Intravesical nitric oxide production discriminates between classic and nonulcer interstitial cystitis
Intravesical nitric oxide production discriminates between classic and nonulcer interstitial cystitis
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DOI：
10.1097/01.ju.0000110501.96416.40
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发表时间：
2004-03-01
影响因子：
6.6
通讯作者：
Peeker, R
中科院分区：
文献类型：
--
作者：
Logadottir, Y;Ehrén, I;Peeker, R
目的：间质性膀胱炎（IC）是泌尿外科最常见的疾病之一。有2种亚型，经典型和非溃疡型IC，症状相似，但在临床病程和治疗反应方面结局不同。在组织学上，这两种亚型之间存在根本性差异，经典型IC表现为尿路上皮的严重异常和特征性炎性细胞浸润，而非溃疡型IC则几乎没有炎症。尿中一氧化氮合酶活性的调节已被认为对IC的免疫应答具有重要意义。我们目前的证据表明，两种亚型之间的一氧化氮的生产，反映在IC的炎症反应的差异的深刻差异。材料和方法：共17例患者的亚型和活动性疾病，以及疾病缓解的患者被纳入研究，所有诊断根据国家研究所糖尿病，消化和肾脏疾病的标准。使用化学发光一氧化氮分析仪测定患者膀胱中的管腔一氧化氮。结果：所有患者与经典IC有高水平的NO。其他患者没有任何显着增加，在膀胱中的NO水平。经典IC患者的NO水平与症状无关，而是与IC的特定亚组的分配有关。最高水平的NO被发现在患者的初始阶段的经典IC。结论：经典和非溃疡IC之间的NO蒸发的差异允许亚型的情况下，满足国家研究所糖尿病和消化道及肾脏疾病的标准，而不进行膀胱镜检查。本系列的研究结果与以前的研究结果一起清楚地表明，IC的2种亚型代表不同的实体。这种分离进一步强调了需要对所有科学问题中包含的所有病例进行分型，确保在临床研究中单独评价2种亚型。
Purpose: Interstitial cystitis (IC) is one of the most bothersome conditions in urological practice. There are 2 subtypes, classic and nonulcer IC, with similar symptoms but different outcomes with respect to clinical course and response to treatment. Histologically there are fundamental differences between the 2 subtypes, classic IC presenting a severe abnormality of the urothelium and characteristic inflammatory cell infiltrates while inflammation is scant in nonulcer IC. Regulation of urinary nitric oxide synthase activity has been proposed to be of importance for immunological responses in IC. We present evidence of a profound difference between the 2 subtypes concerning nitric oxide production, mirroring the differences in inflammatory response in IC.Materials and Methods: A total of 17 patients with both subtypes and active disease as well as patients with disease in remission were included in the study, all diagnosed according to National Institute for Diabetes and Digestive and Kidney Diseases criteria. Luminal nitric oxide was measured in the bladder of patients using a chemiluminescence nitric oxide analyzer.Results: All patients with classic IC had high levels of NO. None of the other patients had any significant increase in NO levels in the bladder. The NO level in patients with classic IC was not related to symptoms but rather to the assignment to this specific subgroup of IC. The highest levels of NO were found in patients in the initial phase of classic IC.Conclusions: The difference in NO evaporation between classic and nonulcer IC allows for subtyping of cases meeting National Institute for Diabetes and Digestive and Kidney Diseases criteria without performing cystoscopy. The findings in the present series together with previous findings clearly demonstrate that the 2 subtypes of IC represent separate entities. This separation further emphasizes the need to subtype all cases included in all scientific matters, ensuring that the 2 subtypes are evaluated separately in clinical studies.