Research Overview
SCOR projects will expand basic knowledge about female urethral,
bladder and pelvic floor function; improve understanding of
the natural history of incontinence; and provide information
for the development of novel treatments for female urinary
incontinence. The projects will also integrate laboratory
and clinical research on lower urinary tract function and
incontinence in women. This “bench to bedside”
collaborative research paradigm will facilitate direct translation
of scientific results into improved patient care.
Clinical Research Program
The UCSF SCOR clinical investigators, Drs. Brown, Subak and
Thom, have a long history of externally funded, successful
research projects with the Kaiser Division of Research SCOR
investigator, Dr. Van Den Eeden. Their productive research
collaboration on the epidemiology of lower urinary tract dysfunction
is focused primarily on urinary incontinence and pelvic organ
prolapse
(SCOR Clinical Research Program: Related Projects). To
answer their proposed questions, they assembled an ethnically
diverse, population-representative cohort of over 2100 middle-aged
and older women who are members of the Kaiser Permanente Medical
Care Plan (Kaiser PMCP). These women have been extensively
characterized by abstracting labor and delivery records, surgical
records, and medical records from up to 50 years ago, conducting
detailed in-person interviews, and maintaining voiding diaries
for those with incontinence. Because Kaiser PMCP is a mature,
large, prepaid health organization, participants in this cohort
are linked to numerous electronic clinical databases that
include pharmacy records, laboratory tests, hospital discharge
files, and outpatient summary clinical records. This level
of detailed information on reproductive and other risk factors
for incontinence is unique in the United States. The SCOR
clinical research projects related to this cohort have been
following patients for 5 years and will continue to be followed,
allowing for assessment of risk factors for incident incontinence,
collection of biological specimens (blood and urine).
Basic Research Program
Members of the SCOR basic science team, consisting of Drs.
Lue, Lin, and Tanagho, have collaborated extensively on projects
related to the structure and function of urinary tract organs.
Drs. Lue and Lin have developed a rat model for the study
of female stress urinary incontinence that will be invaluable
to the research efforts of the SCOR. Dr. Tanagho, who has
investigated the neuroanatomy of the bladder and urethra and
the pathophysiology of incontinence for decades, has particular
expertise in tissue engineering and its potential translational
application for reconstructive urologic surgery. Additionally,
the group has acquired the expertise to perform comprehensive
DNA microarray analysis to compare gene expression in continent
and incontinent rats as well as developed sophisticated systems
for urodynamic testing of female rats with voiding dysfunction.
The SCOR project, Urinary Incontinence: Molecular Mechanism
and Matrix-Based Therapy, will build on previous and ongoing
work from the team's laboratories.
SCOR Research Projects
The SCOR encompasses two clinical research projects, one
basic research project, and a biostatistical core:
• Reproductive
Risks of Incontinence Study at Kaiser 2 (RRISK2)
• Diabetes:
Lower Urinary Tract Dysfuntion and Infections
• Urinary
Incontinence: Molecular Mechanism and Matrix-Based Therapy
A Biostatistics
and Data Management Core supports all SCOR
research projects. (RRISK I & RRISK II documents
found here).
SCOR Scientific Integration
A major strength of the UCSF SCOR is the opportunity it provides
for integration and collaboration between epidemiologic investigations
and basic research. There has been very little previous cross-disciplinary
research between epidemiology and basic science in the area
of lower urinary tract function and urinary incontinence in
women. Such collaboration can move the field forward by facilitating
translation of epidemiologic and laboratory research into
clinically important treatment and preventive interventions.
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