Multi-disciplinary Approach to the Study of Chronic Pelvic Pain (MAPP)

总体描述（由申请人提供）：尽管进行了多年的研究和大量的金钱支出，但泌尿系慢性盆腔疼痛综合征（UCPPS）（称为间质性膀胱炎/疼痛性膀胱综合征（IC/PBS））的病理生理学仍然难以捉摸。爱荷华州大学MAPP的拨款提案旨在从新的角度研究这种情况。该提案是围绕以下一般假设设计的，即IC/PBS膀胱症状和纤维肌痛（FM）或肠易激综合征（IBS）等共病的患者具有其症状的全身基础，并且与单独IC/PBS膀胱症状的患者有根本不同。我们的一般假设是基于研究人员在本MAPP应用中的先前工作，这将在后续章节中详细介绍。在该基金中提出的5个项目的计划项目规划和设计阶段，所有研究人员都从这个一般假设出发。拟议的工作是重要的，因为它的新颖性和5个拟议项目之间的协同作用和横向一体化。这些项目计划检查IC/PBS的异质条件。待研究的患者队列在所有临床项目中相似，包括仅在膀胱中具有IC/PBS症状的患者、具有IC/PBS膀胱症状和全身性共病状况（FM、IBS）的患者、仅具有共病状况（FM、IBS）的患者和健康对照。基础科学项目通过利用临床项目中收集的生物标本来增加对UCPPS综合征（IC/PBS）的基本细胞，分子和生化理解，从而加强和扩大临床项目的范围。项目建议书从多方面审查了IC/PBS的UCPPS。本Discovery Site项目的后续数据分析将描述与HPA轴、应激反应、神经生理学、疼痛模式、生物和行为诱发因素、基础免疫学和生物化学相关的每组的表型和风险因素。

DESCRIPTION, OVERALL (provided by applicant): Despite years of research and a considerable monetary expenditure the pathophysiology of the Urologic Chronic Pelvic Pain Syndrome (UCPPS) known as Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) remains elusive. This University of Iowa MAPP grant proposal is intended to study this condition from a new perspective. The proposal is designed around the general hypothesis that patients with IC/PBS bladder symptoms and a co-morbid condition like fibromyalgia (FM) or irritable bowel syndrome (IBS) have systemic basis for their symptoms and are fundamentally different from patients with IC/PBS bladder symptoms alone. We based our general hypothesis on the previous work of the investigators in this MAPP application which is detailed in subsequent sections. During the program project planning and design phase for the 5 projects proposed in this grant, all investigators worked from this general hypothesis. The proposed work is important because of its novel nature and the synergy and horizontal integration among the 5 proposed projects. The projects were planned to examine the heterogenous condition of IC/PBS. The cohorts of patients to be studied are similar across all clinical projects and include patients with IC/PBS symptoms in the bladder only, patients with IC/PBS bladder symptoms and a systemic co-morbid condition (FM, IBS), patients with only a co-morbid condition (FM.IBS) and healthy controls. The basic science projects reinforce and expand the scope of the clinical projects by utilizing biologic specimens collected in the clinical projects to add basic cellular, molecular and biochemical understanding of the UCPPS syndrome (IC/PBS). The Project proposals examine the UCPPS of IC/PBS from a multifaceted perspective. Subsequent data analysis of this Discovery Site project will describe the phenotype and risk factors of each group related to the HPA axis, stress response, neurophysiology, pain pattern, biologic and behavioral predisposing factors, basic immunology and biochemistry.