{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:46:41Z","timestamp":1792795601181,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To validate urinary myelin basic protein (uMBP) as a mechanism\u2010based diagnostic and prognostic biomarker for paediatric overactive bladder\u2010dry (OAB\u2010dry) in children with 25\u2010hydroxyvitamin D (25[OH]D) levels of &lt;35\u2009ng\/mL, and to explore whether vitamin D supplementation (VDS) targets a reversible neuromyelination pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      This three\u2010phase study comprised: (i) discovery of candidate biomarkers via urinary proteomics; (ii) diagnostic validation in a cross\u2010sectional cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009216); and (iii) a 12\u2010week multicentre randomised controlled trial (RCT,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009180). Children with OAB\u2010dry and 25(OH)D level of &lt;35\u2009ng\/mL were randomised (1:1) to receive high\u2010dose VDS (2400\u2009IU\/day) plus standard urotherapy (SU) or solifenacin (5\u2009mg\/day) plus SU. The primary outcome was the change in daily voiding frequency. We evaluated the interaction between baseline uMBP\/creatinine ratio (uMBP\/Cr) and treatment response and performed moderated mediation analysis to assess the mechanistic role of uMBP\/Cr reduction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The uMBP\/Cr was significantly elevated in paediatric OAB\u2010dry with vitamin D levels of &lt;35\u2009ng\/mL and showed a strong negative correlation with 25(OH)D levels (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u2009\u22120.69,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). It achieved an area under the curve of 0.80 for diagnosing paediatric OAB with 25(OH)D levels of &lt;35\u2009ng\/mL. In the RCT, VDS\u2009+\u2009SU demonstrated superior efficacy compared to solifenacin\u2009+\u2009SU in reducing voiding frequency (adjusted difference: 2.7\u2009voids\/day,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Importantly, baseline uMBP\/Cr significantly modified the treatment effect: higher baseline levels predicted a greater reduction in symptoms with VDS\u2009+\u2009SU (\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>trend<\/jats:sub>\n                      \u2009&lt;\u20090.001). Furthermore, the reduction in uMBP\/Cr during treatment mediated 35.2% of the therapeutic benefit of VDS on voiding frequency, supporting a treatment mechanism involving myelin restoration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Urinary MBP serves as a predictive biomarker for a distinct \u2018neuro\u2010vulnerable\u2019 paediatric OAB\u2010dry subtype, characterised by 25(OH)D levels of &lt;35\u2009ng\/mL. These findings position uMBP as a potential tool for precision treatment stratification and suggest that paediatric OAB may represent a sentinel sign of underlying neural axis vulnerability associated with low vitamin D status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70228","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T11:51:16Z","timestamp":1773921076000},"page":"1047-1057","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Is urinary myelin basic protein the key to understanding the role of vitamin D supplementation in paediatric overactive bladder\u2010dry? Results from a three\u2010stage clinical investigation"],"prefix":"10.1111","volume":"137","author":[{"given":"Hongsong","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology Children's Hospital of Chongqing Medical University  Chongqing China"},{"name":"Ministry of Education Key Laboratory of Child Development and Disorders  Chongqing China"},{"name":"National Clinical Research Center for Child Health and Disorders  Chongqing China"},{"name":"China International Science and Technology Cooperation Base of Child Development and Critical Disorders  Chongqing China"},{"name":"Chongqing Key Laboratory of Pediatrics  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhicheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology Children's Hospital of Chongqing Medical University  Chongqing China"},{"name":"Ministry of Education Key Laboratory of Child Development and Disorders  Chongqing China"},{"name":"National Clinical Research Center for Child Health and Disorders  Chongqing China"},{"name":"China International Science and Technology Cooperation Base of Child Development and Critical Disorders  Chongqing China"},{"name":"Chongqing Key Laboratory of Pediatrics  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihan","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Urology Children's Hospital of Chongqing Medical University  Chongqing China"},{"name":"Ministry of Education Key Laboratory of Child Development and Disorders  Chongqing China"},{"name":"National Clinical Research Center for Child Health and Disorders  Chongqing China"},{"name":"China International Science and Technology Cooperation Base of Child Development and Critical Disorders  Chongqing China"},{"name":"Chongqing Key Laboratory of Pediatrics  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology Children's Hospital of Chongqing Medical University  Chongqing China"},{"name":"Ministry of Education Key Laboratory of Child Development and Disorders  Chongqing China"},{"name":"National Clinical Research Center for Child Health and Disorders  Chongqing China"},{"name":"China International Science and Technology Cooperation Base of Child Development and Critical Disorders  Chongqing China"},{"name":"Chongqing Key Laboratory of Pediatrics  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology Children's Hospital of Soochow University  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nini","family":"An","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, School of Medicine, Shanghai Children's Medical Center GuiZhou Hospital Shanghai Jiao Tong University  Guiyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Shanghai Children's Hospital Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongcheng","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Children's Hospital, National Center for Children's Health Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0083-561X","authenticated-orcid":false,"given":"Shengde","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology Children's Hospital of Chongqing Medical University  Chongqing China"},{"name":"Ministry of Education Key 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