# NIMBLE: Non-Invasive Markers of Bladder Deterioration

> **NIH NIH R01** · BOSTON CHILDREN'S HOSPITAL · 2024 · $533,723

## Abstract

Project Abstract
 Neurogenic bladder from congenital myelodysplasia (Spina Bifida) presents lifelong challenges in bladder
management. Even with improved clinical management up to 50% of patients with SB are at increased risk for
development of chronic kidney disease associated with urologic complications of neurogenic bladder. Bladder
management for patients with neurogenic bladder comprises catheterization to promote emptying, medication to
decrease intravesical pressures and inhibit detrusor overactivity, and regular monitoring of bladder function by
urodynamics (UDS). If conservative therapy fails, patients may undergo surgical intervention to enhance capacity
and reduce intravesical pressure to minimize upper tract damage. Regardless, controversy exists over the best
management protocol for the neurogenic bladder. UDS is considered the gold standard for evaluation of lower
urinary tract function and the impetus for intervention. However, UDS is invasive, expensive, subject to
substantial inter-observer variability and not routinely available beyond tertiary care centers. The availability of a
quantitative, non-invasive approach to signal bladder changes that serve as a harbinger of renal deterioration
would advance clinical management of this patient population significantly. Notably, no such markers have been
validated prospectively as independent markers of functional bladder deterioration.
 In preliminary studies, we have identified a panel of urine biomarkers enriched in urine from two models
of neurogenic bladder (human and rodent), but not detected in kidney urine from human patients with
ureteropelvic junction obstruction. This, together with their detection in bladder tissue from rats with neurogenic
bladder strongly suggests that this unique panel reflects pathological bladder wall remodeling as opposed to
renal damage. Based on these observations we hypothesize that our Non-Invasive Markers of Bladder
Deterioration (NIMBLE) represent prognostic markers of deterioration in bladder function in neurogenic
bladder patients. We believe that these markers may also serve as early predictors of upper tract damage in
this population. We will test the hypothesis with the following aims: Aim 1. Determine the association between
bladder-enriched urine biomarkers and functional parameters in a well characterized prospective cohort of
children with neurogenic bladder. Aim 2. Investigate bladder-enriched urine biomarkers, their association with
function and their response to treatment in a longitudinal cohort of children and rodents with neurogenic bladder.
In each aim we will use mass spectrometry-based proteomics to quantify our unique panel in sample cohorts
with neurogenic bladder, determine their association with functional UDS and their response to pharmacological
intervention. We will also profile the remaining urinary proteome to refine the biomarker panel. At the end of the
project we will know the extent to which our NIMBLE panel reflec...

## Key facts

- **NIH application ID:** 10876348
- **Project number:** 5R01DK127673-04
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Rosalyn M Adam
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $533,723
- **Award type:** 5
- **Project period:** 2021-09-06 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10876348

## Citation

> US National Institutes of Health, RePORTER application 10876348, NIMBLE: Non-Invasive Markers of Bladder Deterioration (5R01DK127673-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10876348. Licensed CC0.

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