Interstitial cystitis

Characteristic genes and immune landscape of interstitial cystitis

BACKGROUND

Interstitial cystitis (IC) was still a disease with the exclusive diagnosis and lacked an effective gold standard. It was of great significance to find diagnostic markers for IC. Our study was aimed to screen characteristic genes via machine learning algorithms, characterize the immune landscape of IC, and show correlations between characteristic genes and immune cell subtypes.

METHODS

RNA sequencing data sets on IC were downloaded from Gene Expression Omnibus (GEO) database, including GSE57560, GSE11783 and GSE621, whose corresponding platforms were GPL16699, GPL570 and GPL262 respectively. Three machine learning algorithms were applied for identification of characteristic gene for IC. Single sample Gene Set Enrichment Analysis (ssGSEA) was applied to figure out the immune cell infiltration (ICI) of IC and normal tissue samples. Correlation analysis was performed via Spearman test. Receiver operator characteristic curve (ROC) was used to evaluate diagnostic efficacy of key genes.

RESULTS

CCL18, MMP10 and WIF1 were identified as characteristic gene via machine learning algorithms. MMP10 and CCL18 were with higher expression in IC tissues compared with normal bladder tissues, while WIF1 had lower expressionin IC tissues (P < 0.05). These three genes had good diagnostic efficacy for IC. Compared with normal bladder tissues, 18 immune cell subtypes were up-regulated in interstitial cystitis tissues (P < 0.05). MMP10 and CCL18 were positively correlated to immune scores in IC, while WIF1 was negatively correlated to immune scores (P > 0.05).

CONCLUSION

We screened the feature genes, CCL18, MMP10 and WIF1, among the differentially expressed genes (DEGs) by three different machine learning algorithms. They showed good diagnostic performance in both training and testing cohorts and were potential diagnostic markers for IC. We paint the immune landscape of IC. In IC tissue, immune cell subtypes infiltrated extensively. Most immune cell subtypes were up-regulated in IC tissue, including mast cells, activated CD4 T cells, and regulatory T cells that suppress immune responses. MMP10 and CCL18 had positive correlation to ICI, while WIF was negatively correlated with ICI. MMP10 and CCL18 may be the driving factors of immune response or their expression levels may be increased by immune response. The effect of characteristic genes of IC on immune cell subtypes still needed to be further explored.

H2S and Pain: A Novel Aspect for Processing of Somatic, Visceral and Neuropathic Pain Signals

Hydrogen sulfide (H2S) formed by multiple enzymes including cystathionine-γ-lyase (CSE) targets Cav3.2 T-type Ca2+ channels (T-channels) and transient receptor potential ankyrin-1 (TRPA1). Intraplantar and intracolonic administration of H2S donors promotes somatic and visceral pain, respectively, via activation of Cav3.2 and TRPA1 in rats and/or mice. Injection of H2S donors into the plantar tissues, pancreatic duct, colonic lumen, or bladder causes T-channel-dependent excitation of nociceptors, determined as phosphorylation of ERK or expression of Fos in the spinal dorsal horn. Electrophysiological studies demonstrate that exogenous and/or endogenous H2S facilitates membrane currents through T-channels in NG108-15 cells and isolated mouse dorsal root ganglion (DRG) neurons that abundantly express Cav3.2 and also in Cav3.2-transfected HEK293 cells. In mice with cerulein-induced pancreatitis and cyclophosphamide-induced cystitis, visceral pain and/or referred hyperalgesia are inhibited by CSE inhibitors and by pharmacological blockade or genetic silencing of Cav3.2, and CSE protein is upregulated in the pancreas and bladder. In rats with neuropathy induced by L5 spinal nerve cutting or by repeated administration of paclitaxel, an anticancer drug, the neuropathic hyperalgesia is reversed by inhibitors of CSE or T-channels and by silencing of Cav3.2. Upregulation of Cav3.2 protein in DRG is detectable in the former, but not in the latter, neuropathic pain models. Thus, H2S appears to function as a nociceptive messenger by facilitating functions of Cav3.2 and TRPA1, and the enhanced function of the CSE/H2S/Cav3.2 pathway is considered to be involved in the pancreatitis- and cystitis-related pain and in neuropathic pain.

Luminal DMSO: effects on detrusor and urothelial/lamina propria function

DMSO is used as a treatment for interstitial cystitis and this study examined the effects of luminal DMSO treatment on bladder function and histology. Porcine bladder was incubated without (controls) or with DMSO (50%) applied to the luminal surface and the release of ATP, acetylcholine, and LDH assessed during incubation and in tissues strips after DMSO incubation. Luminally applied DMSO caused ATP, Ach, and LDH release from the urothelial surface during treatment, with loss of urothelial layers also evident histologically. In strips of urothelium/lamina propria from DMSO pretreated bladders the release of both ATP and Ach was depressed, while contractile responses to carbachol were enhanced. Detrusor muscle contractile responses to carbachol were not affected by DMSO pretreatment, but neurogenic responses to electrical field stimulation were enhanced. The presence of an intact urothelium/lamina propria inhibited detrusor contraction to carbachol by 53% and this inhibition was significantly reduced in DMSO pretreated tissues. Detection of LDH in the treatment medium suggests that DMSO permeabilised urothelial membranes causing leakage of cytosolic contents including ATP and Ach rather than enhancing release of these mediators. The increase in contractile response and high levels of ATP are consistent with initial flare up in IC/PBS symptoms after DMSO treatment.

Increased risk of ischemic stroke among women with bladder pain syndrome/interstitial cystitis: a cohort study from Taiwan

AIM

Vascular factors are proposed in the etiology of bladder pain syndrome/interstitial cystitis (BPS/IC). In this study, we investigated the risk of stroke among women following a diagnosis of BPS/IC over 3 years of follow-up, compared to controls without a BPS/IC diagnosis.

METHODS

This retrospective cohort study used data retrieved from the Taiwan "Longitudinal Health Insurance Database 2000." We identified 847 women who received a diagnosis of BPS/IC between January 1, 2001 and December 31, 2008 (study group) and 4,235 comparison women (women without a BPS/IC diagnosis matched on age and other selected demographic variables. All subjects were tracked for 3 years following the index date to identify those who received a diagnosis of stroke during follow-up.

RESULTS

The stroke incidence rate was 20.86 (95% confidence interval (CI): 15.78-27.07) and 11.65 (95% CI: 9.88-13.64) per 1,000 person-years among the study and comparison cohorts, respectively. Cox regression analysis showed a stroke hazard ratio (HR) of 1.52 (95% CI: 1.09-2.14) in the BPS/IC group relative to the comparison group over 3-year follow-up, after adjusting for hypertension, diabetes, coronary heart disease, atrial fibrillation, hyperlipidemia, and chronic kidney disease. The adjusted HR of ischemic stroke was 1.52 (95% CI: 1.02-2.27). However, there was no significant difference between the two groups in hemorrhagic stroke risk.

CONCLUSIONS

Our study demonstrates an association between BPS/IC and a subsequent ischemic stroke diagnosis among women in Taiwan.

Bladder pain syndrome/interstitial cystitis is associated with anxiety disorder

AIM

Recent research demonstrated that bladder pain syndrome/interstitial cystitis (BPS/IC) is associated with many coexisting physical and psychiatric conditions. In this study, we explored the potential association between anxiety disorder (AD) and BPS/IC using a case-controlled population-based approach in Taiwan.

METHODS

Data on the sampled subjects analyzed in this study were retrieved from the Longitudinal Health Insurance Database 2000. Our study included 396 female cases with BPS/IC and 1,980 randomly selected female controls. We excluded subjects who had a history of major psychosis (except AD) or a substance-related disorder. A conditional logistic regression was performed to calculate the odds ratio (OR) for the association between a previous diagnosis of AD and IC/BPS.

RESULTS

Of the 2,376 sampled subjects, 136 (5.72%) had received an AD diagnosis. AD was found in 64 (16.16%) cases and in 72 (3.64%) controls (P < 0.001). The conditional logistic regression analysis (conditioned on age group and the index year) suggested that compared to controls, the OR for prior AD among cases was 4.59 (95% confidence interval (CI) = 2.32-9.08, P < 0.001). After adjusting for chronic pelvic pain, irritable bowel syndrome, fibromyalgia, migraines, sicca syndrome, allergies, asthma, and an overactive bladder, the OR for prior AD among cases was 4.37 (95% CI = 2.16-8.85, P < 0.001) compared to the controls.

CONCLUSIONS

There was an association between AD and BPS/IC, even after taking demographic characteristics, medical co-morbidities, and substance-related disorders into consideration. Results of this study should alert clinicians to evaluate and monitor the presence of BPS/IC in patients with AD.

Bladder pain syndrome/interstitial cystitis increase the risk of coronary heart disease

AIM

Vascular factor was proposed as being involved in the etiology of bladder pain syndrome/interstitial cystitis (BPS/IC). However, few studies have attempted to investigate the relationship between BPS/IC and cardiovascular disease. This study aimed to investigate the risk of coronary heart disease (CHD) among BPS/IC subjects during a 3-year follow-up period.

METHODS

Data for this retrospective matched-cohort study were retrieved from the Taiwan "Longitudinal Health Insurance Database 2000." There were 752 BPS/IC female subjects in the study cohort and 3,760 randomly selected female subjects in the comparison cohort. We individually tracked each subject for 3 years and identified each subject that received a subsequent diagnosis of CHD during that follow-up period.

RESULTS

Results showed that incidence rates of CHD during the 3-year follow-up period were 19.50 (95% confidence interval (CI): 14.35-25.95) and 8.87 (95% CI: 7.25-10.74) per 1,000 person-years for the study and comparison cohorts, respectively. The Cox proportional hazards regression suggested that the hazard ratio for CHD in subjects with BPS/IC was 1.65 (95% CI: 1.09-2.48) within the 3-year follow-up period following the index date compared to the comparison subjects after adjusting for monthly income, geographic region, hypertension, diabetes, hyperlipidemia, chronic kidney disease, bladder outlet obstruction, urinary tract infection, chronic pelvic pain, overactive bladder, and number of physician visits during the 3-year follow up period.

CONCLUSIONS

Our study demonstrated an association between BPS/IC and a subsequent CHD diagnosis. We advise clinicians to screen subjects with BPS/IC for modifiable risk factors for CHD.

Obstructive sleep apnea increases the risk of bladder pain syndrome/interstitial cystitis: a population-based matched-cohort study

AIMS

Previous studies indicated a possible association between bladder pain syndrome/interstitial cystitis (BPS/IC) and sleep disorders including sleep abnormalities with delayed onset of sleep, waking up before needed, and snoring. Nevertheless, no previous study has reported the association between obstructive sleep apnea (OSA) and BPS/IC. In this retrospective cohort study, we examined the risk of BPS/IC among subjects with OSA during a 3-year follow-up in Taiwan using a population-based dataset.

METHODS

This study comprised 2,940 study subjects with OSA, and 29,400 randomly selected comparison subjects. We individually followed-up each sampled subject (n = 32,340) for a 3-year period to identify those subjects who subsequently received a diagnosis of BPS/IC. A Cox proportional hazards regression model was constructed to estimate the risk of subsequent BPS/IC following a diagnosis of OSA.

RESULTS

Incidences of BPS/IC during the 3-year follow-up period were 13.61 (95% confidence interval [CI] = 7.37-23.13) and 3.60 (95% CI = 2.06-4.39) for subjects with and those without OSA, respectively. After adjusting for diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraines, sicca syndrome, allergies, endometriosis, asthma, tobacco use disorder, and alcohol abuse, the stratified Cox proportional hazards regressions revealed that the hazard ratio for BPS/IC among subjects with OSA was 3.71 (95% CI = 1.81-7.62, P < 0.001) that of comparison subjects.

CONCLUSIONS

This study provides epidemiological evidence of a link between OSA and a subsequent BPS/IC diagnosis. We suggest that clinical practitioners treating subjects with OSA be alert to urinary complaints in this population.

Involvement of the endogenous hydrogen sulfide/Ca(v) 3.2 T-type Ca2+ channel pathway in cystitis-related bladder pain in mice

BACKGROUND AND PURPOSE

Hydrogen sulfide (H(2) S), generated by enzymes such as cystathionine-γ-lyase (CSE) from L-cysteine, facilitates pain signals by activating the Ca(v) 3.2 T-type Ca(2+) channels. Here, we assessed the involvement of the CSE/H(2) S/Ca(v) 3.2 pathway in cystitis-related bladder pain.

EXPERIMENTAL APPROACH

Cystitis was induced by i.p. administration of cyclophosphamide in mice. Bladder pain-like nociceptive behaviour was observed and referred hyperalgesia was evaluated using von Frey filaments. Phosphorylation of ERK in the spinal dorsal horn was determined immunohistochemically following intravesical administration of NaHS, an H(2) S donor.

KEY RESULTS

Cyclophosphamide caused cystitis-related symptoms including increased bladder weight, accompanied by nociceptive changes (bladder pain-like nociceptive behaviour and referred hyperalgesia). Pretreatment with DL-propargylglycine, an inhibitor of CSE, abolished the nociceptive changes and partly prevented the increased bladder weight. CSE protein in the bladder was markedly up-regulated during development of cystitis. Mibefradil or NNC 55-0396, blockers of T-type Ca(2+) channels, administered after the symptoms of cystitis appeared, reversed the nociceptive changes. Further, silencing of Ca(v) 3.2 protein by repeated intrathecal administration of mouse Ca(v) 3.2-targeting antisense oligodeoxynucleotides also significantly attenuated the nociceptive changes, but not the increased bladder weight. Finally, the number of cells staining positive for phospho-ERK was increased in the superficial layer of the L6 spinal cord after intravesical administration of NaHS, an effect inhibited by NNC 55-0396.

CONCLUSION AND IMPLICATIONS

Endogenous H(2) S, generated by up-regulated CSE, caused bladder pain and referred hyperalgesia through the activation of Ca(v) 3.2 channels, one of the T-type Ca(2+) channels, in mice with cyclophosphamide-induced cystitis.

A safety study on single intravenous dose of tetrachloro-diphenyl glycoluril [iodogen] dissolved in dimethyl sulphoxide (DMSO)

1. Iodogen (tetrachloro-diphenyl glycoluril) dissolved in DMSO (dimethyl sulphoxide) appears indispensable in radioiodination of hypericin for a new anticancer strategy. We studied the safety of intravenously administered iodogen/DMSO in mice (n = 132). 2. Median lethal dose (LD50) of iodogen/DMSO was determined with doses of 40.0, 50.0, 55.0, 60.0, 65.0 and 70.0 mg/kg. Next, toxicity of iodogen/DMSO at 30.0 mg/kg was evaluated using saline and DMSO as controls. Changes in behaviour, body weight and serum biochemistry were evaluated. Histopathology of lungs, heart, liver and kidney was performed. 3. LD50 values of iodogen/DMSO were 59.5 mg/kg (95% confidence limits (CI): 54.1-65.4 mg/kg) and 61.0 mg/kg (95%CI: 56.2-66.2 mg/kg) for female and male mice, respectively. Similar to that of control groups, no animal deaths were encountered after iodogen/DMSO administration at 30.0 mg/kg. Body weights over 24 h were not altered in all groups, but significantly higher in iodogen/DMSO and DMSO groups (p < 0.05) 14 d post-injection. Blood urea nitrogen and alkaline phosphatase increased (p < 0.05) in iodogen/DMSO group without clinical symptoms. No pathologies were found by gross and microscopic inspection. 4. A single dose of iodogen/DMSO up to 30.0 mg/kg, over 3000 times the dose in potential human applications, appears safe, with an LD50 doubling that dose in mice.

NAD(P)H:quinone oxidoreductase 1 protects bladder epithelium against painful bladder syndrome in mice

Painful bladder syndrome (PBS), or interstitial cystitis, is a poorly understood chronic disease that is characterized by thinning of the bladder epithelium and intense pain. Here we demonstrate that NAD(P)H:quinone oxidoreductase 1(-/-) (NQO1(-/-)) mice developed in our laboratory represent a new animal model of PBS. NQO1 is known to protect against physiological stress as well as protecting transcription factors against proteasomal degradation. In this study we demonstrate that NQO1 is necessary for bladder epithelium integrity and to prevent the development/progression of PBS. We observed downregulation of energy metabolism, adhesion, and apoptotic signaling cascades, which led to mitochondrial aberrations and profound alterations in energy metabolism, increased susceptibility to reactive oxygen species generation, and apoptosis in luminal epithelium in NQO1(-/-) mice that were absent in wild-type mice. These pathophysiological changes led to the incidence of PBS in NQO1(-/-) mice. Altogether, the results demonstrate for the first time that NQO1 is an endogenous factor in protection against PBS.

Reflux esophagitis increased the risk of bladder pain syndrome/interstitial cystitis: a 3-year follow-up study

AIMS

Reflux esophagitis (RE) is a common disease which has been recognized to be associated with several medical co-morbidities. However, the association between RE and bladder pain syndrome/interstitial cystitis (BPS/IC) is still unknown. The present study aimed to explore the association between these two diseases.

METHODS

We identified 8,962 female patients who had received a diagnosis of RE as the study cohort. We randomly selected 44,810 subjects to be included as the comparison cohort. Each patient in this study was individually tracked for a 3-year period to identify those who subsequently received a diagnosis of BPS/IC. Cox proportional hazards regressions were carried out to estimate the 3-year risk of BPS/IC following a diagnosis of RE.

RESULTS

The incidence of BPS/IC following a diagnosis of RE was 4.3% during the follow-up period for all subjects. The incidence rate of BPS/IC was 2.38 [95% confidence interval (CI): 2.21-2.57] per 100 person-years in patients with RE, and 1.24 (95% CI: 1.18-1.30) per 100 person-years in controls. Cox proportional analysis indicated that the hazard ratio (HR) of BPS/IC for patients with RE was 2.00 (95% CI = 1.82-2.20, P < 0.001) that of controls. The adjusted HR of BPS/IC for patients with RE was 1.40 (95% CI = 1.27-1.55, P < 0.001) after taking age group, urbanization level, and medical comorbidity into consideration.

CONCLUSION

We found that patients with RE were at a higher risk than with comparison patients for having been subsequently diagnosed with BPS/IC during longitudinal follow-up.

Amitriptyline aggravates the fibrosis process in a rat model of infravesical obstruction

Infravesical obstruction (IVO) secondary to benign prostatic hypertrophy can affect up to 50% of men over 50 years old and may cause serious and irreversible alterations throughout the urinary tract, especially in the bladder. Therapeutic approaches are currently limited. Amitriptyline has recently been described as an analgesic, anti-inflammatory and myorelaxant in some experimental models. The objective of this study was to investigate the effects of amitriptyline hydrochloride on the process of fibrosis in a bladder outlet obstruction model in rats. Male Wistar rats were subjected to IVO and studied at intervals of 1 and 14 days postprocedure. The rats were randomly divided into five groups: sham, IVO1-T, IVO1-NT, IVO14-T and IVO14-NT. Bladder tissue was processed for histopathology, immunohistochemistry and RT-PCR. The IVO14 groups presented bladder fibrosis, smooth muscle cell hypertrophy and bladder wall thickening. The IVO14-T group demonstrated a higher intensity of fibrosis, higher macrophage infiltration rate and higher gene expression of Transforming growth factor (TGF) Tgf-β1. Thus this data shows that in this experimental mode amitriptyline had an amplifying effect on the process of fibrosis as a whole.

New aspects in the differential diagnosis and therapy of bladder pain syndrome/interstitial cystitis

Diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is presently based on mainly clinical symptoms. BPS/IC can be considered as a worst-case scenario of bladder overactivity of unknown origin, including bladder pain. Usually, patients are partially or completely resistant to anticholinergic therapy, and therapeutical options are especially restricted in case of BPS/IC. Therefore, early detection of patients prone to develop BPS/IC symptoms is essential for successful therapy. We propose extended diagnostics including molecular markers. Differential diagnosis should be based on three diagnostical “columns”: (i) clinical diagnostics, (ii) histopathology, and (iii) molecular diagnostics. Analysis of molecular alterations of receptor expression in detrusor smooth muscle cells and urothelial integrity is necessary to develop patient-tailored therapeutical concepts. Although more research is needed to elucidate the pathomechanisms involved, extended BPS/IC diagnostics could already be integrated into routine patient care, allowing evidence-based pharmacotherapy of patients with idiopathic bladder overactivity and BPS/IC.

Urologic chronic pelvic pain syndrome

Painful bladder syndrome or urologic chronic pelvic pain syndrome is a chronic condition that presents with lower urinary tract symptoms that include dysuria, urgency, frequent urination, and chronic pelvic pain. Diagnoses included in the painful bladder syndrome are interstitial cystitis and prostatodynia. The history, physical examination, and laboratory evaluation of patients with lower urinary tract symptoms are important in ruling out other diagnoses. Treatment options that are US Food and Drug Administration approved and evidence based are limited; however, many symptom-based treatment options can reduce symptoms and improve quality of life.

Diurnal variation in urodynamics of rat

In humans, the storage and voiding functions of the urinary bladder have a characteristic diurnal variation, with increased voiding during the day and urine storage during the night. However, in animal models, the daily functional differences in urodynamics have not been well-studied. The goal of this study was to identify key urodynamic parameters that vary between day and night. Rats were chronically instrumented with an intravesical catheter, and bladder pressure, voided volumes, and micturition frequency were measured by continuous filling cystometry during the light (inactive) or dark (active) phases of the circadian cycle. Cage activity was recorded by video during the experiment. We hypothesized that nocturnal rats entrained to a standard 12:12 light:dark cycle would show greater ambulatory activity and more frequent, smaller volume micturitions in the dark compared to the light. Rats studied during the light phase had a bladder capacity of 1.44+/-0.21 mL and voided every 8.2+/-1.2 min. Ambulatory activity was lower in the light phase, and rats slept during the recording period, awakening only to urinate. In contrast, rats studied during the dark were more active, had a lower bladder capacities (0.65+/-0.18 mL), and urinated more often (every 3.7+/-0.9 min). Average bladder pressures were not significantly different between the light and dark (13.40+/-2.49 and 12.19+/-2.85 mmHg, respectively). These results identify a day-night difference in bladder capacity and micturition frequency in chronically-instrumented nocturnal rodents that is phase-locked to the normal circadian locomotor activity rhythm of the animal. Furthermore, since it has generally been assumed that the daily hormonal regulation of renal function is a major driver of the circadian rhythm in urination, and few studies have addressed the involvement of the lower urinary tract, these results establish the bladder itself as a target for circadian regulation.

Gene expression profile of bladder tissue of patients with ulcerative interstitial cystitis

Background

Interstitial cystitis (IC), a chronic bladder disease with an increasing incidence, is diagnosed using subjective symptoms in combination with cystoscopic and histological evidence. By cystoscopic examination, IC can be classified into an ulcerative and a non-ulcerative subtype. To better understand this debilitating disease on a molecular level, a comparative gene expression profile of bladder biopsies from patients with ulcerative IC and control patients has been performed.

Results

Gene expression profiles from bladder biopsies of five patients with ulcerative IC and six control patients were generated using Affymetrix GeneChip expression arrays (Affymetrix – GeneChip^® Human Genome U133 Plus 2.0). More than 31,000 of > 54,000 tested probe sets were present (detection p-value < 0.05). The difference between the two groups was significant for over 3,500 signals (t-test p-value < 0.01), and approximately 2,000 of the signals (corresponding to approximately 1,000 genes) showed an IC-to-healthy expression ratio greater than two. The IC pattern had similarities to patterns from immune system, lymphatic, and autoimmune diseases. The dominant biological processes were the immune and inflammatory responses. Many of the up-regulated genes were expressed in leukocytes, suggesting that leukocyte invasion into the bladder wall is a dominant feature of ulcerative IC. Histopathological data supported these findings.

Conclusion

GeneChip expression arrays present a global picture of ulcerative IC and provide us with a series of marker genes characteristic for this subtype of the disease. Evaluation of biopsies from other bladder patients with similar symptoms (e.g. patients with non-ulcerative IC) will further indicate whether the data presented here will be valuable for the diagnosis of IC.

Bacterial cystitis is accompanied by increased peripheral thermal sensitivity in mice

PURPOSE

Visceral inflammation and pain associated with chemical cystitis produce increased sensitivity to noxious stimuli in the sacral dermatomes. We determined whether a similar sensitization occurs in response to bacterial cystitis.

MATERIALS AND METHODS

Bacterial cystitis was induced by intravesical instillation of Escherichia coli 1677 in female C57BL/6N and C3H/OuJ mice (Jackson Laboratories, Bar Harbor, Maine). C3H/HeJ mice (Jackson Laboratories) served as a control because C3H/HeJ mice lack functional toll-like receptor 4, which is an essential component of cellular recognition of bacterial lipopolysaccharide. Hind paw sensitivity to thermal stimulus was quantitatively determined 1, 2, 7 and 14 days after infection.

RESULTS

Intravesical instillation of E. coli produced infection in all strains of mice. Infection persisted in all C3H/OuJ and C3H/HeJ mice but it spontaneously cleared in some C57BL/6N mice. Increased sensitivity to thermal stimuli was observed in C57BL/6N and C3H/OuJ mice starting 1 to 2 days after E. coli instillation and it was still present 14 days after instillation. Increased sensitivity to thermal stimuli did not occur in C3H/HeJ mice.

CONCLUSIONS

E. coli induced cystitis produced increased sensitivity to peripheral thermal stimuli in mice with competent toll-like receptor 4.

Neue Verfahren der optimalen Patientenselektion für die anticholinerge Therapie

BACKGROUND

M3-specific inhibitors are currently preferred for anticholinergic therapy of OAB. However, not all of the patients profit from this regimen. This might reflect a heterogeneity of the patient group. The aim of this work is to define subgroups of patients with specific alterations of receptor expression and to profile the receptor expression individually. These receptor profiles might be used for the development of evidence-based "tailored" therapies.

PATIENTS AND METHODS

Detrusor probes from bladder carcinoma patients (BCa, n=9 F, n=7 male) and interstitial cystitis patients (IC, n=9 female) were examined using confocal immunofluorescence and PCR.

RESULTS

M2, M3, P2X1-3, and H1-3 mRNAs were demonstrated in detrusor tissue. As revealed by immunofluorescence, the M2 receptor expression was significantly higher in female compared to male BCa tissues. In addition, the M2 receptor was further upregulated in IC vs BCa in female detrusor.

CONCLUSIONS

IC patients showed specific alterations of their receptor profile. Individual receptor profiles might be used to optimize medicinal therapies.