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Analyses of urine markers in patients with interstitial cystitis before and after fulguration or hydrodistention

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Sources of Funding: None

Introduction

There are few studies to investigate time-dependent changes in urine markers before and after fulguration or hydrodistention for the treatment of interstitial cystitis (IC) with or without Hunner lesions (HL), respectively. Thus we measured forty-one urine markers in HL type IC (HIC) or non-HL type IC (NHIC) patients before and after the treatment.

Methods

Urine specimens and bladder tissues were collected from 10 NHIC patients before hydrodistention, 10 HIC patients before fulguration and 10 age and gender-matched controls before surgical treatments including transurethral resection of the prostate (n=3) or tension-free vaginal tape operations (n=7). Urine specimens were also collected in IC patients six and twelve months after the treatment. Multiplex analyses of 41 cytokines, chemokines and growth factors were performed with a MIPPLIPLEX immunoassay kit. All participants completed the O’Leary-Sant score including symptom indexes (OSSI) and problem indexes (OSPI), and visual analog scale (VAS) pain score. In addition, the expression of interleukin-1 receptor antagonist (IL-1Ra) in the bladder was evaluated using an immunohistochemistry.

Results

Before the treatment, vascular endothelial growth factor (VEGF) and IL-1α were significantly increased in HIC and NHIC patients compared with controls, and CXCL8 and CXCL10 were significantly increased in HIC patients compared with controls although there were no significant differences in 41 urine markers between HIC and NHIC patients. IL-1Ra mainly expressed in the bladder epithelium was significantly decreased in HIC patients compared with NHIC patients or controls. Urine IL-1Ra was significantly increased in HIC and NHIC patients twelve months after the treatment compared with pretreatment values whereas there were no significant changes in other urine markers before and after the treatment. OSSI, OSPI and VAS scores were significantly decreased in HIC and NHC patients six and twelve months after the treatment compared with pretreatment scores, and significantly correlated positively with urine IL-1Ra levels in NHIC patients, but not in HIC patients.

Conclusions

The increases in angiogenesis-associated proteins such as VEGF and CXCL10 and inflammatory cytokines including IL-1α may be important for the development of IC. IL-1Ra acting as an anti-inflammatory cytokine against IL-1 was mainly expressed in the urothelium and may be positively correlated with the bladder pain symptom. In addition, the increase in urine IL-1Ra induced by hydrodistention or fulguration may contribute to the alleviation of IC symptoms.

Funding

None

Authors
Akira Furuta
Tokunori Yamamoto
Yusuke Koike
Yasuyuki Suzuki
Momokazu Gotoh
Shin Egawa
Naoki Yoshimura
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