Role of spinal nitric oxide synthase-dependent processes in the initiation of the micturition hyperreflexia associated with cyclophosphamide-induced cystitis

The aim of this study was to examine the participation of nitrergic neurotransmission in the initiation of micturition hyperreflexia associated to cyclophosphamide (CP)induced cystitis in rats. Micturition threshold volume was significantly reduced 4 h after CP administration (100 mg/kg, i.p.); this reduction was attenuated by intra-arterially injected N-G-nitro-L-arginine-methyl ester (L-NAME), a non selective nitric oxide synthase (NOS) inhibitor, but not by intravesical infusion of S-methyl-L-thiocitrulline (L-SMTC), another structurally different NOS inhibitor. Interestingly, L-NAME failed to affect micturition threshold volume in normal rats. The magnitude of isolated detrusor strips contractions elicited by either carbachol or nerve activation was significantly reduced in CP-treated rats but was unaffected by the addition of N-G-nitro-L-arginine (L-NOARG), a nonselective NOS inhibitor. In contrast, intrathecal L-NAME and L-SMTC but not N-G-nitro-D-arginine-methyl ester (D-NAME) administration augmented the micturition threshold volume in CP-treated rats in an L-arginine preventable manner. As with the systemic injection, intrathecal L-NAME also did not affect the micturition threshold volume in normal rats. Four hours after CP injection, the number of neuronal NOS immunoreactive or nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) positive neurons in spinal lumbosacral segments (L6-S2) was not altered whereas the number of c-Fos immunoreactive neurons increased significantly in the dorsal gray commissural nucleus (DGC), the parasympathetic sacral nucleus (PSN) and lamina X of these segments. Ca2+-dependent, but not Ca2+-independent NOS activity increased significantly in spinal L6-S2 segments but not in thoracic seg-ments of CP-treated rats. These data indicate that the micturition hyperreflexia observed in the initial hours of CP-induced cystitis is associated with an increase in Ca2+-dependent NOS activity in spinal L6-S2 segments suggesting an increased production of nitric oxide (NO). The increased production of NO in these spinal segments appears to be necessary for the initiation of the micturition hyperreflexia. (C) 2004 IBRO. Published by Elsevier Ltd. All rights reserved.