Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Animal Models

Weight loss surgery improves the metabolic status in an obese rat model but does not affect bladder fibrosis associated with high fat diet feeding

Abstract

Background:

Bladder dysfunction has one of the highest prevalences as a comorbidity of obesity in industrialized countries. The aetiopathogenesis of obesity-associated bladder dysfunction is still obscure, but there is growing evidence that general metabolic changes in obese patients may be in part responsible. As demonstrated recently, high fat diet (HFD) significantly alters the protein expression in the urinary bladder, activates multiple signalling pathways associated with cell survival and inflammation and ultimately provokes bladder fibrosis in an obese rat model. The study aimed to elucidate the role of matrix metalloproteases (MMPs) and their specific tissue inhibitors of metalloproteases (TIMPs) in obesity-related bladder extracellular matrix (ECM) remodelling and the effect of weight loss surgery via sleeve gastrectomy (SG) on phenotype and molecular parameters.

Methods:

Twenty-four male Sprague–Dawley rats were used for (i) characterization of the HFD phenotype and (ii) evaluation of alterations following SG. Metabolic status, the degree of bladder fibrosis and tissue expression and activity of MMP2, MMP9, MMP14, TIMP1 and TIMP2 were analysed by immunohistochemistry, enzyme-linked immunosorbent assay and activity assays. Statistical differences were calculated by analysis of variance or independent Student’s t-test. A P-value <0.05 was considered statistically significant.

Results:

In HFD rats, we found significant alterations in lipid metabolism, fat mass, free fatty acid profile, insulin resistance and inflammatory markers. Voided volume was significantly decreased, and bladder showed marked fibrosis. MMPs and TIMPs were differentially regulated depending on animal status (controls, chow diet, HFD, and SG- and sham-operated animals) in both urothelium and detrusor smooth muscle. Although animal weight and most metabolic parameters were positively affected by SG, bladder fibrosis persisted. The limitations of this study were 1 month follow-up and lack of direct measurement of bladder function.

Conclusions:

Early diagnosis of the bladder dysfunction associated with obesity is essential to allow targeted early intervention, that is, before manifestation of potentially irreversible ECM fibrotic alterations.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Noria SF, Grantcharov T . Biological effects of bariatric surgery on obesity-related comorbidities. Can J Surg 2013; 56: 47–57.

    Article  Google Scholar 

  2. Micha R, Michas G, Lajous M, Mozaffarian D . Processing of meats and cardiovascular risk: time to focus on preservatives. BMC Med 2013; 11: 136.

    Article  CAS  Google Scholar 

  3. Pi-Sunyer X . The medical risks of obesity. Postgrad Med 2009; 121: 21–33.

    Article  Google Scholar 

  4. Hammarsten J, Peeker R . Urological aspects of the metabolic syndrome. Nat Rev Urol 2011; 8: 483–494.

    Article  CAS  Google Scholar 

  5. Kluth LA, Xylinas E, Crivelli JJ, Passoni N, Comploj E, Pycha A et al. Obesity is associated with worse outcomes in patients with T1 high grade urothelial carcinoma of the bladder. J Urol 2013; 190: 480–486.

    Article  Google Scholar 

  6. Liatsikos E, Muhlstadt S, Kallidonis P, Rabenalt R, Do M, Burchardt M et al. Performance and functional outcome of endoscopic extraperitoneal radical prostatectomy in relation to obesity: an assessment of 500 patients. BJU Int 2008; 102: 718–722.

    Article  Google Scholar 

  7. Uzun H, Zorba OU . Metabolic syndrome in female patients with overactive bladder. Urology 2012; 79: 72–75.

    Article  Google Scholar 

  8. Semins MJ, Shore AD, Makary MA, Weiner J, Matlaga BR . The impact of obesity on urinary tract infection risk. Urology 2012; 79: 266–269.

    Article  Google Scholar 

  9. Oberbach A, Jehmlich N, Schlichting N, Heinrich M, Lehmann S, Wirth H et al. molecular fingerprint of high fat diet induced urinary bladder metabolic dysfunction in a rat model. PLoS One 2013; 8: e66636.

    Article  CAS  Google Scholar 

  10. Oberbach A, Schlichting N, Bluher M, Kovacs P, Till H, Stolzenburg JU et al. Palmitate induced IL-6 and MCP-1 expression in human bladder smooth muscle cells provides a link between diabetes and urinary tract infections. PLoS One 2010; 5: e10882.

    Article  Google Scholar 

  11. Oberbach A, Schlichting N, Heinrich M, Till H, Stolzenburg J-U, Neuhaus J . Free fatty acid palmitate impairs the vitality and function of cultured human bladder smooth muscle cells. PLoS One 2012; 7: e41026.

    Article  CAS  Google Scholar 

  12. Deveaud CM, Macarak EJ, Kucich U, Ewalt DH, Abrams WR, Howard PS . Molecular analysis of collagens in bladder fibrosis. J Urol 1998; 160: 1518–1527.

    Article  CAS  Google Scholar 

  13. Jackson BC, Nebert DW, Vasiliou V . Update of human and mouse matrix metalloproteinase families. Hum Genom 2010; 4: 194–201.

    CAS  Google Scholar 

  14. Mannello F, Luchetti F, Falcieri E, Papa S . Multiple roles of matrix metalloproteinases during apoptosis. Apoptosis 2005; 10: 19–24.

    Article  CAS  Google Scholar 

  15. Lijnen HR, Maquoi E, Holvoet P, Mertens A, Lupu F, Morange P et al. Adipose tissue expression of gelatinases in mouse models of obesity. Thromb Haemost 2001; 85: 1111–1116.

    Article  CAS  Google Scholar 

  16. Maquoi E, Munaut C, Colige A, Collen D, Lijnen HR . Modulation of adipose tissue expression of murine matrix metalloproteinases and their tissue inhibitors with obesity. Diabetes 2002; 51: 1093–1101.

    Article  CAS  Google Scholar 

  17. Catalan V, Gomez-Ambrosi J, Rodriguez A, Ramirez B, Silva C, Rotellar F et al. Increased adipose tissue expression of lipocalin-2 in obesity is related to inflammation and matrix metalloproteinase-2 and metalloproteinase-9 activities in humans. J Mol Med (Berl) 2009; 87: 803–813.

    Article  CAS  Google Scholar 

  18. Derosa G, Ferrari I, D'Angelo A, Tinelli C, Salvadeo SA, Ciccarelli L et al. Matrix metalloproteinase-2 and -9 levels in obese patients. Endothelium 2008; 15: 219–224.

    Article  CAS  Google Scholar 

  19. Peters CA, Freeman MR, Fernandez CA, Shepard J, Wiederschain DG, Moses MA . Dysregulated proteolytic balance as the basis of excess extracellular matrix in fibrotic disease. Am J Physiol 1997; 272: R1960–R1965.

    Article  CAS  Google Scholar 

  20. Goldsmith EC, Bradshaw AD, Spinale FG . Cellular mechanisms of tissue fibrosis. 2. Contributory pathways leading to myocardial fibrosis: moving beyond collagen expression. Am J Physiol Cell Physiol 2013; 304: C393–C402.

    Article  CAS  Google Scholar 

  21. Spinale FG, Janicki JS, Zile MR . Membrane-associated matrix proteolysis and heart failure. Circ Res 2013; 112: 195–208.

    Article  CAS  Google Scholar 

  22. Radisky DC, Kenny PA, Bissell MJ . Fibrosis and cancer: do myofibroblasts come also from epithelial cells via EMT? J Cell Biochem 2007; 101: 830–839.

    Article  CAS  Google Scholar 

  23. Tan TK, Zheng G, Hsu TT, Lee SR, Zhang J, Zhao Y et al. Matrix metalloproteinase-9 of tubular and macrophage origin contributes to the pathogenesis of renal fibrosis via macrophage recruitment through osteopontin cleavage. Lab Invest 2013; 93: 434–449.

    Article  CAS  Google Scholar 

  24. Mannello F, Raffetto JD . Matrix metalloproteinase activity and glycosaminoglycans in chronic venous disease: the linkage among cell biology, pathology and translational research. Am J Transl Res 2011; 3: 149–158.

    CAS  PubMed  Google Scholar 

  25. Hopps E, Caimi G . Matrix metalloproteinases in metabolic syndrome. Eur J Intern Med 2012; 23: 99–104.

    Article  CAS  Google Scholar 

  26. Divoux A, Tordjman J, Lacasa D, Veyrie N, Hugol D, Aissat A et al. Fibrosis in human adipose tissue: composition, distribution, and link with lipid metabolism and fat mass loss. Diabetes 2010; 59: 2817–2825.

    Article  CAS  Google Scholar 

  27. Alqahtani AR, Antonisamy B, Alamri H, Elahmedi M, Zimmerman VA . Laparoscopic sleeve gastrectomy in 108 obese children and adolescents aged 5 to 21 years. Ann Surg 2012; 256: 266–273.

    Article  Google Scholar 

  28. Chambers AP, Stefater MA, Wilson-Perez HE, Jessen L, Sisley S, Ryan KK et al. Similar effects of roux-en-Y gastric bypass and vertical sleeve gastrectomy on glucose regulation in rats. Physiol Behav 2011; 105: 120–123.

    Article  CAS  Google Scholar 

  29. Cacho J, Sevillano J, de Castro J, Herrera E, Ramos MP . Validation of simple indexes to assess insulin sensitivity during pregnancy in Wistar and Sprague–Dawley rats. Am J Physiol Endocrinol Metab 2008; 295: E1269–E1276.

    Article  CAS  Google Scholar 

  30. Romeis B Mikroskopische Technik. München Wien Baltimore: Urban u. Schwarzenberg 1989.

  31. Rasband WS Image J. US National Institutes of Health: Bethesda, MD, USA. Available at http://rsb.info.nih.gov/ij/ 1997–2006.

  32. Gasbarro G, Lin DL, Vurbic D, Quisno A, Kinley B, Daneshgari F et al. Voiding function in obese and type 2 diabetic female rats. Am J Physiol Renal Physiol 2010; 298: F72–F77.

    Article  CAS  Google Scholar 

  33. Yang L, Liu R, Wang X, He D . Imbalance between matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) contributes to bladder compliance changes in rabbits with partial bladder outlet obstruction (PBOO). BJU Int 2013; 112: E391–E397.

    Article  CAS  Google Scholar 

  34. Rodriguez Faba O, Palou-Redorta J, Fernandez-Gomez JM, Algaba F, Eiro N, Villavicencio H et al. Matrix metalloproteinases and bladder cancer: what is new? ISRN Urol 2012; 2012: 581539.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Szarvas T, vom Dorp F, Ergun S, Rubben H . Matrix metalloproteinases and their clinical relevance in urinary bladder cancer. Nat Rev Urol 2011; 8: 241–254.

    Article  CAS  Google Scholar 

  36. Biga PR, Froehlich JM, Greenlee KJ, Galt NJ, Meyer BM, Christensen DJ . Gelatinases impart susceptibility to high-fat diet-induced obesity in mice. J Nutr Biochem 2013; 24: 1462–1468.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

AO, HT received financial support by Bundesministerium für Bildung und Forschung (BMBF—Integrated Research and Treatment Centre). We thank Mrs Annett Weimann and Mrs Mandy Berndt for their excellent technical assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J Neuhaus.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on International Journal of Obesity website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Oberbach, A., Schlichting, N., Heinrich, M. et al. Weight loss surgery improves the metabolic status in an obese rat model but does not affect bladder fibrosis associated with high fat diet feeding. Int J Obes 38, 1061–1067 (2014). https://doi.org/10.1038/ijo.2013.199

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2013.199

Keywords

Search

Quick links