Evaluating symptom severity and urinary cytokine levels in interstitial cystitis/bladder pain syndrome patients, with and without Hunner's lesions.

Bernadette Mm Zwaans, Sabrina Mota, Sarah N Bartolone, Elijah P Ward, Kenneth M Peters, Michael B Chancellor
Author Information
  1. Bernadette Mm Zwaans: Oakland University William Beaumont School of Medicine Rochester, MI, USA.
  2. Sabrina Mota: Corewell Health William Beaumont University Hospital Royal Oak, MI, USA.
  3. Sarah N Bartolone: Corewell Health William Beaumont University Hospital Royal Oak, MI, USA.
  4. Elijah P Ward: Corewell Health William Beaumont University Hospital Royal Oak, MI, USA.
  5. Kenneth M Peters: Oakland University William Beaumont School of Medicine Rochester, MI, USA.
  6. Michael B Chancellor: Oakland University William Beaumont School of Medicine Rochester, MI, USA.

Abstract

PURPOSE: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a condition characterized in part by urinary urgency, frequency, and pain. There is a strong interest in gathering more data to compare and assess the differences in characteristics based on the presence of Hunner's lesions in patients with IC/BPS.
MATERIALS AND METHODS: Using a nationwide crowdsource effort, we collected surveys and urine samples from patients with a history of IC/BPS. Participants completed the Interstitial Cystitis Symptom Index (ICSI) and Problem Index (ICPI), Overactive Bladder questionnaire (OABq SF), and pain scores. In addition, participants reported any co-morbidities and lifestyle modifications. Urinary cytokine levels were measured and compared to symptom severity.
RESULTS: 491 participants enrolled: 119 with history of ulcerative Hunner's lesions (UIC), 372 reported no lesions (NHIC), and 2 unknowns. 96.3% were female, and prevalence of UIC was equal for both genders. Average age was higher for UIC vs. NHIC group (P = 0.011), as was the duration since diagnosis (P < 0.001). Symptom scores were elevated in UIC patients (P < 0.001). Both groups widely implemented lifestyle modifications, with dietary changes being most prevalent (70.1%), followed by prescription medication usage (63.1%). More UIC compared to NHIC participants experienced co-morbidities (P = 0.010). Urine samples were analyzed for GRO, IL-6, IL-8, and MCP-1. MCP-1 levels were significantly higher in UIC patients (P = 0.044). Weak positive correlation was found between cytokines and symptom scores.
CONCLUSIONS: Patients with UIC and NHIC from across the United States displayed distinct phenotypic and urine biological characteristics. These findings contribute to increased understanding of IC/BPS and may aid in improving our knowledge of the condition.

Keywords

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Word Cloud

Created with Highcharts 10.0.0UICpatientsP0painIC/BPSlesionsNHICHunner'sscoresparticipantslevelssymptom=Interstitialcystitis/bladdersyndromeconditionurinarycharacteristicsurinesampleshistorySymptomIndexreportedco-morbiditieslifestylemodificationscytokinecomparedseverityhigher<0011%UrineMCP-1interstitialPURPOSE:characterizedparturgencyfrequencystronginterestgatheringdatacompareassessdifferencesbasedpresenceMATERIALSANDMETHODS:UsingnationwidecrowdsourceeffortcollectedsurveysParticipantscompletedCystitisICSIProblemICPIOveractiveBladderquestionnaireOABqSFadditionUrinarymeasuredRESULTS:491enrolled:119ulcerative3722unknowns963%femaleprevalenceequalgendersAverageagevsgroup011durationsincediagnosiselevatedgroupswidelyimplementeddietarychangesprevalent70followedprescriptionmedicationusage63experienced010analyzedGROIL-6IL-8significantly044WeakpositivecorrelationfoundcytokinesCONCLUSIONS:PatientsacrossUnitedStatesdisplayeddistinctphenotypicbiologicalfindingscontributeincreasedunderstandingmayaidimprovingknowledgeEvaluatingwithoutbiomarkerbladderinflammationcystitis

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