Abstract
Following transposition into the urinary tract, intestinal segments continue to produce mucus and problems related to excessive production do not to diminish with time. Currently, 20 human mucin genes have been described and their protein products partially or fully characterised. As the use of transposed intestinal segments in urology increases, there is now a need for a better understanding of mucins at the gene and protein levels. There is also a need for urologists to be aware of the many complications related to excess mucus production. Whilst effective therapeutic measures to reduce mucus production and its related complications remain elusive, it is now clear that without such effective mucoregulatory agents the quality of life of patients will continue to be less than satisfactory. This review describes the biology of mucus and the problems related to continued production following transposition of intestinal segments into the urinary tract. Difficulties related to quantification of urinary mucus, in addition to the structural and mucin gene changes that occur in transposed segments, are addressed.
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Akerlund S, Berglund B, Kock NG, Philipson BM (1989) Voiding pattern, urinary volume, composition and bacterial contamination in patients with urinary-diversion via a continent ileal reservoir. Br J Urol 63:619–623
Allen A (1989) Gastrointestinal mucus. In: Forte JG (ed) Handbook of physiology—the gastrointestinal system, vol 3. American Physiological Society, Bethesda, pp 359–382
Allen A, Hoskins LC (1988) Colonic mucus in health and disease. In: Kirsner JB, Shorter RG (eds) Diseases of the rectum and colon. Williams and Wilkens, Baltimore, pp 65–94
Allen A, Hutton DA, Leonard AJ, Pearson JP, Sellers LA (1986) The role of mucus in the protection of the gastroduodenal mucosa. Scand J Gastroenterol 21:71–78
Allen A, Hutton DA, Pearson JP (1998) The muc2 gene product: a human intestinal mucin. Int J Biochem Cell B 30:797–801
Anderson GG, Palermo JJ, Schilling JD, Roth R, Heuser J, Hultgren SJ (2003) Intracellular bacterial biofilm-like pods in urinary tract infections. Science 301:105–107
Benderev TV (1988) Acetylcysteine for urinary tract mucolysis. J Urol 139:353–354
Bueler MR, Wiederkehr F, Vonderschmitt DJ (1995) Electrophoretic, chromatographic and immunological studies of human urinary proteins. Electrophoresis 16:124–134
Buisine M-P, Janin A, Maunoury V, Audie J-P, Delescaut M-P, Copin M-C, Colombel J-F, Degand P, Aubert J-P, Porchet N (1996) Aberrant expression of a human mucin gene (muc5ac) in rectosigmoid villous adenoma. Gastroenterology 110:84–91
Caponegro PJ, Leadbetter GWJr (1974) Acute ureteral obstruction secondary to mucoid impaction in supravesical diversion. Treatment with n-acetylcysteine. Urology 3:486–487
Chang SK, Dohrman AF, Basbaum CB, Ho SB, Tsuda T, Toribara NW, Gum JR, Kim YS (1994) Localization of mucin (muc2 and muc3) messenger-RNA and peptide expression in human normal intestine and colon-cancer. Gastroenterology 107:28–36
Chen Y, Zhao YH, Kalaslavadi TJ, Hamati E, Nehrke K, Le AD, Ann DK, Wu R (2004) Genome-wide search and identification of a novel gel-forming mucin muc19/muc19 in glandular tissues. Am J Resp Cell Mol 30:155–165
Clamp JR, Creeth JM (1984) Some non-mucin components of mucus and their possible biological roles. Ciba Found Symp 109:121–136
Dekker J, Rossen JWA, Buller HA, Einerhand AWC (2002) The muc family: an obituary. Trends Biochem Sci 27:126–131
Desseyn JL, Aubert JP, Porchet N, Laine A (2000) Evolution of the large secreted gel-forming mucins. Mol Biol Evol 17:1175–1184
Devaraj N, Sheykhnazari M, Warren WS, Bhavanandan VP (1994) Differential binding of Pseudomonas aeruginosa to normal and cystic fibrosis tracheobronchial mucins. Glycobiology 4:307–316
Forstner JF, Forstner GG (1994) Gastrointestinal mucus. In: Johnson LR (ed) Physiology of the gastrointestinal tract. Raven Press, New York, pp 1255–1283
George VK, Gee JM, Wortley MI, Stott M, Gaches CGC, Ashken MH (1992) The effect of ranitidine on urine mucus concentration in patients with enterocystoplasty. Br J Urol 70:30–32
Gillon G, Mundy AR (1989) The dissolution of urinary mucus after cystoplasty. Br J Urol 63:372–374
Godl K, Johansson MEV, Lidell ME, Morgelin M, Karlsson H, Olson FJ, Gum JRJ, Kim YS, Hansson GC (2002) The n terminus of the muc2 mucin forms trimers that are held together within a trypsin-resistant core fragment. J Biol Chem 277:47248–47256
Haupt G, Pannek J, Knopf HJ, Schulze H, Senge T (1990) Rupture of ileal neobladder due to urethral obstruction by mucous plug. J Urol 144:740–741
Hendren WH, Hendren RB (1990) Bladder augmentation—experience with 129 children and young adults. J Urol 144:445–453
Ho SB, Roberton AM, Shekels LL, Lyftogt CT, Niehans GA, Toribara NW (1995) Expression cloning of gastric mucin complementary DNA and localization of mucin gene expression. Gastroenterology 109:735–747
Ho SB, Shekels LL, Toribara NW, Kim YS, Lyftogt C, Cherwitz DL, Niehans GA (1995) Mucin gene-expression in normal, preneoplastic, and neoplastic human gastric epithelium. Cancer Res 55:2681–2690
Hoskins LC (1981) Human enteric population ecology and degradation of gut mucins. Digest Dis Sci 26:769–772
Keegan SJ, Graham C, Neal DE, Blum-Oehler G, N’Dow J, Pearson JP, Gally DL (2003) Characterisation of Escherichia coli strains causing infections in patients with transposed intestinal segments. J Urol 169:2382–2387
Kent PW, Allen A (1968) The biosynthesis of intestinal mucins. The effect of salicylate on glycoprotein biosynthesis by sheep colonic and human gastric mucosal tissues in vitro. Biochem J 106:645–658
Kim YS, Gum J, Brockhausen I (1996) Mucin glycoproteins in neoplasia. Glyconjugate J 13:693–707
Lapensee L, Paquette Y, Bleau G (1997) Allelic polymorphism and chromosomal localization of the human oviductin gene (muc9). Fertil Steril 68:702–708
Mantle M, Allen A (1978) A colorimetric assay for glycoproteins based on the periodic acid/Schiff stain. Biochem Soc Trans 6:607–609
Murray K, Nurse DE, Mundy AR (1987) Secretomotor function of intestinal segments used in lower urinary tract reconstruction. Br J Urol 60:532–535
N’Dow J, Pearson JP, Bennett MK, Neal DE, Robson CN (2000) Mucin gene expression in human urothelium and in intestinal segments transposed into the urinary tract. J Urol 164:1398–1404
N’Dow J, Robson CN, Matthews JN, Neal DE, Pearson JP (2001) Reducing mucus production after urinary reconstruction: a prospective randomized trial. J Urol 165:1433–1440
Pearson JP, Brownlee IA, Taylor C (2004) Mucin genes in the gi tract. In: Williams PA, Phillips GO (eds) Gums and stabilisers for the food industry, vol 12. Royal Society of Chemistry, Cambridge, (in press)
Quigley EMM, Turnberg LA (1987) Ph of the microclimate lining human gastric and duodenal mucosa in vivo—studies in control subjects and in duodenal ulcer patients. Gastroenterology 92:1876–1884
Rhodes M, Allen A, Dowling RH, Murphy G, Lennard TWJ (1992) Inhibition of human gall-bladder mucus synthesis in patients undergoing cholecystectomy. Gut 33:1113–1117
Rhodes M, Allen A, Lennard TWJ (1992) Mucus glycoprotein-biosynthesis in the human gall bladder—inhibition by aspirin. Gut 33:1109–1112
Roberton AM, Rabel B, Stubbs L, Tasmanjones C, Lee SP (1996) Aspirin changes the secretion rate and amino acid composition of human small intestinal mucin in subjects with ileal conduits. Glycoconjugate J 13:781–789
Sarosiek J, Mizuta K, Slomiany A, Slomiany BL (1986) Effect of acetylsalicylic acid on gastric mucin viscosity, permeability to hydrogen ion, and susceptibility to pepsin. Biochem Pharmacol 35:4291–4295
Scharfman A, Lamblin G, Roussel P (1995) Interactions between human respiratory mucins and pathogens. Biochem Soc Trans 23:836–839
Schroten H, Hanisch FG, Plogmann R, Hacker J, Uhlenbruck G, Nobisbosch R, Wahn V (1992) Inhibition of adhesion of s-fimbriated Escherichia coli to buccal epithelial cells by human milk fat globule membrane components—a novel aspect of the protective function of mucins in the nonimmunoglobulin fraction. Infect Immun 60:2893–2899
Seifter S, Dayton S, Novic B, Muntwyler E (1950) The estimation of glycogen with the anthrone reagent. Arch Biochem Biophys 25:191–200
Shankar V, Gilmore MS, Elkins RC, Sachdev GP (1994) A novel human airway mucin cDNA encodes a protein with unique tandem-repeat organization. Biochem J 300:295–298
Smirnova MG, Guo L, Birchall JP, Pearson JP (2003) Lps up-regulates mucin and cytokine mRNA expression and stimulates mucin and cytokine secretion in goblet cells. Cell Immunol 221:42–49
Strugala V, Allen A, Dettmar PW, Pearson JP (2003) Colonic mucin: methods of measuring mucus thickness. Proc Nutr Soc 62:237–243
Taylor C, Allen A, Dettmar PW, Pearson JP (2003) The gel matrix of gastric mucus is maintained by a complex interplay of transient and nontransient associations. Biomacromolecules 4:922–927
Weimer HE, Moshin JR (1953) Serum glycoprotein concentrations in experimental tuberculosis of guinea pigs. Am Rev Tubercul Pulmonol 68:594–602
Williams SJ, Wreschner DH, Tran M, Eyre HJ, Sutherland GR, McGuckin MA (2001) Muc13, a novel human cell surface mucin expressed by epithelial and hemopoietic cells. J Biol Chem 276:18327–18336
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N’Dow, J., Pearson, J. & Neal, D. Mucus production after transposition of intestinal segments into the urinary tract. World J Urol 22, 178–185 (2004). https://doi.org/10.1007/s00345-004-0436-6
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DOI: https://doi.org/10.1007/s00345-004-0436-6