Biology subjects

Burnett, L.

Publications and source records attributed to Burnett, L..

2 recordsLinked to original sources

bioRxiv2022

Repeated birth injuries lead to pelvic floor muscle dysfunction and impairment in regeneration

ObjectivesChildbirth is a key risk factor for pelvic floor muscle (PFM) injury and dysfunction, and subsequent pelvic floor disorders (PFDs). Multiparity further exacerbates these risks. Using the pre-clinical rat model of simulated birth injury (SBI), we previously identified that an SBI leads to PFM atrophy and fibrosis. We hypothesized that multiple SBIs further overwhelm PFM regenerative capacity, leading to functionally relevant pathological alterations long-term. Study DesignRats underwent SBI and were allowed to recover for 8 weeks to undergo another SBI. Animals were sacrificed at acute, subacute, and long-term time points post-second injury (N=3-6/time point), and pubocaudalis (PCa) was harvested to assess ex vivo muscle function, histomorphological properties and gene expression. ResultsAcutely following the 1st SBI, PCa force was decreased relative to controls. At 4 weeks, PCa force was recovered and remained unchanged at 8 weeks. Similarly, lower PCa force was observed immediately after repeated SBI. In contrast to functional recovery after 1st SBI, PCa force remained lower at 4 weeks post-2nd SBI and continued to be decreased even after 12 weeks after repeated injury. Fiber size was smaller at the long-term time points after 2nd SBI compared to controls and single SBI groups. As opposed to the resolution of centralized nuclei at 8 weeks post-1st SBI, regenerating myofibers persisted even at 12 weeks post-2nd SBI. In contrast to the peak of collagen content at 4 weeks post-1st SBI, this parameter raised progressively over 12 weeks after repeated SBIs. Prolonged inflammatory response, impairment in muscle anabolism, and sustained expression of ECM remodeling genes were observed after repeated SBIs. ConclusionsRepeated birth injuries delay PFM regeneration and impair function in the pre-clinical rat model.

physiology↗

bioRxiv2021

Pro-regenerative Extracellular Matrix Hydrogel Prevents and Mitigates Pathological Alterations of Pelvic Muscles Following Birth Injury

Pelvic floor disorders, which include pelvic organ prolapse, and urinary and fecal incontinence, affect millions of women globally and represent a major public health concern. Pelvic floor muscle (PFM) dysfunction has been identified as one of the leading risk factors for the development of these morbid conditions. Even though childbirth, specifically vaginal delivery, has been long recognized as the most important potentially modifiable risk factor for PFM injury, the precise mechanisms of PFM dysfunction following childbirth remain elusive. In this study we demonstrate that PFMs undergo atrophy and severe fibrosis in parous women with symptomatic pelvic organ prolapse compared to age-matched nulliparous cadaveric donors without history of pelvic floor disorders. These pathological alterations are recapitulated in the pre-clinical rat model of simulated birth injury. The transcriptional signature of PFMs post-injury demonstrates a sustained inflammatory response, impairment in muscle anabolism, and persistent expression of extracellular matrix (ECM) remodeling genes. Next, we evaluated the administration of acellular injectable skeletal muscle extracellular matrix hydrogel for the prevention and mitigation of these pathological alterations. Treatment of PFMs with the biomaterial either at the time of birth injury or 4 weeks post-injury reduced muscle atrophy and mitigated fibrotic degeneration. By evaluating gene expression, we demonstrate that these changes are mainly driven by the hydrogel-induced modulation of the immune response and intramuscular fibrosis, as well as enhancement of the endogenous myogenesis. This work furthers our understanding of PFM birth injury and demonstrates proof-of-concept for a new pragmatic pro-regenerative biomaterial approach for treating injured PFMs.

bioengineering↗