Small-Fiber Polyneuropathy Is Prevalent in Patients With Interstitial Cystitis/Bladder Pain Syndrome.
Small-Fiber Polyneuropathy Is Prevalent in Patients With Interstitial Cystitis/Bladder Pain Syndrome.
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DOI：
10.1097/spv.0000000000001240
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发表时间：
2022-11-01
期刊：
影响因子：
--
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中科院分区：
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间质性膀胱炎/膀胱痛综合征(IC/BPS)的病理生理学机制尚不完全清楚。最近的研究报道，小纤维多神经病(SFPN)在纤维肌痛中很常见，这是一种常见的IC/BPS并存的疾病。这项研究的目的是确定SFPN在大量IC/BPS患者中的患病率。被诊断为IC/BPS的成人计划接受治疗性水膨胀(n=97)或膀胱切除尿流改道(n=3)，前瞻性地纳入本研究。小腿皮肤活检用于测定表皮内神经纤维密度(IENFD)。通过比较线性−(纤维/mm~2)和标准参考值来确定SFPN(+/mm2)状态。从自我报告和电子病历中记录已知与IC/BPS并存的14种疾病(包括泌尿科和非泌尿科)的人口统计信息、病史和诊断。在这一大群IC/BPS患者中，31%(31/100)的患者SFPN阳性。81%(81/100)的患者IENF密度低于年龄和性别的中位数。大约三分之一(31%)的SFPN+患者报告了共同发生的慢性疲劳综合征(CFs)，而SFPN−组的这一比例为10.6%(p=0.034)。SFPN+患者的过敏反应显著低于sfpn−患者(37.9%vs60.6%；p=0.047)。SFPn+和SFPn−亚组之间在膀胱容量或Hunner‘s病变状态方面无显著差异。小纤维多发性神经病是IC/BPS患者的常见发现，SFPN状态与共发的CFS显著相关，与该人群中过敏的存在呈负相关。间质性膀胱炎/膀胱痛综合征是一种知之甚少的慢性疼痛症状。虽然患者会经历慢性膀胱疼痛和排尿习惯的改变，但他们通常也会经历广泛的疼痛和膀胱以外的问题。这些症状的原因(S)还不清楚。我们的研究发现，有证据表明间质性膀胱炎患者的皮肤神经通常受损/变薄，这与慢性疲劳有关。这一发现可能解释了这些患者经历的一些普遍症状。
The pathophysiology of interstitial cystitis/bladder pain syndrome (IC/BPS) is imperfectly understood. Recent studies reported that small fiber polyneuropathy (SFPN) is common in fibromyalgia, a condition commonly comorbid with IC/BPS. The objective of this study was to determine the prevalence of SFPN in a large cohort of IC/BPS patients. Adults diagnosed with IC/BPS scheduled to undergo either therapeutic hydrodistention (n=97), or cystectomy with urinary diversion (n=3), were prospectively recruited to this study. A skin biopsy obtained from the lower leg was used for intraepidermal nerve fiber density (IENFD) measurement. SFPN (+/−) status was determined by comparing linear IENFD (fibers/mm2) with normative reference values. Demographic information, medical history, and diagnoses for 14 conditions (both urologic and non-urologic) known to co-occur with IC/BPS were documented from self-report and electronic medical record. In this large cohort of patients with IC/BPS, 31% (31/100) were positive for SFPN. IENF density was below the median for age and gender in 81% (81/100) of patients. Approximately one-third (31%) of SFPN+ patients reported co-occurring chronic fatigue syndrome (CFS), compared to 10.6% of the SFPN− group (p = 0.034). SFPN+ patients reported significantly fewer allergies than SFPN− patients (37.9% vs 60.6%; p = 0.047). There were no significant differences in bladder capacity or Hunner’s lesion status between the SFPN+ and SFPN− subgroups. Small fiber polyneuropathy is a common finding in patients with IC/BPS and SFPN status is significantly correlated with co-occurring CFS, and negatively correlated with the presence of allergies in this population. Interstitial cystitis/bladder pain syndrome is a poorly understood chronic pain condition. While patients experience chronic pain in their bladders and changes to their urinary habits, they also commonly experience widespread pain and issues beyond their bladder. The cause(s) of these symptoms is not well understood. Our research found evidence that patients with interstitial cystitis commonly have damage/thinning to the nerves in their skin which is associated with being chronically fatigued. This finding may explain some of the widespread symptoms these patients experience.
DOI：
10.3389/fpain.2021.810809
发表时间：
2021
期刊：
Frontiers in pain research (Lausanne, Switzerland)
影响因子：
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作者：
Wolff DT;Walker SJ
通讯作者：
Walker SJ
影响因子：
1.8
作者：
Matthews CA;Deveshwar SP;Evans RJ;Badlani G;Walker SJ
通讯作者：
Walker SJ