New effects of ketamine abuse uncovered

March 18, 2016

Research conducted by scientists at the University of York has revealed how recreational ketamine abuse damages the bladder.

In two studies, one of which is published today, the team shows how ketamine present in urine causes damage to the epithelial lining of the bladder, allowing urine to penetrate into underlying tissues which causes inflammation and extreme pain. In some cases this pain can be so extreme that patients need to have their bladder removed (cystectomy).

Led by Dr Simon Baker in the University of York's Department of Biology, in collaboration with clinicians from Middlesbrough and Leeds hospitals, the first study looked at a cystectomy case. This would determine whether bladder damage was caused by direct contact with urinary ketamine or whether the drug causes a systemic change in the whole body that affects the organ.

Reporting a rare physiological coincidence, the team studied epithelial cells lining the bladder and also in an adjacent remnant of the foetal urinary tract, not in contact with urine, known as an urachus.

Finding that epithelial cells lining the bladder were almost completely absent, having died and been sloughed off into the urine, epithelial cells from the urachus appeared healthy. This shows direct contact with urine is critical to the toxicity of ketamine to the bladder epithelium, ruling out systemic factors.

In the second study, the researchers used epithelium cells taken from healthy patients to study how ketamine affects the bladder. Used to produce laboratory models, cells were exposed to ketamine and their responses analysed.

The researchers found that ketamine overwhelms the cell's internal power stations, known as mitochondria, causing a catastrophic release of toxins. To avoid this "melt-down", cells commit a controlled form of suicide (apoptosis) resulting in cell death. This occurs in a regulated fashion that does not cause excessive toxicity to other cells in an attempt to protect the remaining tissue; however, in the case of chronic ketamine abuse, all epithelial cells are killed.

Dr Baker, Senior Postdoctoral Research Fellow in York's Jack Birch Unit for Molecular Carcinogenesis, said: "These two studies combine to demonstrate that direct contact with urinary ketamine causes significant bladder damage, and shows how this drug causes the death of previously healthy bladder cells.

"We now have a more detailed understanding of how and why chronic ketamine abuse results in bladder problems and cystitis. Understanding the full side-effects of ketamine is very important as other researchers are currently investigating the potential for this drug to spawn a new generation of anti-depressants."

Ketamine poisoning of the epithelial lining can lead to extreme pain associated with ketamine cystitis. Urologists advise anyone who experiences bladder pain when using ketamine to stop taking the drug immediately, as if too many bladder cells are killed there will not be enough remaining to repair the tissue.

University of York

Related Pain Articles from Brightsurf:

Pain researchers get a common language to describe pain
Pain researchers around the world have agreed to classify pain in the mouth, jaw and face according to the same system.

It's not just a pain in the head -- facial pain can be a symptom of headaches too
A new study finds that up to 10% of people with headaches also have facial pain.

New opioid speeds up recovery without increasing pain sensitivity or risk of chronic pain
A new type of non-addictive opioid developed by researchers at Tulane University and the Southeast Louisiana Veterans Health Care System accelerates recovery time from pain compared to morphine without increasing pain sensitivity, according to a new study published in the Journal of Neuroinflammation.

The insular cortex processes pain and drives learning from pain
Neuroscientists at EPFL have discovered an area of the brain, the insular cortex, that processes painful experiences and thereby drives learning from aversive events.

Pain, pain go away: new tools improve students' experience of school-based vaccines
Researchers at the University of Toronto and The Hospital for Sick Children (SickKids) have teamed up with educators, public health practitioners and grade seven students in Ontario to develop and implement a new approach to delivering school-based vaccines that improves student experience.

Pain sensitization increases risk of persistent knee pain
Becoming more sensitive to pain, or pain sensitization, is an important risk factor for developing persistent knee pain in osteoarthritis (OA), according to a new study by researchers from the Université de Montréal (UdeM) School of Rehabilitation and Hôpital Maisonneuve Rosemont Research Centre (CRHMR) in collaboration with researchers at Boston University School of Medicine (BUSM).

Becoming more sensitive to pain increases the risk of knee pain not going away
A new study by researchers in Montreal and Boston looks at the role that pain plays in osteoarthritis, a disease that affects over 300 million adults worldwide.

Pain disruption therapy treats source of chronic back pain
People with treatment-resistant back pain may get significant and lasting relief with dorsal root ganglion (DRG) stimulation therapy, an innovative treatment that short-circuits pain, suggests a study presented at the ANESTHESIOLOGY® 2018 annual meeting.

Sugar pills relieve pain for chronic pain patients
Someday doctors may prescribe sugar pills for certain chronic pain patients based on their brain anatomy and psychology.

Peripheral nerve block provides some with long-lasting pain relief for severe facial pain
A new study has shown that use of peripheral nerve blocks in the treatment of Trigeminal Neuralgia (TGN) may produce long-term pain relief.

Read More: Pain News and Pain Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to