Urinary NGF level was measured in 38 normal controls and 70 patients with OAB.51 Patients were treated with tolterodine 4 mg once daily. The urinary NGF/Cr levels and urgency severity scale (USS) were compared at baseline, 1, 2, and 3 months after antimuscarinics and 1 month after discontinuing treatment.51 Urinary NGF/Cr level was significantly reduced at 3 months in 50 responders (1.10 ± 0.26 before vs 0.41 ± 0.09 after, P = .008), but not in 20 nonresponders (1.39 ± 0.54 before vs 1.30 ± 0.46 after, P = .879). After discontinuing antimuscarinic treatment for 1 month, Inhibitors,research,lifescience,medical however, urinary

NGF/Cr level was elevated in 23 responders (0.85 ± 0.33) and in 5 nonresponders (2.72 ± 1.41). The USS significantly changed with urinary NGF/Cr level in responders at different time points. The change of urinary NGF level Inhibitors,research,lifescience,medical is associated with the change of USS after antimuscarinic treatment and discontinued medication. The urinary NGF level could be a potential biomarker for evaluating therapeutic results of antimuscarinic therapy (Figure 7). Figure 7 Urinary nerve growth Inhibitors,research,lifescience,medical factor/creatinine

(NGF/Cr) levels were significantly reduced at 3 months in responders (A) but not in nonresponders (B). After discontinuation of antimuscarinic treatment for 1 month, urinary NGF/Cr level was elevated in both responders … Previous studies have shown that urinary NGF is a sensitive biomarker for the diagnosis of OAB.20,26,29 It is possible that NGF is taken up by sensory nerves and transported through the CNS in retrograde

fashion. Therefore, NGF production could be a biomarker for neuroplasticity via some common pathway involved in the pathogenesis of OAB.44 This Inhibitors,research,lifescience,medical study further demonstrated that urinary NGF level decreased in association with the reduction of urgency severity and increased when OAB symptoms recurred. Interestingly, a lag response time between changes in USS and NGF was noted in responders. The mechanism for this difference could be due to a subjective report of USS and time lag of NGF production decreases after antimuscarinic treatment. Inhibitors,research,lifescience,medical Patients with improved USS might still have incompletely solved underlying OAB pathophysiology. After 3 months of antimuscarinic treatment, USS had not decreased to zero and urinary NGF Mephenoxalone levels also remained significantly higher than those of controls. The elevated urinary NGF level might imply the existence of residual inflammation in the CNS. Conclusions Measurement of urinary NGF level in patients with OAB and other urinary conditions provides insight into the underlying pathophysiology of this sensory disorder. Patients with OAB had significantly higher urinary NGF levels compared with controls and patients with increased bladder SCH772984 clinical trial sensation. BOO with OAB or DO correlates with elevated urinary NGF that returns to normal after medical treatment of BOO. These results suggest that urinary NGF level is a promising biomarker for the diagnosis of OAB.