Researchers in the Department of Urology have joined forces with colleagues from the Institute for Regenerative Medicine to uncover genetic aspects of stress urinary incontinence (SUI) as well as to develop an animal model to test potential treatments. Their goal is to develop evidence-based approaches to prevention and treatment of SUI, a condition that affects more than 5 million Americans.
In one line of research, the scientists have established a biochemical basis for the degradation of collagen and elastin that they hypothesize leads to weakened support of pelvic floor organs. Preliminary data suggest that collagenolytic and elastolytic activity are greater in women with SUI compared to continent women and can be measured in plasma, supporting the hypothesis that SUI is the result of a systemic process.
Unpublished data from Gopal Badlani, M.D., professor of urology, provides evidence that collagenolytic activity, specifically matrix metalloproteinase-1 (MMP-1), is greater in women with SUI compared to continent women. MMP-1 is the enzyme primarily responsible for initiating the breakdown of collagens 1 and III. Collagen plays a key role in remodeling during various phases of life where these tissues are subject to mechanical stress.
Badlani has published evidence that collagen synthesis is normal in women with SUI, even though there is an increased excretion of collagen breakdown products, demonstrating that in women with SUI, the balance between collagen breakdown and synthesis is altered in favor of breakdown.
Badlani and Jan Rohozinski, Ph.D., assistant professor of regenerative medicine, plan to conduct a two-year study to determine the association of known MMP-1 promoter polymorphic subtypes with the presence or absence of SUI using a blood sample assay. They hypothesize that variations within the promoter region of the MMP-1 gene determine levels of expression and explain differences in MMP-1 observed in women with and without SUI. They hope to determine if promoter sequence can be used a genetic marker and predictive factor in the development of SUI.