Abstract
ABSTRACTObjective:To evaluate the effect of intravesical hyaluronic acid (HA) treatment on inflammatory cells and the severity of inflammation in an interstitial cystitis rat model created with hydrogen chloride (HCL) via immunohistochemical studies and myeloperoxidase activity for the first time in the literature.Materials and Methods:A total of 30 adult female white Rattus Norvegicus rats were divided into 3 groups as the HCL group, hyaluronic acid treatment (HCL-HA) group and control group. Chemical cystitis was created by administering HCL(400 microL,10 mM) except control group. A single dose of intravesical HA(0.5 mL,0.8 mg/mL) was administered to the treatment group. The bladder tissues of all subjects were immunohistochemically stained. The cell surface markers were used to evaluate inflammatory cell infiltration. Mast cell activation and IL-6 was evaluated to assess the inflammation and severity of inflammation, respectively. Myeloperoxidase activity was measured as it shows neutrophil density. Statistical significance was accepted as P<0.05.Results:It was observed that there was rich monocyte, T lymphocyte, B lymphocyte, and Natural Killer cells infiltration and high IL-6 levels in the bladder tissue after the intravesical hydrogen chloride instillation, especially in the stroma layer(p<0.005). In the HCL-HA group, severity of inflammation had statistically significantly regressed to the levels of the control group(p<0.005). An increase was observed in the bladder myeloperoxidase activity of the HCL group compared to the other two groups(p<0.05).Conclusions:Single dose intravesical hyluronic acid instillation reduces inflammatory cell infiltration and the severity of bladder inflammation in the rat model of bladder pain syndrome/interstitial cystitis.
Highlights
The European Society for the Study of Interstitial Cystitis (ESSIC) and the European Association of Urology (EAU) define Bladder Pain Syndrome (BPS)/Interstitial Cystitis (IC) as the complaint of suprapubic pain associated with filling of the bladder accompanied by other symptoms such as increased frequency of daytime and nighttime urination, in the absence of a urinary infection or other pathology [1, 2].The etiology of BPS/IC is still not fully understood
Intravesical hyaluronic acid (HA), a treatment option recommended by guidelines, strengthens the uriibju | Hyaluronic acid in interstitial cystitis rat model ne-tissue barrier by integrating with the GAG layer and creates an anti-inflammatory effect by inhibiting the leukocyte migration, adhesion of immune complexes, and bonding with specific receptors (I-CAM 1) that occur during the inflammatory process [5, 6]
The rats were divided into 3 groups including the treatment group (HA-treated group) in which chemical cystitis was created by administering hydrogen chloride (HCl) and HA was administered, the disease group (HCl group) in which chemical cystitis was created using HCl but no treatment was administered, and the control group (PBS group) in which the stress of the test subjects was mimicked with phosphate buffered saline (PBS), so that there would be 10 rats in each group
Summary
The European Society for the Study of Interstitial Cystitis (ESSIC) and the European Association of Urology (EAU) define Bladder Pain Syndrome (BPS)/Interstitial Cystitis (IC) as the complaint of suprapubic pain associated with filling of the bladder accompanied by other symptoms such as increased frequency of daytime and nighttime urination, in the absence of a urinary infection or other pathology [1, 2].The etiology of BPS/IC is still not fully understood. Causes of urothelial dysfunction such as glycosaminoglycan (GAG) layer disorders and inhibition of urothelial cell proliferation have been reported as etiological factor [3, 4]. Lymphocytes and other cells express a large number of different marker molecules that can be used to identify cells and characterize the cell type on their surfaces. These marker molecules were named CD (Cluster of Differentiation) by the International Human Leukocyte Differentiation Antigens (HLDA) Study Group [7]. Mast cells have been shown to be active in bladder injury models generated by intravesical instillation of protamine sulfate [10]
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