Washington University MAPP Network Discovery Site

描述（由申请人提供）：这是华盛顿大学探索网站继续参与MAPP研究网络的申请。MAPP于2008年10月启动，旨在更好地了解泌尿系统慢性盆腔疼痛综合征（UCPPS），其中包括男性和女性间质性膀胱炎/膀胱疼痛综合征（IC/BPS）和男性慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）。通过MAPP第一阶段广泛的科学发现项目，我们更好地了解了表型亚群、生物标志物、症状加重（“耀斑”）的流行病学因素、UCPPS疼痛的生理相关性（如定量感觉测试、解剖和功能神经成像），以及盆腔疼痛的机制基础，使用了重现UCPPS主要临床症状的临床前模型。华盛顿大学的探索网站尤其富有成效。到目前为止，我们已经发表了九篇出版物，涵盖了UCPPS表型，耀斑，感染性和膀胱疼痛的动物研究等关键领域。我们已经达到并超过了25%的招聘目标。事实上，我们招募的UCPPS和健康对照者比其他任何网站都多。我们在生物标志物研究中收集生物标本的成功率也达到97%。对于MAPP- ii，我们提出以下五个具体目标：目标1：在MAPP研究网络中进行症状模式研究。初步数据表明，UCPPS参与者的某些亚组倾向于在六个月的过程中改善他们的症状，而其他亚组则倾向于恶化。在此，我们提出一项前瞻性观察性研究，以确定与泌尿和非泌尿症状恶化和/或改善相关的表型因素，为期三年。这项提议的研究很重要，原因有很多。在最基本的层面上，能够准确预测个体患者的UCPPS症状的临床病程是有帮助的。这些信息对于指导管理决策至关重要。更好地了解UCPPS内表型对于开发更有效和个性化的治疗方法至关重要。此外，我们将提出以下扩展评估，以加强核心症状模式研究：目标2：定量感觉测试，骨盆底和躯体负担的扩展评估。目标3：对UCPPS症状发作（UCPPS症状加重）的扩展评估；目标4:UCPPS的尿液代谢组学特征；目标5：使用临床前模型的双向转化研究

DESCRIPTION (provided by applicant): This is an application from the Washington University Discovery Site to continue participation in the MAPP Research Network. The MAPP was launched in October 2008 to better understand urologic chronic pelvic pain syndromes (UCPPS), which include interstitial cystitis/ bladder pain syndrome (IC/BPS) in men and women, and chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS) in men. Through a wide range of scientific discovery projects in Phase 1 of the MAPP, we have better understanding of the phenotype subgroups, biomarkers, epidemiological factors of symptom exacerbation ("flare"), physiological correlates of UCPPS pain (e.g. quantitative sensory testing, anatomic and functional neuroimaging), and mechanistic underpinnings of pelvic pain, using preclinical models that recapitulated the key clinical symptoms of UCPPS. The Washington University Discovery Site has been particularly productive. We have nine publications so far, covering key areas such as UCPPS phenotypes, flares, infectious, and animal studies of bladder pain. We have met and exceeded our recruitment target by 25%. In fact, we have recruited more UCPPS and healthy controls than any other sites. We also have a 97% success rate in collecting biospecimens for the biomarker studies. For MAPP-II, we propose the following five specific aims: Aim 1: To conduct a Symptom Patterns Study across the MAPP Research Network. Preliminary data suggested that certain subgroups of UCPPS participants tend to improve their symptoms over the course of six months, whereas other subgroups tend to worsen. Here we propose a prospective observational study to identify phenotypic factors associated with worsening and/or improvement of urinary and non-urinary symptoms over a longer period of three years. The proposed study is important for many reasons. At the most basic level, it would be helpful to be able to accurately predict the clinical course of UCPPS symptoms for individual patients. This information is vital to guide management decisions. Having a better understanding of the UCPPS endo-phenotypes would be crucial to developing more effective and personalized treatments. In addition, we will propose the following expanded assessment to enhance the core Symptom Patterns Study: Aim 2: Expanded Assessment of Quantitative Sensory Testing, Pelvic Floor, and Somatic Burden. Aim 3: An expanded assessment of UCPPS symptom flares (exacerbation of UCPPS symptoms) Aim 4: Urinary Metabolomic Profiles of UCPPS Aim 5: Bi-directional Translational Study Using Preclinical Models