Washington University MAPP Network Discovery Site

描述（由申请人提供）：这是华盛顿大学发现网站继续参与MAPP研究网络的申请。MAPP于2008年10月启动，以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的间质性膀胱炎/膀胱疼痛综合征（IC/BPS）以及男性的慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）。通过MAPP第1阶段的广泛科学发现项目，我们更好地了解了UCPPS疼痛的表型亚组，生物标志物，症状加重（“耀斑”）的流行病学因素，生理相关性（例如定量感觉测试，解剖和功能神经成像），以及骨盆疼痛的机制基础，使用临床前模型概括了UCPPS的关键临床症状。华盛顿大学探索网站特别富有成效。到目前为止，我们有9篇出版物，涵盖了关键领域，如UCPPS表型，耀斑，感染和膀胱疼痛的动物研究。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和健康对照组比其他任何研究中心都多。我们也有97%的成功率在收集生物样本的生物标志物研究。对于MAPP-II，我们提出了以下五个具体目标：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内改善他们的症状，而其他亚组则倾向于恶化。在这里，我们提出了一个前瞻性的观察性研究，以确定表型因素与恶化和/或改善的泌尿系统和非泌尿系统症状在一个较长的时间为三年。这项研究之所以重要，有很多原因。在最基本的水平上，能够准确预测个体患者的UCPPS症状的临床过程将是有帮助的。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：UCPPS症状发作（UCPPS症状加重）的扩展评估目的4：UCPPS的尿代谢组学特征目的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