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<p class="publishdate"><span property="dc:date" datatype="xsd:dateTime" content="2020-10-27T00:00:00-04:00" class="date-display-single">October 27, 2020</span></p><div class='syndicate'><h1>How your body senses the urge to urinate</h1><div class="callout callout-with-border"><h3>At a Glance</h3>
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<ul>
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<li>Researchers discovered a gene that may be responsible for the powerful urge to urinate that we normally feel many times throughout the day.</li>
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<li>These findings expand the growing list of newly discovered senses under the gene’s control.</li>
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</ul></div><div class="media-float-right"><div class="ds-1col file file-image file-image-jpeg view-mode-floated_media clearfix">
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<picture title="Microscope image of mouse bladder">
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<!--[if IE 9]><video style="display: none;"><![endif]-->
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-large/public/news-events/research-matters/2020/20201027-urinary.jpg?itok=JSFfxh7c&timestamp=1603800974 1x" media="screen and (min-width: 960px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2020/20201027-urinary.jpg?itok=cufyRMPw&timestamp=1603800974 1x" media="screen and (min-width: 800px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium-small/public/news-events/research-matters/2020/20201027-urinary.jpg?itok=ntFm2Qex&timestamp=1603800974 1x" media="screen and (min-width: 600px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-small/public/news-events/research-matters/2020/20201027-urinary.jpg?itok=jfx7ag4Q&timestamp=1603800974 1x" media="screen and (min-width: 480px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-tiny/public/news-events/research-matters/2020/20201027-urinary.jpg?itok=JfiBDssG&timestamp=1603800974 1x" media="screen and (min-width: 0)" />
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<img src="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2020/20201027-urinary.jpg?itok=cufyRMPw&timestamp=1603800974" alt="Microscope image of mouse bladder" title="Microscope image of mouse bladder" />
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</picture><span class="caption">Researchers discovered a protein that may help us sense when our bladders are full. Above is an example of a mouse bladder used in the study. </span><span class="credit">Patapoutian lab, Scripps Researcher Institute</span></div>
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</div><p>How often you need to urinate depends on how quickly your kidneys produce the urine that fills the bladder. It also depends on how much urine your bladder can comfortably hold. Over time, your bladder fills up and expands like a balloon, putting tension on the bladder muscles. At a certain point, the body senses that it is reaching a limit, which triggers the urge to urinate.</p>
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<p>But how your body senses a full bladder isn’t known. Certain proteins can be activated by cells being stretched or squeezed. One gene, called <em>PIEZO2</em>, holds the instructions to make such proteins. PIEZO2 has been shown to play a role in sensing mechanical stimulation, including touch, vibration, pain, and proprioception (the awareness of one’s body in space).</p>
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||
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<p>To investigate whether PIEZO2 also helps the body sense a full bladder, a research team led by Dr. Ardem Patapoutian at the Scripps Research Institute, Dr. Alex Chesler at NIH’s National Center for Complementary and Integrative Health (NCCIH), and Dr. Carsten Bönnemann at NIH’s National Institute of Neurological Disorders and Stroke (NINDS) studied how mutations in <em>PIEZO2</em> affect people and mice. Results were published on October 14, 2020 in <em>Nature</em>.</p>
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||
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||
<p>The researchers examined 12 patients at the NIH Clinical Center, ages 5 to 43 years, who were born with inactivating mutations in their <em>PIEZO2</em> genes. The team reviewed medical records, performed ultrasound scans, administered questionnaires, and conducted detailed interviews with the patients and their families.</p>
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||
<p>Most patients reported problems with urination. Nearly all could go an entire day without feeling the urge to urinate. Most urinated less than the normal five to six times per day. Seven said they found it difficult to urinate. They either had to wait for it to happen or needed to press their lower abdomen for it to start.</p>
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||
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||
<p>The researchers also studied <em>PIEZO2</em> in the cells involved in bladder control in mice: dorsal root ganglion (DRG) neurons, which send nerve signals from the mouse bladder to the brain, and “umbrella” cells that line the inside of the bladder.</p>
|
||
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||
<p>Genetically removing <em>PIEZO2</em> from either the neurons or the umbrella cells reduced the cells’ response to the bladder filling. It also caused the mice to have urination problems. Mice with the genetically altered cells required more fluid and greater pressure in the bladder to trigger urination. This phenomenon was similar to the patient reports. Mice with the mutated gene also had thicker bladder muscles than the controls, suggesting that the loss of sensation altered the bladder over time.</p>
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||
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<p>“Our results show how the <em>PIEZO2</em> gene tightly coordinates urination,” Chesler says. “This is a major advance in our understanding of interoception—or the sense of what’s going inside our bodies.”</p>
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<p>“Urination is essential for our health. It’s one of the primary ways our bodies dispose of waste,” Patapoutian adds. “We hope that these results provide a more detailed understanding of how urination works under healthy and disease conditions.”</p></div><h2 class="label-above">Related Links</h2><ul class="spaced print-urls"><li><a href="https://www.nih.gov/news-events/nih-research-matters/how-gentle-touch-can-turn-painful-after-injury" target="_top">How Gentle Touch Can Turn Painful After Injury</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/rare-disorder-reveals-insights-into-touch-body-awareness" target="_top">Rare Disorder Reveals Insights into Touch and Body Awareness</a></li><li><a href="https://www.nih.gov/news-events/nih-research-matters/discriminating-touch" target="_top">Discriminating Touch</a></li><li><a href="http://www.niddk.nih.gov/health-information/urologic-diseases/urinary-tract-how-it-works" target="_top">The Urinary Tract & How It Works</a></li></ul><p class="footnote"><strong class="label-inline">References: </strong><a href="https://pubmed.ncbi.nlm.nih.gov/33057202/">PIEZO2 in sensory neurons and urothelial cells coordinates urination</a>. Marshall KL, Saade D, Ghitani N, Coombs AM, Szczot M, Keller J, Ogata T, Daou I, Stowers LT, Bönnemann CG, Chesler AT, Patapoutian A. <em>Nature</em>. 2020 Oct 14. doi: 10.1038/s41586-020-2830-7. Online ahead of print. PMID: 33057202.</p><p class="footnote"><strong class="label-inline">Funding: </strong>NIH’s National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and National Center for Complementary and Integrative Health (NCCIH); Howard Hughes Medical Institute.</p>
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<div about="/block/research-matters---popular-stori" class="ds-1col entity entity-bean bean-research-matters-block view-mode-default clearfix">
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<p><a href="https://www.nih.gov/news-events/nih-research-matters/research-context-can-we-slow-aging">Research in Context: Can we slow aging?</a></p>
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<p><a href="https://www.nih.gov/news-events/nih-research-matters/brain-changes-observed-during-pregnancy">Brain changes observed during pregnancy</a></p>
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<p><a href="https://www.nih.gov/news-events/nih-research-matters/research-context-detecting-cancer">Research in Context: Detecting cancer</a></p>
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<p><a href="https://www.nih.gov/news-events/nih-research-matters/risk-future-burden-dementia-united-states">Risk and future burden of dementia in the United States </a></p>
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||
|
||
<p><a href="https://www.nih.gov/news-events/nih-research-matters/complete-wiring-map-adult-fruit-fly-brain">Complete wiring map of an adult fruit fly brain</a></p>
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<h3 class="block__title">About NIH Research Matters</h3>
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<p><strong>Editor:</strong> Harrison Wein, Ph.D.</p>
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<p><strong>Assistant Editors:</strong> Vicki Contie and Brian Doctrow, Ph.D.</p>
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<p><strong><em>NIH Research Matters </em></strong>is a weekly update of NIH research highlights reviewed by NIH’s experts. It's published by the <a href="/institutes-nih/nih-office-director/office-communications-public-liaison">Office of Communications and Public Liaison</a> in the <a href="/institutes-nih/nih-office-director">NIH Office of the Director</a>.</p>
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<p>ISSN 2375-9593</p>
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