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Urology. 2016 Apr;90:56-61. doi: 10.1016/j.urology.2015.12.040. Epub 2016 Jan 6.

Inflammation and Symptom Change in Interstitial Cystitis or Bladder Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Study.

Author information

1
Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI.
2
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA.
3
Department of Urology, University of Iowa, Iowa City, IA.
4
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA; Department of Urology, University of Iowa, Iowa City, IA.
5
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA; Department of Urology, University of Iowa, Iowa City, IA; Department of Psychological and Brain Science, University of Iowa, Iowa City, IA. Electronic address: Susan-lutgendorf@uiowa.edu.

Abstract

OBJECTIVE:

To explore inflammatory factors that influence symptom changes in interstitial cystitis or bladder pain syndrome (IC or BPS). This longitudinal, prospective study examined the association of inflammation elicited by Toll-like receptor (TLR) stimulation in peripheral blood mononuclear cells (PBMCs) and diurnal cortisol rhythms with changes in painful and urinary symptoms of IC or BPS and symptom flares over a 48-week period.

MATERIALS AND METHODS:

Participants were 24 women meeting criteria for IC or BPS who supplied blood for isolation of PBMCs and 3 days of salivary cortisol samples prior to a baseline visit. Participants completed the Genitourinary Pain Index (pain and urinary subscales) and reported symptom flares every 2 weeks for 48 weeks. Mixed effects longitudinal and regression models were used to determine if inflammatory variables were associated with the changes in IC or BPS symptoms (time × variable interactions), and the probability of a symptom flare.

RESULTS:

Elevated TLR-4 inflammation (P = .031) and elevated TLR-2 inflammation (P = .045) from PBMCs, and flattened diurnal cortisol slope (P = .012) were each associated with less improvement in genitourinary pain over time. Additionally, elevated TLR-4 inflammation was associated with less improvement in urinary symptoms (P = .018), whereas TLR-2 inflammation and cortisol slopes were not (both P > .16). In contrast, no inflammatory measure was associated with an increased likelihood of reporting a symptom flare (all P > .25).

CONCLUSION:

TLR-mediated inflammation and diurnal cortisol slope may be useful as markers of symptom changes in IC or BPS.

PMID:
26768711
PMCID:
PMC4892365
DOI:
10.1016/j.urology.2015.12.040
[Indexed for MEDLINE]
Free PMC Article

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