Relationship of Bladder Pain With Clinical and Urinary Markers of Neuroinflammation in Women With Urinary Urgency Without Urinary Incontinence.
Relationship of Bladder Pain With Clinical and Urinary Markers of Neuroinflammation in Women With Urinary Urgency Without Urinary Incontinence.
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DOI：
10.1097/spv.0000000000000951
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发表时间：
2021-02-01
影响因子：
1.6
通讯作者：
Arya L
中科院分区：
文献类型：
--
作者：
Soriano A;Andy U;Hassani D;Whitmore K;Harvie H;Malykhina AP;Arya L
膀胱疼痛的发病机制知之甚少。我们的假设是，在没有尿失禁的尿急女性中，膀胱疼痛与膀胱壁中神经源性炎症和尿液中神经炎症生物标志物的存在相关。我们对无尿失禁的尿急妇女进行了一项前瞻性横断面研究。使用女性泌尿生殖道疼痛指数测量泌尿系统症状。使用PainDETECT问卷测量神经性疼痛，神经炎症的临床生物标志物。尿液中检测的炎性神经肽包括神经生长因子（NGF）、脑源性神经营养因子（BDNF）、血管内皮生长因子（VEGF）和骨桥蛋白（Opn）。采用单变量和多变量分析比较有和无膀胱疼痛患者的神经病理性疼痛评分和尿神经肽水平。在101例无尿失禁的尿急患者中，62例（61%）属于膀胱疼痛组（VAS ≤ 3），39例（39%）属于无膀胱疼痛组。膀胱疼痛组的泌尿系统症状评分（5.0 ± 3.1 vs 3.5 ± 2.4，p <0.001）和神经性疼痛评分（13.3 ± 8.6 vs 5.1 ± 4.8，p <0.001）显著高于无膀胱疼痛组。在控制年龄、BMI和尿急严重程度后的多变量分析中，膀胱疼痛评分与尿VEGF水平升高（p=0.04）和Opn水平升高（p=0.02）显著相关，而神经性疼痛评分与NGF水平升高（p=0.03）显著相关。在无尿失禁的尿急女性中，膀胱疼痛与神经炎症的临床和尿液生物标志物的存在相关。
The pathogenesis of bladder pain is poorly understood. Our hypothesis is that in women with urinary urgency without incontinence, bladder pain is associated with the presence of neurogenic inflammation in the bladder wall and neuroinflammatory biomarkers in the urine. We conducted a prospective cross-sectional study of women with urinary urgency without incontinence. Urinary symptoms were measured using Female Genitourinary Pain Index. Neuropathic pain, a clinical biomarker of neuroinflammation, was measured using the PainDETECT questionnaire. Inflammatory neuropeptides measured in the urine included nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and osteopontin (Opn). Neuropathic pain scores and urinary neuropeptide levels were compared between patients with and without bladder pain using univariable and multivariable analysis. In 101 women with urinary urgency without incontinence, 62 (61%) were in the bladder pain group (VAS ≤ 3) while 39 (39%) were in the no bladder pain group. Urinary symptom scores (5.0 +/−3.1 versus 3.5 +/−2.4, p < .001) and neuropathic pain scores (13.3 ± 8.6 versus 5.1 ± 4.8, p <.001) were significantly higher for the bladder pain group than for the no bladder pain group. On multivariable analysis after controlling for age, BMI, and severity of urinary urgency, bladder pain score was significantly associated with elevated urinary levels of VEGF (p=0.04) and Opn (p=0.02) while neuropathic pain score was significantly associated with an increased NGF level (p=0.03). In women with urinary urgency without incontinence, bladder pain is associated with the presence of clinical and urinary biomarkers of neuroinflammation.