Inflammation characteristics in bladder pain syndrome ESSIC type 3C/classic interstitial cystitis
Inflammation characteristics in bladder pain syndrome ESSIC type 3C/classic interstitial cystitis
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DOI：
10.1111/iju.12370
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发表时间：
2014-04-01
影响因子：
2.6
通讯作者：
Peeker, Ralph
中科院分区：
文献类型：
--
作者：
Logadottir, Yr;Delbro, Dick;Peeker, Ralph
目的：间质性膀胱炎被认为是一种异质综合征，有两种可区分的形式：非溃疡性和经典形式的间质性膀胱炎，后者具有Hunner病变;或分别为3C型膀胱疼痛综合征和非Hunner膀胱疼痛综合征。方法：对379例诊断为间质性膀胱炎的患者进行了研究。使用化学发光一氧化氮分析仪测量膀胱的一氧化氮释放。通过常规组织病理学检查分析患者和健康对照的膀胱活检。还通过免疫组织化学和实时聚合酶链反应分析了患者和对照组的活检组织和细胞因子基因表达。与非Hunner膀胱疼痛综合征/非溃疡性间质性膀胱炎患者和健康个体相比，患有3C型膀胱疼痛综合征/经典间质性膀胱炎的患者具有相当高的一氧化氮水平，并且在组织学上显示膀胱粘膜中的慢性炎症，膀胱壁各层均有大量肥大细胞浸润。在非Hunner膀胱疼痛综合征/非溃疡性间质性膀胱炎患者中未观察到炎症。在膀胱疼痛综合征3C型/经典间质性膀胱炎患者的膀胱粘膜中的炎性细胞中强烈表达同工酶诱导型一氧化氮合酶（一氧化氮产生中的催化剂）。此外，与健康对照组相比，膀胱疼痛综合征3C型/经典性间质性膀胱炎患者的促炎细胞因子白细胞介素-6和白细胞介素-17 A信使核糖核酸以及抗炎性白细胞介素-10信使核糖核酸的表达水平显著升高。膀胱疼痛综合征3C型/经典性间质性膀胱炎是一种独特的炎性疾病，在许多方面具有炎性自身免疫性疾病的特征。这些发现可以开辟新的研究途径，期望为药物治疗的新目标。
Objectives: Interstitial cystitis is regarded as a heterogenous syndrome with two distinguishable forms: the non-ulcer and the classic form of interstitial cystitis, the latter with Hunner's lesions; or bladder pain syndrome type 3C and non-Hunner bladder pain syndrome, respectively.Methods: A cohort of 379 patients diagnosed with interstitial cystitis was studied. Nitric oxide release from the bladder was measured using a chemiluminescence nitric oxide analyzer. Bladder biopsies from the patients and healthy controls were analyzed by routine histopathological examination. Biopsies from a subset of patients and controls were also analyzed by immunohistochemistry and cytokine gene expression by real-time polymerase chain reaction.Results: Patients with bladder pain syndrome type 3C/classic interstitial cystitis had considerably higher levels of nitric oxide as compared with non-Hunner bladder pain syndrome/non-ulcer interstitial cystitis patients and healthy individuals, and showed histologically a chronic inflammation in the bladder mucosa, with abundant mast cell infiltration in all layers of the bladder wall. No inflammation was noted in non-Hunner bladder pain syndrome/non-ulcer interstitial cystitis patients. The isoenzymes inducible nitric oxide synthase, the catalyst in the nitric oxide production, was strongly expressed in the inflammatory cells in the bladder mucosa of bladder pain syndrome type 3C/classic interstitial cystitis patients. In addition, the expression of the pro-inflammatory cytokines interleukin-6 and interleukin-17A messenger ribonucleic acid, and of anti-inflammatory interleukin-10 messenger ribonucleic acid showed significantly increased levels in bladder pain syndrome type 3C/classic interstitial cystitis compared with healthy controls.Conclusion: Bladder pain syndrome type 3C/classic interstitial cystitis is a distinct inflammatory disease and in many aspects shares features of inflammatory autoimmune diseases. These findings could open up novel research avenues with expectations for new targets for pharmacological treatment.