Abstract
ObjectiveThe etiology and pathogenesis of interstitial cystitis/bladder pain syndrome (IC/BPS) are unclear. Chronic inflammation is considered the main pathology of IC/BPS. This study measured the serum c-reactive protein (CRP), nerve growth factor (NGF) and pro-inflammatory cytokine/chemokine interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and IL-8 expression in patients with IC/BPS to elucidate the involvement of systemic inflammation in IC/BPS.MethodsSerum samples were collected from 30 IC/BPS patients and 26 control subjects. The concentrations of serum nerve growth factor (NGF), IL-1β, IL-6, TNF-α, and IL-8 were quantified using a bead-based, human serum adipokine panel kit. Serum C-reactive protein (CRP) was also assessed. Differences of serum CRP, NGF, IL-1β, IL-6, TNF-α, and IL-8 levels between the IC/BPS patients and controls were compared, and correlations between CRP and pro-inflammatory cytokines and chemokine were also evaluated.ResultsThe results showed that CRP level (p = 0.031), NGF (p = 0.015) and pro-inflammatory cytokines/chemokine IL-1β, IL-6, TNF-α, and IL-8 levels were significantly higher in the patients with IC/BPS than among controls (all p<0.001). Significant associations were observed between IL-1β and IL-8 (p<0.001), IL-6 and CRP (p = 0.01), IL-6 and IL-8 (p = 0.02), and IL-6 and TNF-α (p = 0.03).ConclusionIncreased pro-inflammatory cytokines/chemokine (IL-1β, IL-6, TNF-α, and IL-8) expression in the sera of IC/BPS patients implies not only mast cell activation, but also that other inflammatory mediators play important roles in the pathogenesis of IC/BPS. Thus, for some patients, IC/BPS is considered a chronic inflammatory disease.
Highlights
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a syndrome characterized by urinary urgency and frequency, usually with pelvic pain and nocturia, in the absence of bacterial infection or identifiable pathology [1]
The mean serum C-reactive protein (CRP) level was significantly greater in IC/BPS patients (p = 0.031), as was the mean serum nerve growth factor (NGF) level (p = 0.015), compared to those of the control subjects
The pro-inflammatory cytokines/chemokine IL-1b, IL-6, tumor necrosis factor (TNF)-a, and IL-8 levels were significantly higher in the patients with IC/BPS than in the control subjects (Table 1, Fig. 1)
Summary
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a syndrome characterized by urinary urgency and frequency, usually with pelvic pain and nocturia, in the absence of bacterial infection or identifiable pathology [1]. There is a lack of consensus on the pathophysiology of IC/BPS. The chronic pain symptomatology in IC/BPS may be due to persistent abnormalities in the urinary bladder, which activate the afferent sensory system and central nervous system sensitization [2]. The diagnosis of IC/BPS solely made by clinical and cystoscopic hydrodistention and exclusion of other bladder disorders might no longer be adequate [4]. Development of urine or serum biomarkers that can be used in conjunction with clinical symptoms might increase the rate of early and accurate diagnosis of subtypes of IC/BPS
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