Potential Urinary Biomarkers To Diagnosis Interstitial Cystitis And Overactive Bladder
Yuan-Hong Jiang (1), Hann-Chorng Kuo (1)
(1) Department Of Urology, Buddhist Tzu Chi General Hospital And Tzu Chi University, Hualien, Taiwan
Urothelial dysfunction and suburothelial inflammation were important pathognomonic bladder features in both interstitial cystitis (IC) and overactive bladder (OAB). Inflammatory cytokines and chemokines play crucial roles in their pathogenesis. This study is aimed to investigate the diagnostic values of urine cytokines and chemokines in IC and OAB, and to find the potential biomarkers.
Urine samples were prospectively and consecutively collected from 90 IC patients (ESSIC type 2 with glomerulations), 30 OAB patients (proven detrusor overactivity in video-urodynamic studies), and 28 controls (genuine stress urinary incontinence women without other lower urinary tract dysfunction). Commercially available multiplex immunoassays (MILLIPLEX®map kit) were used to analyse 32 targets including inflammatory cytokines, chemokine, and neurotrophins. Urine cytokines levels were compared among groups. The diagnostic values of each target were calculated, and the diagnostic flow-chart was developed to discriminate IC from OAB and controls according to the diagnostic values
Among groups, urine cytokines profiles were significantly different (Table 1). The cytokines with high diagnostic values (AUC > 0.7) to discriminate the diseased status (including IC and OAB) from controls included MCP-1, MIP-1β, IL-12p40, and IL-7. Among these cytokines, MIP-1β was the cytokine with high diagnostic value (AUC 0.722), the highest sensitivity (86.3%) and the acceptable specificity (50.0%). MIP-1β was selected as the screening test to distinguish IC and OAB from controls by the optimal cut-off value 1.57pg/mL, with the diagnostic rate of 87.7% (Fig 1). Furthermore, the cytokines with high diagnostic values (AUC > 0.7) to distinguish IC and OAB, included IL-10, Eotaxin, IL-1RA, RANTES, IP-10, BDNF, and IL-2. The diagnostic rates of IC by Eotaxin, RANTES, and IP-10 were more than 75%.ic information of the pathologic bladder in IC and OAB.
In compared with controls, both IC/BPS and OAB patients had different urine cytokines profiles, which might reflect their different pathologic conditions inside the bladder. By the combination of multiple targets in urine, we could use MIP-1β to serve as screening test of diseased status and use Eotaxin, RANTES, and IP-10 to serve as confirmation tests of IC. Urinary cytokines, serving as non-invasive biomarkers, might have diagnostic roles in IC and OAB.