{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:21:25Z","timestamp":1790014885191,"version":"4.0.1"},"reference-count":33,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2016,5,30]],"date-time":"2016-05-30T00:00:00Z","timestamp":1464566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Chornic spinal cord injury (SCI) will induce bladder urothelium dysfunction. This study investigated the therapeutic effects on urothelial dysfunction after repeated detrusor injections of onabotulinumtoxinA (BoNT-A) in SCI patients with neurogenic detrusor overactivity (NDO). Twenty chronic suprasacral SCI patients with NDO were enrolled. The patients received 300 U BoNT-A injection into the detrusor every six months. The urothelium was assessed by cystoscopic biopsy at baseline and six months after each BoNT-A treatment. Immunofluorescence staining for urothelial dysfunction, including E-cadherin, zonula occludens-1 (ZO-1), tryptase for mast cell activity, and urothelial apoptosis were investigated. The outcome of urothelial dysfunction parameters after BoNT-A injection were compared between baseline and six months after each treatment. Repeated 300 U BoNT-A injections showed a sustained decrease of detrusor pressure compared with baseline. After three repeated BoNT-A detrusor injections, significantly greater distributions of E-cadherin (p = 0.042) and ZO-1 (p = 0.003) expressions, but no significant changes, of urothelial apoptosis and mast cell activation were found after repeated BoNT-A therapy. Urothelial dysfunction, such as adhesive and junction protein concentrations in SCI patients\u2019 bladders, recovered after three repeated cycles of BoNT-A treatment. The therapeutic effects sustained. However, urothelial inflammation and apoptosis after SCI were not significantly improved after three repeated BoNT-A injections.<\/jats:p>","DOI":"10.3390\/toxins8060164","type":"journal-article","created":{"date-parts":[[2016,5,30]],"date-time":"2016-05-30T10:26:58Z","timestamp":1464604018000},"page":"164","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Clinical Efficacy and Changes of Urothelial Dysfunction after Repeated Detrusor Botulinum Toxin A Injections in Chronic Spinal Cord-Injured Bladder"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1761-1185","authenticated-orcid":false,"given":"Sheng-Fu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, 707, Section 3, Chung Yang Road, Hualian 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Hwei","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, 707, Section 3, Chung Yang Road, Hualian 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hann-Chorng","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, 707, Section 3, Chung Yang Road, Hualian 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1159\/000279335","article-title":"Incidence of spinal cord injury worldwide: A systematic review","volume":"34","author":"Castellote","year":"2010","journal-title":"Neuroepidemiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1159\/000019676","article-title":"Quality of life after active urological management of chronic spinal cord injury in eastern Taiwan","volume":"34","author":"Kuo","year":"1998","journal-title":"Eur. 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