOA). Urine samples of each child were collected before and after BoNT-A injections, specifically at the first and third postoperative months. Urine samples were analyzed with ELISA method and NGF, TGF-Beta-1, and TIMP-2 levels were measured. Urine marker levels and clinical findings were assessed for statistical significance with Wilcoxon Signed Ranks Test and Friedman Test.

Results: A total of 15 children (5 boys and 10 girls) were assigned as the study group. Mean age of the patients was 7.1 ± 2.5 years (range 2.5-11). A statistically significantly decline was observed in urinary TGF-Beta-1 and NGF levels following BoNT-A injections, compared to the preoperative levels (P < 0.05). TIMP-2 levels also tend to decrease following BoNT-A injections but this was not statistically significant compared to the preoperative levels.

Conclusion: This preliminary study, suggests urinary TGF-Beta-1 and NGF as a potent marker in children with NDOA, as they decline following BoNT-A injection. Further studies are needed in identifying their special role in assessing treatment success after invasive interventions.

Keywords: botulinum neurotoxin type A; myelodysplasia; nerve growth factor; tissue inhibitor of matrix metalloproteinase 2; transforming growth factor beta 1.

MeSH terms

  • Acetylcholine Release Inhibitors / therapeutic use*
  • Biomarkers
  • Botulinum Toxins, Type A / therapeutic use*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Injections, Intramuscular
  • Male
  • Nerve Growth Factor / urine
  • Neural Tube Defects / complications
  • Prospective Studies
  • Tissue Inhibitor of Metalloproteinase-2 / urine
  • Transforming Growth Factor beta1 / urine
  • Treatment Outcome
  • Urinary Bladder, Neurogenic / drug therapy*
  • Urinary Bladder, Neurogenic / etiology
  • Urinary Bladder, Neurogenic / urine
  • Urinary Bladder, Overactive / drug therapy*
  • Urinary Bladder, Overactive / etiology
  • Urinary Bladder, Overactive / urine
  • Urodynamics

Substances

  • Acetylcholine Release Inhibitors
  • Biomarkers
  • NGF protein, human
  • TGFB1 protein, human
  • TIMP2 protein, human
  • Transforming Growth Factor beta1
  • Tissue Inhibitor of Metalloproteinase-2
  • Nerve Growth Factor
  • Botulinum Toxins, Type A