Inflammation and Symptom Change in Interstitial Cystitis or Bladder Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Study

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• 作者：Andrew Schrepf^a ; Michael A. O'Donnell^b ; Yi Luo^c ; Catherine S. Bradley^b ; ^c ; Karl J. Kreder^c ; Susan K. Lutgendorf^b ; ^c ; ^d ; ^{Susan-lutgendorf@uiowa.edu" class="auth_mail" title="E-mail the corresponding author}
• 刊名：Urology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：90
• 期：Complete
• 页码：56-61
• 全文大小：275 K

文摘

To explore inflammatory factors that influence symptom changes in interstitial cystitis or bladder pain syndrome (IC or BPS). This longitudinal, prospective study examined the association of inflammation elicited by Toll-like receptor (TLR) stimulation in peripheral blood mononuclear cells (PBMCs) and diurnal cortisol rhythms with changes in painful and urinary symptoms of IC or BPS and symptom flares over a 48-week period.

Materials and Methods

Participants were 24 women meeting criteria for IC or BPS who supplied blood for isolation of PBMCs and 3 days of salivary cortisol samples prior to a baseline visit. Participants completed the Genitourinary Pain Index (pain and urinary subscales) and reported symptom flares every 2 weeks for 48 weeks. Mixed effects longitudinal and regression models were used to determine if inflammatory variables were associated with the changes in IC or BPS symptoms (time × variable interactions), and the probability of a symptom flare.

Results

Elevated TLR-4 inflammation (P = .031) and elevated TLR-2 inflammation (P = .045) from PBMCs, and flattened diurnal cortisol slope (P = .012) were each associated with less improvement in genitourinary pain over time. Additionally, elevated TLR-4 inflammation was associated with less improvement in urinary symptoms (P = .018), whereas TLR-2 inflammation and cortisol slopes were not (both P > .16). In contrast, no inflammatory measure was associated with an increased likelihood of reporting a symptom flare (all P > .25).

Conclusion

TLR-mediated inflammation and diurnal cortisol slope may be useful as markers of symptom changes in IC or BPS.