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

总体描述(申请人提供)：尽管多年的研究和可观的金钱支出，被称为间质性膀胱炎/疼痛膀胱综合征(IC/PBS)的泌尿系统慢性盆腔疼痛综合征(UCPPS)的病理生理学仍然难以捉摸。这项爱荷华大学MAPP拨款提案旨在从一个新的角度研究这种情况。这项建议是围绕这样一个普遍假设设计的，即具有IC/PBS膀胱症状的患者与纤维肌痛(FM)或肠易激综合征(IBS)等共病情况的患者有其症状的全身性基础，并且与仅有IC/PBS膀胱症状的患者有根本不同。我们的一般假设是基于这个Mapp应用程序中的研究人员之前的工作，这将在后面的部分中详细介绍。在这笔赠款中提出的5个项目的计划项目计划和设计阶段，所有的研究人员都从这个一般假设出发。拟议的工作很重要，因为它具有新颖性，而且拟议的5个项目之间存在协同作用和横向一体化。这些项目的目的是检验IC/PBS的异质性状况。所有临床项目的患者队列都是相似的，包括仅在膀胱有IC/PBS症状的患者、有IC/PBS膀胱症状并伴有全身合并症(FM、IBS)的患者、仅有合并症的患者(FM.IBS)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加强和扩大临床项目的范围，以增加对UCPPS综合征(IC/PBS)的基本细胞、分子和生化方面的了解。项目建议书从多方面的角度审查了IC/PBS的UCPPS。该发现站点项目的后续数据分析将描述每组与HPA轴、应激反应、神经生理学、疼痛模式、生物和行为易感因素、基础免疫学和生化相关的表型和风险因素。

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.