# Inflammasome Mediated Inflammation in Diabetic Bladder Dysfunction

> **NIH NIH R01** · DUKE UNIVERSITY · 2022 · $362,250

## Abstract

Diabetic bladder dysfunction (DBD) is one of the most prevalent complications that affect diabetic
patients, causing a constellation of symptoms and significantly impacting quality of life. Currently, there are no
specific treatments for patients who suffer from this complication. In the early stages of the disease, patients
typically complain of having to urinate frequently and they often have difficulty sensing when their bladders are
full. Over time, the bladder deteriorates with scarring and diminished neurological control leading to a
decompensated bladder. In this late stage, incontinence develops and the dysfunction of the lower urinary
tract can negatively affect the upper tracts to cause kidney failure. Based upon studies of diabetic changes in
the eye, kidney, heart, and nerves, we now understand that diabetes causes tissue damage by initiating an
inflammatory process in the target organs. Further, this inflammation is mediated by a supramolecular
structure in cells, called the NLRP3 inflammasome, which detects the metabolic dysregulation caused by
diabetes and responds by activating the immune system. Our laboratory was the first to localize NLRP3 to the
urothelium in the bladder and characterize its role in sterile inflammation in other benign urological pathologies
including chemical and obstructive disease models.
 In this proposal, we test the hypothesis that NLPR3-mediated inflammation is a critical pathway
in the emergence and development of DBD.
 Preliminary data from our genetic diabetic mouse model support our hypothesis by showing that
diabetic animals lacking the NLRP3 gene do not develop DBD. Our first aim will explore how DBD starts and
progresses in diabetic animals that have a functioning NLRP3 versus diabetic NLRP3 knock out animals that
do not. If our predictions are correct that lacking NLRP3 prevents, delays or diminishes bladder deterioration
over time, that would suggest pharmacological inhibition of this target would benefit patients suffering from this
complication. In our second aim, we will apply our approach to the clinical scenario of managing DBD in
patients who are actively trying to manage their diabetes with blood glucose control. We will define what
benefit could be derived by inhibiting NLRP3 in patients who have difficulty achieving good control of their
blood sugars. Considering that a substantial percentage of diabetic patients have difficulty maintaining strict
glycemic control, the addition of a useful adjunct therapy to prevent complications could be of tremendous
benefit. Currently there is considerable development of NLRP3 inhibitors within the pharmaceutical industry
and so, if we can demonstrate their potential usefulness in the treatment of DBD, a number of new compounds
will soon be available for clinical testing. Therefore, translating our results to a clinically useful therapy will be
rapid.

## Key facts

- **NIH application ID:** 10352408
- **Project number:** 5R01DK117890-04
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** J. Todd Purves
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $362,250
- **Award type:** 5
- **Project period:** 2019-04-15 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10352408

## Citation

> US National Institutes of Health, RePORTER application 10352408, Inflammasome Mediated Inflammation in Diabetic Bladder Dysfunction (5R01DK117890-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10352408. Licensed CC0.

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