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EFFECT
OF HYDROGEN PEROXIDE ON RABBIT URINARY BLADDER CITRATE SYNTHASE ACTIVITY
IN THE PRESENCE AND ABSENCE OF A GRAPE SUSPENSION
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VIJAY VENUGOPAL,
ROBERT E. LEGGETT, CATHERINE SCHULER, ROBERT M. LEVIN
Albany College
of Pharmacy and Health Sciences (VV, REL, CS, RML), Albany, New York,
USA, Stratton VA Medical Center (RML), Albany, NY and Albany Medical College
(CS, RML), Albany, New York, USA
Basic and
Translational Urology
Vol. 36 (6):
749-758, November - December, 2010
doi: 10.1590/S1677-55382010000600014
ABSTRACT
Purpose:
The etiology of obstructive bladder dysfunction includes free radical
damage to mitochondria. Feeding rabbits a standardized grape suspension
protects the ability of the bladder to contract and empty in part by preventing
mitochondrial damage, thus maintaining smooth muscle and mucosal metabolism.
The objective of the current study is to determine the direct effect of
this grape suspension on the response of mitochondria to the oxidative
effects of hydrogen peroxide.
Materials
and Methods: Six male rabbits were anesthetized with sodium pentobarbital
and the bladders excised. Four full thickness strips were obtained for
contractile studies and the balance separated into smooth muscle and mucosa
compartments by blunt dissection. The effect of hydrogen peroxide on the
contractile response to field stimulation was quantitated. Each tissue
was homogenized and the effects of increasing concentrations of hydrogen
peroxide in the presence and absence of grape suspension on citrate synthase
activity was determined.
Results:
Citrate synthase activity was significantly higher in the mucosa than
in the muscle. The grape suspension had no effect on control citrate synthase
activity. However, the grape suspension provided significant protection
of both smooth muscle and mucosal citrate synthase activity.
Conclusions:
These studies support the conclusion that the grape suspension provides
direct protection of mitochondrial function.
Key
words: urinary bladder; voiding dysfunction; antioxidants; oxidation
Int Braz J Urol. 2010; 36: 749-58
INTRODUCTION
Partial
outlet obstruction secondary to BPH (benign prostatic hyperplasia) is
a common affliction of aging men (1,2). Recent evidence has demonstrated
that ischemia followed by reperfusion are major etiological factors in
obstructive bladder dysfunction (3,4). Specifically, blood flow to the
bladder’s smooth muscle and mucosa decrease with obstructive dysfunction
resulting in tissue hypoxia, increased free radical generation, decreased
contraction, denervation, and mitochondrial dysfunction (5-7).
Hydrogen
peroxide is a common oxygen radical capable of causing significant cellular
damage even at low concentrations (8,9). The oxygen radical can ultimately
cause oxidative stress, resulting in significant cellular and intracellular
damage and necrosis (10-12). In the body, superoxide dismutase catalyses
the formation of oxygen and hydrogen peroxide; the enzyme catalase is
then responsible for reacting with the hydrogen peroxide (H2O2) species,
to ultimately form water and oxygen. Partial outlet obstruction and in
vivo models of ischemia have marked deleterious effects on superoxide
dismutase and catalase, and as stated above have also been demonstrated
to produce significant oxidative damage (10,12-14). A variety of antioxidants
and natural products that show significant antioxidant properties have
been shown to protect the rabbit urinary bladder from contractile, cellular,
and subcellular damage and dysfunction mediated by both partial outlet
obstruction, and bilateral ischemia / reperfusion (15-20). One of the
most potent of these agents has been shown to be a grape suspension made
from whole grapes (13,21,22). Grapes are known to have very significant
antioxidant and membrane protective properties; characteristics which
can ultimately reduce the levels of generated free radicals and oxidative
damage (23). In a series of published articles, we have clearly demonstrated
that in-vivo oral administration of a standardized grape suspension protected
the bladder from both obstructive and ischemic damage (13,21,22). The
antioxidants bind to free radicals, thus rendering them harmless.
From
our studies on partial outlet obstruction and bilateral ischemia, we have
shown that mitochondria are one of the most sensitive sub-cellular organelles
to develop oxidative stress and free radical damage (3,4,24-27). We use
citrate synthase as a marker enzyme for mitochondrial function (28,29).
Citrate synthase is an enzyme found in virtually all living cells, and
plays an important role in the first step of the Krebs, or Citric Acid
Cycle (30-32). It is synthesized by the cytoplasm ribosomes and housed
in the mitochondrial matrix (31,32). Its key role in the Krebs cycle is
catalysis of the condensation reaction with acetyl coenzyme A (Acetyl-CoA)
and oxaloacetate. This reaction involves the conversion of Acetyl-CoA,
the thioester between coenzyme A (CoA) and acetic acid (AcOH), and oxaloacetate,
the conjugate base of oxaloacetic acid, into citrate via an aldol condensation
reaction. The reaction produces CoA along with citrate, both of which
are used extensively within the cycle (31,32).
We
hypothesized that the mitochondrial citrate synthase activity of bladder
tissue would decrease proportionally when exposed to increasing concentrations
of hydrogen peroxide, and that pre-treating the preparation with a grape
suspension would reduce the level of damage caused by the peroxide.
MATERIALS AND METHODS
All
studies were approved by the Institutional Animal Care and Use Committee
of the Stratton VA Medical Center. Six male New Zealand rabbits were anesthetized
with pentobarbital (25 mg/kg) and the bladder exposed through a midline
incision. The bladder was sectioned between body and base at the level
of the ureteral orifices. The bladder was opened longitudinally and 4
full thickness isolated strips were taken (1 x 0.3 mm) and mounted in
individual baths containing oxygenated tyrodes solution (15 mL) at 37C
for contractile studies. Two of the four strips from each bladder were
incubated in the presence of 1 mg/mL grape suspension for 30 minutes;
the other two strips were incubated in the presence of 1 mg/mL sugar composed
of equal parts sucrose and fructose. The balance of the bladder was separated
by blunt dissection into muscle and mucosal compartments and each compartment
frozen in liquid nitrogen and stored at -80C for biochemical evaluation.
Grape Suspension (13,21,22)
A
standardized freeze dried powder was kindly supplied by the California
Table Grape Commission. The grape powder is a composite of whole red,
green and blue-black California grapes, seeded and seedless varieties,
in a freeze-dried powder form. It was created using Good Manufacturing
Practices and precautions to preserve the integrity of the biologically
active compounds found in fresh grapes. As with fresh grapes, the grape
powder is known to contain anthocyanins, catechins, resveratrol, flavonols
(including quercetin), flavans and simple phenolics as well as sugars.
The composition has been published previously (21).
The
control for the grape suspension is a sugar suspension made of equal parts
sucrose and fructose, which gives the same carbohydrate content.
Contractile Studies
(33)
Each
isolated strip was allowed to equilibrate for 30 minutes. Passive tension
(2g) was placed on each strip and equilibrated for an additional 30 minutes.
Preliminary studies demonstrated that at 2g passive tension, maximal active
tension is generated. Each strip was then stimulated by field stimulation
(FS) at 32 Hz, 1 ms. 80V which gives a maximal contractile response. We
start out with a stock solution of 25% H2O2. For the contractile studies,
each isolated bath has 15 mL of Tyrode’s solution. We do an initial
stimulation using field stimulation (32 Hz, 80V, 1 ms duration, 20 second
train) monitoring the maximal contraction. The stock H2O2 solution was
incubated for 30 minutes in a closed dark bottle at 37C. For the lowest
H2O2 concentration, 0.025% we take out 15µL from the bath and add
15µL of 25% H2O2. Thus, the final concentration in the bath is 0.025%
H2O2. We wait 10 minutes and then do a second stimulation. Similarly,
we then take out an additional 15µL from the bath and place 15µL
of the 25% H2O2 in order to get 0.05% H2O2 final concentration. We wait
10 minutes and then stimulate again. Similar operations give us the 0.1
and 0.2% H2O2. Dilution of the baths by these small volumes of H2O2 do
not significantly change the chemical composition of the Tyrode’s
solution. In this way, each bath receives a complete dose-response to
H2O2.
Citrate Synthase Studies
(28)
Samples
of muscle and mucosa are homogenized in 0.05M Tris buffer (200 mg/mL).
Sample aliquots (100 µL) are added to ten 0.5 cm cuvettes, along
with 1.0 mL 0.05M Tris buffer (pH 7.6), 100 µL 12.3 mM acetyl-coenzyme
A, 100 µL 1 mM 5.5’- dithiobis-2-nitrobenzoic acid (DTNB),
and 100 µL 10% Triton X-100. 10 mg/mL grape powder is added to cuvettes
1-5; 10 mg/mL sucrose-fructose is added to cuvettes 6-10 and the cuvettes
incubated at 37C for 30 minutes. The final volume in each cuvette is 1400
mL excluding the 50 µL oxaloacetate (10 mM - substrate) used to
start the reaction. The stock H2O2 solution is incubated at 37C for 30
minutes in a dark closed bottle before the experiment began. Before the
oxaloacetate is added, 1.4 µL of the mixtures in cuvettes 1 and
6 are removed and 1.4 µL of water added. Similarly, for cuvettes
2 and 7 1.4 µL of the mixtures are removed and 1.4 µL of 25%
H2O2 are added (H2O2 final concentration - 0.025%). Similarly, cuvettes
3 and 8 are made to contain 0.05% H2O2; cuvettes 4 and 9 are made to contain
0.1%; and cuvettes 5 and 10 contain 0.2% H2O2. After 10 minute incubations,
the oxaloacetate is added and the free coenzyme-A generated by citrate
synthase activity reacts with DTNB to form a colored compound that is
quantified at 412 nm. Absorbance is recorded every 30 sec for 6 min (reaching
steady state), using a Hitachi spectrophotometer.
CUPRAC Assay for Total
Antioxidants (34,35)
The
CUPRAC assay was utilized to determine the total antioxidant capacity
of the homogenates of bladder smooth muscle and mucosa. This assay relies
on the electron donating capabilities of antioxidants to reduce the copper
ion. The CUPRAC working solution consisted of 10 mM copper (II) chloride
dihydrate, 1 M ammonium acetate, and 7.5 mM neocuproine. 0.15 mL of the
above three solutions were added to 0.15 mL of each sample and allowed
to react for 30 minutes at room temperature, after which the absorbance
was read at 450 nm in a Hitachi U-2001 spectrophotometer. The standard
curve utilized in this assay was ascorbic acid with the following concentrations:
1000, 500, 250, 125, 62.5, 31.25 and 0µM.
BCA Protein Assay (Pierce)
against a BSA protein standard
The
final activity is given as activity per mg protein. This assay is performed
on each of the tissues (muscle and mucosa) from each of the 6 individual
rabbits.
Statistical Analyses
Statistical
analysis used analysis of variance followed by the Tukey test for individual
differences among individual groups; p < 0.05 required for statistical
significance.
RESULTS
Contraction
and muscle citrate synthase activity have similar sensitivities to H2O2
except at the two highest concentrations where there was a small but statistically
significant difference (Figure-1).

The
activity of the citrate synthase is significantly higher in the mucosa
than the muscle. The grape suspension had no effect on the activity of
control muscle or mucosa (Figure-2). In order to visualize the comparison
of the sensitivities of the muscle and mucosal preparations to H2O2, the
citrate synthase activity in the absence of H2O2 has been normalized to
100% (Figure 3A and B). In the absence of the grape suspension, the citrate
synthase activity of the mucosa was significantly more sensitive to H2O2
than was the muscle. For the mucosa, the citrate synthase activity of
the mucosa was protected at all concentrations of H2O2, (Figure-3A). For
the muscle, the lowest concentration of H2O2 had no effect on citrate
synthase activity in the presence or absence of the grape suspension;
the citrate synthase activity of the muscle was protected by the grape
suspension at 0.05; 0.1; and 0.2 % H2O2 (Figure-3B).


Figure-4
shows the total antioxidant activities of the muscle and mucosal homogenates.
The mucosa has a significantly greater antioxidant activity than the muscle.

COMMENTS
These
current studies confirmed that the citrate synthase activity of the mucosal
tissue is significantly higher than the activity of the mucosa. Because
the citrate synthase activity directly corresponds to the level of oxidative
phosphorylation and ATP generation, one can conclude that the level of
oxidative phosphorylation and rate of ATP generation is also significantly
higher in the mucosal tissue than in the muscle; which supports previously
published data (36,37).
The
control bladder muscle and mucosa citrate synthase activity were not affected
by the grape suspension. In the absence of the grape suspension, the mucosa
was significantly more sensitive to the H2O2 than was the muscle; whereas
the contractile response of isolated strips of bladder had a very similar
sensitivity to H2O2 as the smooth muscle homogenates. The grape suspension
was very protective of the citrate synthase activity of both muscle and
mucosa against damage by H2O2.
The
citrate synthase activity in the presence of the grape suspension was
significantly greater than the activity in the absence of the suspension
at all concentrations. Interestingly, although the effect of peroxide
in the absence of the grape suspension was significantly greater on the
mucosal enzyme activity, the effect of peroxide in the presence of the
grape suspension was virtually identical for both muscle and mucosal tissues.
This difference in sensitivity to H2O2 in the absence of the grape suspension
between muscle and mucosa led us to believe that there was a specific
difference between the supernatants of the mucosa and muscle. One obvious
possibility is that the mucosa has a higher catalase activity than the
muscle which would then make the hydrogen peroxide less effective in the
muscle. However, prior studies on superoxide dismutase and catalase activities
of the rabbit bladder muscle and mucosa demonstrated that in fact the
mucosa had a significantly higher catalase activity than the muscle (13,38).
Using
the CUPRAC method of total antioxidant capacity, the mucosal homogenates
have a significantly higher antioxidant activity than homogenates of bladder
smooth muscle which does not support the hypothesis that the smooth muscle
preparations have a higher antioxidant activity than the mucosa.
We believe that it is the combination of antioxidants found in the grape
suspension rather than an individual component that work in synergy to
produce the protective effect. With other natural products, we have separated
them into their individual components and found that none of the individual
components worked as well as the parent product.
CONCLUSION
These
data demonstrate that direct incubation of a crude mitochondrial preparation
of both rabbit bladder smooth muscle and mucosa with a standardized grape
suspension significantly protects the integrity of citrate synthase activity.
These results are entirely consistent with the in vivo studies on the
protective effects of this same grape suspension on the functional damage
mediated by partial outlet obstruction and in vivo bilateral ischemia
(13,21,22).
ACKNOWLEDGEMENTS
This
material is based upon work supported in part by the Office of Research
and Development Medical Research Service, Department of Veteran’s
Affairs, and in part by the Capital Region Medical Research Foundation.
The
California Table Grape Commission supplied us with the freeze-dried whole
grape powder used in these experiments.
CONFLICT OF INTEREST
None
declared.
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____________________
Accepted after revision:
May 26, 2010
_______________________
Correspondence address:
Dr. Robert M. Levin
Albany College of Pharmacy & Health Sciences
106 New Scotland Ave
Albany, NY, 12208, USA
Fax: + 1 518 694-7248
E-mail: robert.levin@acphs.edu
EDITORIAL
COMMENT
Protective
effects of grape extracts have been widely developed and already in 2003,
Helen Kolettis published a paper entitled “The Goodness of Grapes”.
Grape extracts may be beneficial to prevent
cardiovascular diseases, hepatotoxicity and to protect urinary bladder
function and from chronic degenerative diseases.
Active components of grape extracts include
polyphenols, anthocyanins, flavonoids which are present in grape seed,
grape skin and grape juice.
Interest in natural phytotherapic produces increases from many years due
to their expected efficacy, to organoleptic factors and to the great compliance
of consumers for that treatment because most of them believe that herbal
medicines are safe because they are natural. The number of scientific
articles dealing with herbal medicine has increased from almost zero in
1990 to over 15,000 in 2007.
Originality of this study is to give insights on the direct protection
of mitochondrial function after treatment with a grape suspension, because
this study is a complement to a previous paper on the in vivo effects
of grape suspension on bladder function of rabbit.
Studies of the effect of each component
of the grape extract could be more informative although the authors think
that a combination of antioxidants works in synergy. That question has
been already widely evoked for studies of the effects of on bladder function
following intake of Pygeum africanum extracts (Tadenan), Serona repens
(Permixon) or Saw Palmetto.
Dr.
Françoise A. Valentini
Dept of Physical Medicine and Rehabilitation
Hôpital Rothschild
Université Pierre et Marie Curie
Paris, France
E-mail: favalentini@gmail.com
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