Expansion of the MAPP Research Network: Microbial and Biopsychosocial Contributio

描述（由申请人提供）：Nickel博士及其合作研究网络在慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）和间质性膀胱炎/膀胱疼痛综合征（IC/BPS）（统称为泌尿系慢性盆腔疼痛综合征（UCPPS））领域进行了大量病因学、流行病学、诊断和治疗研究。他和他的研究小组参加了NIH资助的CPCRN（1和2），ICTTG和ICCRN合作研究网络，分别评估CP/CPPS和IC/BPS，Nickel博士是第一个trans-MAPP感染病原学研究的项目负责人。基于这一经验，我们假设，定义的患者表型中的症状严重程度、影响和模式（包括发作）与非常异质的患者特异性泌尿微生物或微生物组模式（或变化）以及（伴侣）因素、其他心理参数（抑郁、灾难化、疾病感知）、睡眠、性状态和环境因素（饮食、感知压力、运动）相关。我们的目标（目标1）是通过成为一个活跃的发现研究中心，利用我们的专业知识和经验来帮助患者入组（尤其是难以入组的患者亚型），并建议临床、体格、泌尿和心理社会评估以及用于预测表型鉴定的结局工具，从而增强拟议的trans-MAPP症状模式研究。我们进一步计划（目标2）扩展我们的初始和正在进行的trans-MAPP感染病因学项目（使用最先进的培养物独立技术），以确定下尿路微生物组对入组trans-MAPP症状模式研究的UCPPS患者的症状（症状表型）和症状模式变化（包括发作）的临床意义和影响。

DESCRIPTION (provided by applicant): Dr. Nickel and his collaborative research network have undertaken numerous etiology, epidemiology, diagnostic, and treatment studies in the field of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and interstitial cystitis/bladder pain syndrome (IC/BPS) referred to collectively as Urologic Chronic Pelvic Pain Syndrome (UCPPS). He and his research group have participated in the NIH funded CPCRN (1 and 2), ICTTG and ICCRN collaborative research networks evaluating CP/CPPS and IC/BPS respectively and Dr. Nickel was the Project Leader for the first Trans-MAPP Infection Etiology Study. Based on this experience, we hypothesize that symptom severity, impact and patterns (including flares) in defined patient phenotypes are associated with very heterogeneous patient-specific urinary microbial or microbiome patterns (or changes) as well as (partner) factors, other psychological parameters (depression, catastrophizing, illness perception), sleep, sexual status, and environment factors (diet, perceived stress, exercise). Our aim (Aim 1) is the enhance the proposed trans-MAPP Symptom Pattern Study by becoming an active Discovery Site, employing our expertise and experience to assist in patient enrollment (particularly difficult to enroll patient subtypes) as well as to suggest clinical, physical, urological and psychosocial assessment and outcome tools for predictive phenotype identification. We further plan (Aim 2) to expand our initial and ongoing trans-MAPP Infection Etiology Project (using state of the art culture independent technology) to determine the clinical implications and impact of the microbiome of the lower urinary tract on symptoms (symptom phenotype) and changing symptom patterns (including flares) in patients with UCPPS enrolled in the trans-MAPP Symptom Pattern Study.