Dr Donna Daly

The urinary bladder is responsible for the collection, storage and controlled elimination of urine from the body. Its normal function relies on a complex array of events which, when disrupted, can give rise to a number of extremely distressing clinical conditions, such as overactive bladder syndrome and urinary incontinence. The incidence of these conditions significantly increases with age. Staggeringly across Europe in 2014 the sales of adult incontinence products outsold sales of infant nappies for the first time. This is due to the fact that western populations are demographically ageing yet, few pharmacological therapies have been developed to alleviate bladder conditions. UK National Institute for Health and Care Excellence (NICE) estimates that 90% of men 50-80 years of age experience disorders of the lower urinary tract, with storage symptoms (such as those associated with overactive bladder syndrome and incontinence) increasing from 3% at age 40–44 years to 42% in those aged ≥75 years. However surprisingly there are very few studies which have actually investigated how age alters bladder function. Dr Daly has had a long standing interest in functional urology since 2003 when her first introduction to science was a summer internship with Dr Chess-Williams at the University of Sheffield. Since then her research has been directed at understanding how the sensory nerves and epithelial cells which line the lumen of the bladder (the urothelial cells) interact to control bladder filling. We currently know that the urothelium exhibits unique sensory properties. During filling, the apical urothelial cells detect stretch and perform exocytosis of a large population of subapical discoidal/fusiform vesicles, which significantly increases the apical surface area of the cell. This allows the urothelium to adapt to stretch while still maintaining a tight barrier. Simultaneously the underlying urothelial cells release excitatory and inhibitory neurotransmitters which then act on close lying afferent nerve terminals to signal the degree of bladder fullness. To date, some of the mechanisms involved in this membrane trafficking have been identified however the mechanosensor which triggers the process and the downstream signalling cascades which induce release of transmitters from the underlying urothelial cells remain to be determined. Clinical and experimental studies both suggest that changes in the way the urothelium detects filling may drive a number of urological disorders. Dr Dalys research is focussed on understanding the interaction between the urothelium and the sensory nerves.