Multi-Disciplinary Evaluation of Chronic Pelvic Pain Syndrome

总体描述（由申请人提供）：我们对（UCPPS）如间质性膀胱炎/膀胱疼痛综合征（IC/PBS）和慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）的了解较差。我们的建议的目的是调查病因，病理生理学和流行病学的UCPPS在多学科的方式。我们召集了一个来自圣路易斯的华盛顿大学、伯明翰的亚拉巴马大学、迈阿密大学和德克萨斯大学达拉斯西南医学院的研究人员组成的研究小组，该小组由来自多个学科的研究人员组成：麻醉学、流变学、胃肠病学、神经放射学、分子微生物学、传染病、流行病学、心理学和泌尿学。通过汇集这些成功和富有成效的研究人员，他们在泌尿外科以外的学科参与合作科学方面有着良好的记录，其中许多人是UCPPS研究的新手，我们希望引入新的专业知识，测试新的假设，并为UCPPS研究提供新的方向。为实现我们的目标，共提出了5个项目。项目1和2将分别调查IC/PBS和CP/CPPS的流行病学。在项目1中，Drs Hooton和Hultgren将在一项前瞻性队列研究中评价菌尿、病毒尿和感染原作为IC/PBS的潜在病因的作用，该研究采用频繁的生物标本采集和每日患者报告的症状日记。在项目2中，科迪茨、Sutcliffe和Andriole博士将采用病例对照研究和纵向研究，研究CP/CPPS发展和症状加重的生物学和行为学风险因素。项目3、4和5有一个共同的目标，即评价中枢神经系统异常在IC/PBS中的作用。在项目3中，Gereau博士和Lai博士将使用模拟IC疼痛的动物模型研究脊髓疼痛致敏的分子机制。在项目4中，Ness博士、布拉德利博士和多伊奇博士将使用定量感觉测试（QST）和创新的脑内血流神经成像技术（CASL-fMRI）来评估伴或不伴纤维肌痛的IC/PBS患者的感觉处理。在项目5中，洪博士和诺斯博士将研究IC/PBS和躯体化障碍之间的关系。总的来说，我们相信这5个项目将解决UCPPS研究中的关键问题，并加深我们对慢性疼痛综合征的理解。

DESCRIPTION, OVERALL (provided by applicant): Our understanding of (UCPPS) such as interstitial cystitis/painful bladder syndrome (IC/PBS) and chronic prostatitis/chronic pelvic pain syndrome, (CP/CPPS) is poor. The objective of our proposal is to investigate the etiology, pathophysiology, and epidemiology of UCPPS in a multi-disciplinary manner. We have assembled a team of investigators from Washington University In St. Louis, the University of Alabama at Birmingham, the University of Miami, and the University of Texas at Dallas Southwestern Medical School, that consists of researchers from several disciplines: anesthesiology, rheumatology, gastroenterology, neuroradiology, molecular microbiology, infectious disease, epidemiology, psychology, and urology. By bringing together these successful and productive investigators with strong record of participating in collaborative science from disciplines outside of urology, many of them new to UCPPS research, we hope to introduce new expertise, test new hypotheses, and provide new direction to UCPPS research. A total of 5 projects are proposed to achieve our objective. Projects 1 and 2 will investigate the epidemiology of IC/PBS and CP/CPPS, respectively. In PROJECT 1, Drs Hooton and Hultgren will evaluate the role of bacteriuria, viruria, and infectious agents as an underlying etiology for IC/PBS in a prospective cohort study with frequent biologic specimen collection and daily patient-reported symptom diary. In PROJECT 2, Drs Colditz, Sutcliffe and Andriole will investigate the biologic and behavioral risk factors for development of CP/CPPS and symptom exacerbation using case-control studies and longitudinal studies. Projects 3, 4, and 5 share a common goal to evaluate the role of central nervous system abnormality in IC/PBS. In PROJECT 3, Drs Gereau and Lai will study the molecular mechanisms of spinal cord pain sensitization using an animal model that mimics IC pain. In PROJECT 4, Drs Ness, Bradley and Deutsch will use quantitative sensory testing (QST) and innovative intracerebral blood-flow neuroimaging techniques (CASL-fMRI) to evaluate sensory processing in IC/PBS patients with and without associated fibromyalgia. In PROJECT 5, Drs Hong and North will investigate the relationship between IC/PBS and somatization disorder. Collectively, we are confident that these 5 projects will address key questions in UCPPS research, and deepen our understanding of chronic pain syndromes.