Differences of urine markers in patients with interstitial cystitis/bladder pain syndrome with or without Hunner lesion
Dr Akira Furuta (1), Dr Yasuyuki Suzuki (2), Dr Shin Egawa (1)
(1) Jikei University School Of Medicine, Tokyo, Japan, (2) Tokyo Metropolitan Rehabilitation Hospital, Tokyo, Japan
The current conception of interstitial cystitis/bladder pain syndrome (IC/BPS) is that it would be reasonable to distinguish Hunner-type IC from non-Hunner-type BPS. Therefore, we investigated the differences of urine markers for IC/BPS.
Urine was collected from 22 IC patients, 25 BPS patients, age and gender-matched 23 overactive bladder patients and 12 controls. In other groups of patients, bladder biopsied tissues were collected from 14 IC female patients, 12 BPS female patients and 14 age-matched female patients (controls). Representative four urine markers of IC/BPS such as VEGF-A, CXCL1, CXCL8 and CXCL10, and immunohistochemical staining of VEGF-A and CD3 were examined
According to the receiver operating characteristic analysis, VEGF-A (0.83), CXCL10 (0.79), CXCL1 (0.75) and CXCL8 (0.70) were significantly useful to detect IC/BPS patients among the study participants. On the other hand, CXCL10 (0.86), CXCL8 (0.78) and CXCL1 (0.70) were significantly useful to detect IC patients whereas VEGF-A (0.76) was significantly useful to detect BPS patients in the participants. In addition, the expression of VEGF-A in bladder tissues was significantly increased in IC and BPS patients compared with controls whereas the significant increases in the number of T lymphocytes were observed in IC patients compared with controls or BPS patients
CXCL10 can induce pro-inflammatory response by activating T lymphocytes whereas CXCL1 and CXCL8 are mainly chemotactic for neutrophils. VEGF not only plays a key stimulatory role in angiogenesis, but also induces sensory and motor peripheral plasticity, alters bladder function, and promotes visceral sensitivity. It would be useful to detect IC and BPS using CXCL10 and VEGF-A as urine markers, respectively, suggesting that IC and BPS could be classified as a separate entity of the disorder in the future.