Elucidation of inflammatory-fibrotic microenvironment in human urethral stricture disease
6 affiliations
- 1VA San Diego Healthcare System, San Diego, USA
- 2Department of Urology, School of Medicine, UC San Diego, San Diego, USA
- 3Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, Tamil Nadu 600036 India
- 4Department of Urology, Tulane University School of Medicine, New Orleans, USA
- 5Department of Mechanical Engineering and Department of Bioengineering, School of Engineering, UC San Diego, San Diego, USA
- 6Department of Surgery, University of Maryland School of Medicine, Baltimore, USA
Abstract
Urethral stricture disease (USD) is marked by inflammation with subsequent tissue fibrosis that disrupts urinary flow. Recent studies suggest lower urinary tract biome dysbiosis increases proinflammatory cytokines, impeding tissue repair as well as promoting fibrotic scarring of the urethra. Despite these insights, the comprehensive molecular mechanisms underlying the formation, progression, and recurrence of the USD remain unclear. We aim to identify molecular targets and designate pathways contributing to USD, thereby identifying potential targets for future therapeutic interventions. We performed a comprehensive multi-modal analysis in USD patient urine and scar tissues. Urinary cytokines were assayed, transcriptome profiling and pathway enrichment were performed, and network mapping identified fibrotic hubs. Biomechanical tissue stiffness was quantified by atomic force microscopy (AFM), and protein and histological analysis employed both immunostaining and Western blotting. IFN-β, IFN-γ, IL-1β, IL-6, and IL-8.were significantly elevated in USD. Transcriptomic profiling revealed 745 differentially expressed genes, with enrichment in ECM organization, cytokine storm, TGF-β, integrin, IL-17A, WNT/β-catenin. ECM organization and cytokine storm are identified as central interactive hubs, dominated by collagen and fibrogenic regulators such as SMAD3 and TGF-β1. Tissue stiffness increased threefold in USD tissues compared to controls, highlighting ECM remodeling. Immunostaining demonstrated enhanced vimentin, elastin, COL1, and TGF-β expression, along with Western blot studies for observing the trend of elevated protein levels. The integrative approach evaluating pathway enrichment with transcriptome profiling reveals interconnections between mechanisms of inflammation, matrix remodeling, and mechanotransduction driving USD. The findings provide a mechanistic foundation for individualized models and therapeutic targets.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1038/s41598-026-68540-4.
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BibTeX
@article{gopinath2026elucidation,
title = {{Elucidation of inflammatory-fibrotic microenvironment in human urethral stricture disease}},
author = {Varshiny Gopinath and Manesh Kumar Panner Selvam and Jill C. Buckley and Jennifer Anger and Kyoko Sakamoto and Nirav Patel and Ratnesh Lal and Michael Witthaus and Mahadevan Rajasekaran},
journal = {Scientific Reports},
year = {2026},
month = sep,
doi = {10.1038/s41598-026-68540-4},
url = {https://doi.org/10.1038/s41598-026-68540-4},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Elucidation of inflammatory-fibrotic microenvironment in human urethral stricture disease
AU - Varshiny Gopinath
AU - Manesh Kumar Panner Selvam
AU - Jill C. Buckley
AU - Jennifer Anger
AU - Kyoko Sakamoto
AU - Nirav Patel
AU - Ratnesh Lal
AU - Michael Witthaus
AU - Mahadevan Rajasekaran
PY - 2026
DA - 2026/09/01
JO - Scientific Reports
DO - 10.1038/s41598-026-68540-4
UR - https://doi.org/10.1038/s41598-026-68540-4
AB - Urethral stricture disease (USD) is marked by inflammation with subsequent tissue fibrosis that disrupts urinary flow. Recent studies suggest lower urinary tract biome dysbiosis increases proinflammatory cytokines, impeding tissue repair as well as promoting fibrotic scarring of the urethra. Despite these insights, the comprehensive molecular mechanisms underlying the formation, progression, and recurrence of the USD remain unclear. We aim to identify molecular targets and designate pathways contributing to USD, thereby identifying potential targets for future therapeutic interventions. We performed a comprehensive multi-modal analysis in USD patient urine and scar tissues. Urinary cytokines were assayed, transcriptome profiling and pathway enrichment were performed, and network mapping identified fibrotic hubs. Biomechanical tissue stiffness was quantified by atomic force microscopy (AFM), and protein and histological analysis employed both immunostaining and Western blotting. IFN-β, IFN-γ, IL-1β, IL-6, and IL-8.were significantly elevated in USD. Transcriptomic profiling revealed 745 differentially expressed genes, with enrichment in ECM organization, cytokine storm, TGF-β, integrin, IL-17A, WNT/β-catenin. ECM organization and cytokine storm are identified as central interactive hubs, dominated by collagen and fibrogenic regulators such as SMAD3 and TGF-β1. Tissue stiffness increased threefold in USD tissues compared to controls, highlighting ECM remodeling. Immunostaining demonstrated enhanced vimentin, elastin, COL1, and TGF-β expression, along with Western blot studies for observing the trend of elevated protein levels. The integrative approach evaluating pathway enrichment with transcriptome profiling reveals interconnections between mechanisms of inflammation, matrix remodeling, and mechanotransduction driving USD. The findings provide a mechanistic foundation for individualized models and therapeutic targets. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1038/s41598-026-68540-4.
SN - 2045-2322
ER -