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      Indwelling urinary catheter assembled with lidocaine‐loaded polymeric strand for local sustained alleviation of bladder discomfort

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          Abstract

          Indwelling urinary catheters (IUCs) are used in clinical settings to assist detrusor contraction in hospitalized patients. However, an inserted IUC often causes catheter‐related bladder discomfort. To resolve this, we propose an IUC coupled with local, sustained release of an anesthetic drug, lidocaine. For this, a thin strand composed of poly (lactic‐co‐glycolic acid) and lidocaine was separately prepared as a drug delivery carrier, which was then wound around the surface of the IUC to produce the drug‐delivery IUC. Our results revealed that the drug‐delivery IUC could exert the pain‐relief effects for up to 7 days when placed in the bladder of living rats. Cystometrogram tests indicated that the drug‐delivery IUC could significantly relieve bladder discomfort compared with the IUC without lidocaine. Furthermore, the expression of pain‐related inflammatory markers, such as nerve growth factor, cyclooxygenase‐2, and interleukin‐6 in the biopsied bladder tissues was significantly lower when the drug‐delivery IUC was used. Therefore, we conclude that an IUC simply assembled with a drug‐loaded polymer strand can continuously release lidocaine to allow for the relief of bladder discomfort during the period of IUC insertion.

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          Most cited references72

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          Guideline for prevention of catheter-associated urinary tract infections 2009.

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            Urinary bladder contraction and relaxation: physiology and pathophysiology.

            The detrusor smooth muscle is the main muscle component of the urinary bladder wall. Its ability to contract over a large length interval and to relax determines the bladder function during filling and micturition. These processes are regulated by several external nervous and hormonal control systems, and the detrusor contains multiple receptors and signaling pathways. Functional changes of the detrusor can be found in several clinically important conditions, e.g., lower urinary tract symptoms (LUTS) and bladder outlet obstruction. The aim of this review is to summarize and synthesize basic information and recent advances in the understanding of the properties of the detrusor smooth muscle, its contractile system, cellular signaling, membrane properties, and cellular receptors. Alterations in these systems in pathological conditions of the bladder wall are described, and some areas for future research are suggested.
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              Interleukin-6: Biology, signaling and strategies of blockade.

              Interleukin-6 (IL-6) is one of the most important inflammatory cytokines. IL-6 is unique in signaling via a membrane bound and a soluble receptor. Intriguingly, these two pathways strongly differ in their biologic consequences. While classic IL-6 signaling via the membrane bound receptor is mainly regenerative and protective, IL-6 trans-signaling via the soluble IL-6R is rather pro-inflammatory. Intracellular signaling of IL-6 in response to receptor activation is through STAT-dependent and STAT-independent signaling modules, which are regulated by a complex regulatory network. The complex biology of IL-6 has consequences for therapeutic targeting of this cytokine. We hypothesize that specific inhibition of the trans-signaling pathway may be superior to global blockade of IL-6 activity with help of antibodies directed against IL-6 or IL-6R.
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                Author and article information

                Contributors
                moonuro@hanyang.ac.kr
                ybchoy@snu.ac.kr
                Journal
                Bioeng Transl Med
                Bioeng Transl Med
                10.1002/(ISSN)2380-6761
                BTM2
                Bioengineering & Translational Medicine
                John Wiley & Sons, Inc. (Hoboken, USA )
                2380-6761
                31 March 2021
                May 2021
                : 6
                : 2 ( doiID: 10.1002/btm2.v6.2 )
                : e10218
                Affiliations
                [ 1 ] Interdisciplinary Program for Bioengineering, College of Engineering Seoul National University Seoul Republic of Korea
                [ 2 ] Department of Urology, College of Medicine Hanyang University Seoul Republic of Korea
                [ 3 ] Department of Translational Medicine, Graduate School of Biomedical Science & Engineering Hanyang University Seoul Republic of Korea
                [ 4 ] Institute of Medical & Biological Engineering, Medical Research Center Seoul National University Seoul Republic of Korea
                [ 5 ] Department of Biomedical Engineering Seoul National University, College of Medicine Seoul Republic of Korea
                Author notes
                [*] [* ] Correspondence

                Hong Sang Moon, Department of Urology, Hanyang University Medical Center, 153 Gyeongchun‐ro, Guri‐si, Gyeonggi‐do 11923, Republic of Korea.

                Email: moonuro@ 123456hanyang.ac.kr

                Young Bin Choy, Department of Biomedical Engineering, College of Medicine and Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea.

                Email: ybchoy@ 123456snu.ac.kr

                Article
                BTM210218
                10.1002/btm2.10218
                8126825
                6cdd6dd6-9403-4dfe-b80c-e696e284cf3d
                © 2021 The Authors. Bioengineering & Translational Medicine published by Wiley Periodicals LLC on behalf of American Institute of Chemical Engineers.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 March 2021
                : 11 December 2020
                : 14 March 2021
                Page count
                Figures: 8, Tables: 0, Pages: 12, Words: 7505
                Funding
                Funded by: National Research Foundation of Korea , open-funder-registry 10.13039/501100003725;
                Award ID: 2019019401
                Award ID: 2021R1A2B5B03001914
                Categories
                Research Report
                Research Reports
                Custom metadata
                2.0
                May 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.2 mode:remove_FC converted:17.05.2021

                catheter‐related bladder discomfort,indwelling urinary catheters,lidocaine,local drug delivery,sustained drug delivery

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