A hypothesis for the etiology of interstitial cystitis.
A hypothesis for the etiology of interstitial cystitis.
复制标题
间质性膀胱炎病因学的假设。
DOI：
10.1007/978-1-4419-8889-8_43
复制
发表时间：
2003
影响因子：
--
通讯作者：
Elgavish,Ada
中科院分区：
文献类型：
--
作者：
Elgavish,Ada
间质性膀胱炎（IC）是膀胱壁的慢性炎症性疾病。病因学尚不明确。18，19，35，44，47，56多年来，已提出了几种IC病因学理论，包括感染、6，56免疫病因学、1由于糖胺聚糖表面涂层缺乏导致的渗漏性尿道炎、41，42活化的肥大细胞、6，49和神经原性病因学。6，17然而，这些理论中没有一个被证实是毫无疑问的。6 IC的快速发病，在中年出现，以及缺乏强有力的家庭联系，向我们8 - 11和许多其他人6表明IC可能是一种获得性疾病，可能由损伤引起。反复暴露于细菌感染，这在膀胱中很常见，被认为是一种假定的损伤机制。47，56早期的研究是基于这样的假设，即有害物质与膀胱相互作用的唯一途径是终末分化的“伞”细胞暴露于管腔中的物质。然而，仅仅暴露于损伤的浅表层，如细菌感染，可能不会导致尿路上皮的慢性变化。这些终末分化的细胞通常在感染因子的作用下脱落，2，38而位于基底层的未暴露的尿路上皮细胞祖细胞（干细胞）分裂并使损伤区域再上皮化。
Interstitial cystitis (IC) is a chronic inflammatory disease of the bladder wall. The etiology is obscure.18,19,35,44,47,56Several theories for the etiology of IC have been proposed over the years, including infection,6,56immunological etiology,1leaky urothelium resulting from a deficiency of its surface coat of glycosaminoglycans,41,42activated mast cells,6,49and neurogenic etiology.6,17However, none of these theories have been proven beyond doubt.6The rapid onset of IC, its appearance in mid-life, and the absence of strong family association have suggested to us8–11and many others6that IC could be an acquired disease, possibly caused by injury. Recurrent exposure to bacterial infection, which is common in the bladder, has been proposed as a putative mechanism of injury.47,56Earlier studies were based on the assumption that the sole avenue for the interaction of noxious agents with the bladder is exposure of terminally differentiated “umbrella” cells to agents in the lumen. However, mere exposure of the superficial layer to injury, such as bacterial infection, may not result in chronic changes in the urothelium. These terminally differentiated cells are often shed in response to infectious agents,2,38and unexposed progenitors of urothelial cells located in the basal layer (stem cells) divide and re-epithelize the injured area.