Dr. John Downie studies the nervous system’s hold on bladder function
Dr. John Downie wants to improve people’s quality of life by examining how the nervous system controls urinary bladder function. His key questions are: “What is the structure in the nervous system that makes the bladder function?” and “Could this system be manipulated to improve or regain lost bladder function?”
A professor in the Department of Pharmacology at Dalhousie Medical School, Dr. Downie is seeking answers by analyzing neurons in the brain. “Ultimately we hope for a better understanding of the nervous system,” he says. “This could lead to the development of drugs to control bladder function.”
This would be welcome news for people who suffer from interstitial cystitis and other painful conditions that cause bladder inflammation and affect bladder function. “Interstitial cystitis causes very frequent urination and extreme pain among other symptoms. Unfortunately, current treatments are only about 50 per cent effective,” says Dr. Downie. “Learning more about what happens to the neurons that control bladder function when the bladder is inflamed is particularly crucial to developing better treatments.”
Dr. Downie’s work to unravel nervous-system control of the bladder has led him to study bladder function following spinal cord injury. “When people have an injury in a specific part of the spinal cord, the bladder stops working,” he notes. “In some cases, proper bladder function is never regained. This can cause kidney problems.”
“We’ve found that, after a spinal cord injury, the bladder starts to work again when bladder-controlling neurons make new working contacts with other neurons,” explains Dr. Downie. “While these new contacts appear normal, the neurons don’t re-establish a connection to the brain so proper bladder control can never be regained.”
He and his colleagues are exploring how the neurons establish new contacts: “We believe it may be possible to reconnect the new spinal circuit to the brain, enabling people to regain proper bladder function.”