POSSIBLE NEUROPATHIC ORIGIN OF INTERSTITIAL CYSTITIS

这项建议针对的是一种主要出现在 女性间质性膀胱炎(I.C.)。这项研究的动力来自于 感觉性症状在这种综合征中的突出感觉症状和一个明显的 ICC的发生在可能遭受过创伤的女性中 因生育或盆腔疾病而导致的盆腔结构。有没有可能 骨盆区域的神经损伤可导致自主神经病变 在某种程度上影响感觉纤维，类似于躯体综合症， 伤痛，是有待探索的。自主神经传出产生的影响 对膀胱传入神经的活动进行测试，以及如何部分去神经 修改任何效果都需要检查。问题是是否部分地 去神经支配导致残存或死亡的特征改变 再生的提供膀胱的传入神经元，使它们 对自主活动感到兴奋，并产生迹象和 I.C.的症状。这项研究建议系统地调查 膀胱测速生理学刺激的传入纤维特性 在正常成年大鼠的膀胱扩张，以建立一个 对照组基线。作为这项调查的一部分，计划收集 关于这样的膀胱传入单位的子集是否 专门用于检测过度膨胀。刺激的效果 自主神经传出神经到膀胱和自主化学物质 介质(去甲肾上腺素、Sp、VIP、神经肽Y、胆碱、三磷酸腺苷 类似物)有关这种传入特性的信息将被研究。有多偏颇 腹下、盆腔或交感神经损伤所致的失神经 神经(在无菌手术条件下)改变任何自主神经 感官的调节，然后将评估器官的特征。是这样的 关于膀胱感觉器官及其修饰的信息 在模拟临床情况下的特征将 是一项新的贡献，并为可能的- I.C.的感觉神经元病因学。它有可能开辟新的 本病与其他脏腑辨证论治 可能是神经性疾病引起的疾病。

This proposal is aimed at the etiology of a syndrome largely appearing in women, interstitial cystitis (I.C.). The impetus for the study comes from the prominence of sensory symptoms in this syndrome and a predominant occurrence of I.C. in women who may have suffered traumatic injury of pelvic structures by childbearing or pelvic disease. The possibility that neural damage in the pelvic region can lead to an autonomic neuropathy affecting sensory fibers in some way comparable to the somatic syndrome, causalgia, is to be explored. The effects produced by autonomic efferent activity on bladder afferents are to be tested and how partial denervation modifies any effects is to be examined. The issue is whether partial denervation leads to alterations in characteristics of remaining or regenerated afferent neurons supplying the urinary bladder so, that they become excited by autonomic activity and give rise to the signs and symptoms of I.C. The study proposes a systematic survey of the range of characteristics of afferent fibers excited by cystometric physiological distension of the bladder in normal adult rats in order to establish a control group baseline. As part of this survey, it is planned to gather information on whether a subset of such bladder afferent units are specialized for detection of excessive distention. Effects of stimulation of autonomic efferent nerves to the bladder and of autonomic chemical mediators (norepinephrine, Sp, VIP, neuropeptide Y, cholinergics, ATP analogues) on such afferent characteristics will be examined. How partial denervation produced by injury of the hypogastric, pelvic or sympathetic nerves (under sterile surgical conditions) modifies any autonomic modulation of sense, organ characteristics will then be evaluated. Such information on sense organs of the bladder and modifications in their characteristics under circumstances simulating clinical conditions would be a novel contribution and provide important insight into a possible- sensory neuron etiology of I.C. It has the potential of opening new approaches to treatment of this syndrome and that of other visceral disorders of possible neuropathic origin.