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Akshay A, Besic M, Kuhn A, Burkhard FC, Bigger-Allen A, Adam RM, Monastyrskaya K, Hashemi Gheinani A. Machine Learning-Based Classification of Transcriptome Signatures of Non-Ulcerative Bladder Pain Syndrome. Int J Mol Sci 2024; 25:1568. [PMID: 38338847 PMCID: PMC10855300 DOI: 10.3390/ijms25031568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024] Open
Abstract
Lower urinary tract dysfunction (LUTD) presents a global health challenge with symptoms impacting a substantial percentage of the population. The absence of reliable biomarkers complicates the accurate classification of LUTD subtypes with shared symptoms such as non-ulcerative Bladder Pain Syndrome (BPS) and overactive bladder caused by bladder outlet obstruction with Detrusor Overactivity (DO). This study introduces a machine learning (ML)-based approach for the identification of mRNA signatures specific to non-ulcerative BPS. Using next-generation sequencing (NGS) transcriptome data from bladder biopsies of patients with BPS, benign prostatic obstruction with DO, and controls, our statistical approach successfully identified 13 candidate genes capable of discerning BPS from control and DO patients. This set was validated using Quantitative Polymerase Chain Reaction (QPCR) in a larger patient cohort. To confirm our findings, we applied both supervised and unsupervised ML approaches to the QPCR dataset. A three-mRNA signature TPPP3, FAT1, and NCALD, emerged as a robust classifier for non-ulcerative BPS. The ML-based framework used to define BPS classifiers establishes a solid foundation for comprehending the gene expression changes in the bladder during BPS and serves as a valuable resource and methodology for advancing signature identification in other fields. The proposed ML pipeline demonstrates its efficacy in handling challenges associated with limited sample sizes, offering a promising avenue for applications in similar domains.
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Affiliation(s)
- Akshay Akshay
- Functional Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, 3008 Bern, Switzerland; (A.A.); (M.B.); (F.C.B.)
- Graduate School for Cellular and Biomedical Sciences, University of Bern, 3012 Bern, Switzerland
| | - Mustafa Besic
- Functional Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, 3008 Bern, Switzerland; (A.A.); (M.B.); (F.C.B.)
| | - Annette Kuhn
- Department of Gynaecology, Inselspital University Hospital, 3010 Bern, Switzerland;
| | - Fiona C. Burkhard
- Functional Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, 3008 Bern, Switzerland; (A.A.); (M.B.); (F.C.B.)
- Department of Urology, Inselspital University Hospital, University of Bern, 3012 Bern, Switzerland
| | - Alex Bigger-Allen
- Urological Diseases Research Center, Boston Children’s Hospital, Boston, MA 02115, USA; (A.B.-A.); (R.M.A.)
- Department of Surgery, Harvard Medical School, Boston, MA 02114, USA
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Rosalyn M. Adam
- Urological Diseases Research Center, Boston Children’s Hospital, Boston, MA 02115, USA; (A.B.-A.); (R.M.A.)
- Department of Surgery, Harvard Medical School, Boston, MA 02114, USA
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Katia Monastyrskaya
- Functional Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, 3008 Bern, Switzerland; (A.A.); (M.B.); (F.C.B.)
- Department of Urology, Inselspital University Hospital, University of Bern, 3012 Bern, Switzerland
| | - Ali Hashemi Gheinani
- Functional Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, 3008 Bern, Switzerland; (A.A.); (M.B.); (F.C.B.)
- Department of Urology, Inselspital University Hospital, University of Bern, 3012 Bern, Switzerland
- Urological Diseases Research Center, Boston Children’s Hospital, Boston, MA 02115, USA; (A.B.-A.); (R.M.A.)
- Department of Surgery, Harvard Medical School, Boston, MA 02114, USA
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
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Di Bello F, Pezone G, Muzii B, Cilio S, Ruvolo CC, Scandurra C, Mocini E, Creta M, Morra S, Bochicchio V, Salzano G, Vaira LA, Mangiapia F, Motta G, Maldonato NM, Longo N, Cantone E, Califano G. Lower urinary tract symptoms in young-middle aged males with a diagnosis of obstructive sleep apnea syndrome. Neurourol Urodyn 2024; 43:144-152. [PMID: 38010890 DOI: 10.1002/nau.25338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The aim of the current study is to measure the prevalence and the potential role of International Prostate Symptom Score (IPSS) score as a predictor of obstructive sleep apnea syndrome (OSAS) in male experienced lower urinary tract symptoms (LUTS). METHODS A cross-sectional web-based Italian survey was administered via Google Forms between July 17 and October 31, 2022. The urinary functioning was measured through the IPSS questionnaire. Specifically, we considered symptoms occurring more than "about half the time" (score ≥ 3) as bothering symptoms. Multivariable logistic regression models (LRMs) adjusting for age, body mass index (BMI), International Index of Erectile Function-5, IPSS, and hypertension were fitted to predict OSAS in the cohort of men responding to the survey and experiencing LUTS. RESULTS Overall, 58 (24.4%) patients had a confirmed diagnosis of OSAS. The overall median IPSS was 5 (inter quartile range [IQR]: 3-8), respectively. According to IPSS items, 24 (10%), 44 (18.4%), 12 (5%), 12 (5%), 12 (5%), 11 (4.6%), 63 (26.4%) patients exhibit incomplete bladder emptying, urinary frequency, intermittency, urgency, weak stream, straining, nocturia with a score ≥ 3, respectively. After multivariable LRMs predicting the developing OSAS, age (odds ratio [OR]: 1.09, p < 0.001), BMI (OR:1.12, p < 0.001) and IPSS total score (OR:1.08, p = 0.02) were independent predicting factors. CONCLUSION This analysis revealed that the IPSS total score, age, and BMI are independent predictors of OSAS in males. In this context, the use of IPSS in daily practice could be helpful in assessing the LUTS presence and in supporting physicians to identify a hidden sleep apnea condition.
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Affiliation(s)
- Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Gabriele Pezone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Benedetta Muzii
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Simone Cilio
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Cristiano Scandurra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | | | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Hospital of Naples "Federico II", Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Gaetano Motta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Nelson Mauro Maldonato
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Elena Cantone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
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Hill K, Hug S, Smith A, O’Sullivan P. The Role of Illness Perceptions in Dyspnoea-Related Fear in Chronic Obstructive Pulmonary Disease. J Clin Med 2023; 13:200. [PMID: 38202207 PMCID: PMC10780095 DOI: 10.3390/jcm13010200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
Dyspnoea is often the most distressing symptom described by people with a chronic respiratory condition. The traditional biomedical model of neuromechanical uncoupling that explains the physiological basis for dyspnoea is well accepted. However, in people with chronic obstructive pulmonary disease (COPD), measures that are linked with neuromechanical uncoupling are poorly related to the restriction in activity during daily life attributed to dyspnoea. This suggests that activity restriction that results from dyspnoea is influenced by factors other than expiratory airflow limitation and dynamic pulmonary hyperinflation, such as the ways people perceive, interpret and respond to this sensation. This review introduces the common-sense model as a framework to understand the way an individual's lay beliefs surrounding sensations can lead to these sensations being perceived as a health threat and how this impacts their emotional and behavioural responses. The aim is to provide insight into the nuances that can shape an individual's personal construct of dyspnoea and offer practical suggestions to challenge unhelpful beliefs and facilitate cognitive re-structuring as a pathway to reduce distress and optimise health behaviours and outcomes.
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Affiliation(s)
- Kylie Hill
- Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia; (S.H.); (A.S.); (P.O.)
| | - Sarah Hug
- Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia; (S.H.); (A.S.); (P.O.)
- Physiotherapy Department, Royal Perth Hospital, Victoria Square, Perth, WA 6000, Australia
| | - Anne Smith
- Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia; (S.H.); (A.S.); (P.O.)
| | - Peter O’Sullivan
- Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia; (S.H.); (A.S.); (P.O.)
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