Relationship of Pain Catastrophizing With Urinary Biomarkers in Women With Bladder Pain Syndrome.
Relationship of Pain Catastrophizing With Urinary Biomarkers in Women With Bladder Pain Syndrome.
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DOI：
10.1097/spv.0000000000001041
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发表时间：
2021-12-01
影响因子：
1.6
通讯作者：
Arya L
中科院分区：
文献类型：
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作者：
Soriano A;Allen A;Malykhina AP;Andy U;Harvie H;Arya L
脑源性神经营养因子(BDNF)参与中枢神经过程。我们假设，在患有膀胱痛综合征的女性中，更大的疼痛灾难与更高的尿脑源性神经营养因子水平有关。对女性尿路急症数据库的二次分析。我们确定了符合AUA膀胱疼痛综合征标准的女性。分别采用女性泌尿生殖道疼痛指数(F-GUPI)、疼痛灾变量表(PCS)和疼痛诊断问卷(Pain DETECT)评定患者的尿路症状、疼痛剧变和神经病理性疼痛。采用单因素和多因素分析评估突变评分与尿脑源性神经营养因子(BDNF)和其他尿液生物标志物包括神经生长因子(NGF)、血管内皮生长因子(VEGF)和骨桥蛋白的关系。在62名患有膀胱痛综合征的妇女中，15名(24%)报告了疼痛灾难性症状(PCS评分和GT；30)。更高的灾难性评分与更严重的泌尿症状、更严重的骨盆疼痛、更严重的神经性疼痛和更差的生活质量评分相关(均P<；0.01)。在多变量分析中，在控制了年龄、BMI和泌尿症状后，疼痛灾难性评分越高，BDNF越低(p=0.04)，VEGF水平越低(p=0.03)。尿急与较高的NGF水平相关(p=0.04)，而膀胱疼痛与较高的NGF(p=0.03)和较高的VEGF水平(p=0.01)相关。神经炎性机制参与了膀胱痛综合征患者疼痛的中枢处理。尿路症状越重，NGF和VEGF水平越高，而疼痛灾难越严重，BDNF和VEGF水平越低。尿BDNF水平可能有助于疼痛处理中枢增强的女性的表型鉴定。
Brain-derived neurotrophic factor (BDNF) has been implicated in central neurological processes. We hypothesize that greater pain catastrophizing is associated with higher urinary BDNF levels in women with bladder pain syndrome. Secondary analysis of a database of women with urinary urgency. We identified women who met AUA criteria of bladder pain syndrome. Urinary symptoms, pain catastrophizing, and neuropathic pain were measured using the Female Genitourinary Pain Index (F-GUPI), Pain Catastrophizing Scale (PCS) and painDETECT questionnaires respectively. Relationship of catastrophizing score with urinary BDNF (primary outcome) and other urinary biomarkers including nerve growth factor (NGF), vascular endothelial growth factor (VEGF) and osteopontin was evaluated using univariable and multivariable analyses. In 62 women with bladder pain syndrome, 15 (24%) reported pain catastrophizing symptoms (PCS score >30). Higher catastrophizing scores were associated with worse urinary symptoms, greater pelvic pain, greater neuropathic pain, and worse quality of life scores (all p<0.01). On multivariable analysis, after controlling for age, BMI and urinary symptoms, higher pain catastrophizing score was associated with lower BDNF (p=0.04) and lower VEGF levels (p=0.03). Urinary urgency was associated with higher NGF level (p=0.04) while bladder pain was associated with higher levels of NGF (p=0.03) and VEGF (p=0.01). Neuroinflammatory mechanisms contribute to the central processing of pain in women with bladder pain syndrome. Worse urinary symptoms are associated with higher NGF and VEGF levels, but worse pain catastrophizing is associated with lower BDNF and VEGF levels. Urinary BDNF levels may be useful in phenotyping women who have central augmentation of pain processing.