MP72-02 FREQUENT EXPANSION OF CLONAL B-CELLS SUGGESTIVE OF SPECIFIC IMMUNE RESPONSES IN HUNNER TYPE INTERSTITIAL CYSTITIS

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Interstitial Cystitis1 Apr 2016MP72-02 FREQUENT EXPANSION OF CLONAL B-CELLS SUGGESTIVE OF SPECIFIC IMMUNE RESPONSES IN HUNNER TYPE INTERSTITIAL CYSTITIS Yoshiyuki Akiyama, Daichi Maeda, Teppei Morikawa, Aya Niimi, Akira Nomiya, Yukio Yamada, Jun Kamei, Naoki Aizawa, Yasuhiko Igawa, Masashi Fukayama, and Yukio Homma Yoshiyuki AkiyamaYoshiyuki Akiyama More articles by this author , Daichi MaedaDaichi Maeda More articles by this author , Teppei MorikawaTeppei Morikawa More articles by this author , Aya NiimiAya Niimi More articles by this author , Akira NomiyaAkira Nomiya More articles by this author , Yukio YamadaYukio Yamada More articles by this author , Jun KameiJun Kamei More articles by this author , Naoki AizawaNaoki Aizawa More articles by this author , Yasuhiko IgawaYasuhiko Igawa More articles by this author , Masashi FukayamaMasashi Fukayama More articles by this author , and Yukio HommaYukio Homma More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1615AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Interstitial cystitis (IC) is classified into either Hunner type IC (HIC) or non-Hunner type IC (NHIC) based on cystoscopy. It has been controversial whether HIC is a distinct disorder or progressive condition from NHIC. Besides, abundance of infiltrating plasma cells and up-regulated genes associated with a B-cell process in IC have been reported. However, no study had assessed the clonality of the infiltrating B-cells. To address these issues, we scrutinized pathological manifestations of IC quantitatively by applying novel image analysis software, especially paying attention to the difference between both types, and the presence of light chain restriction (LCR) in plasma cells. LCR is defined as an aberrant ratio of the kappa/lambda light chain expressing plasma cells, and reflects the presence of a clonal B cell process. METHODS Bladder biopsy specimens were taken from 27 HIC patients (n = 54, each from the lesions and a non-lesion area), 39 NHIC patients (n = 39) and 15 non-IC patients with chronic cystitis (n = 23). We performed immunohistochemical detection of infiltrating T-lymphocytes, B-lymphocytes, plasma cells, and residual epithelium in all the groups and in situ hybridization (ISH) for the kappa/lambda light chains in plasma cells in HIC and non-IC cystitis groups, followed by digital quantification with image analysis software. An aberrant kappa/lambda ratio in plasma cells to detect LCR was defined as more than 5.5 or less than 0.7. RESULTS Lymphoplasmacytic infiltration was significantly more severe in HIC specimens than in NHIC specimens (p<0.0001, Fig. 1A). The amount of epithelium was significantly smaller in HIC specimens compared with the others (p<0.0001, Fig. 1B). LCR in plasma cells was observed in 30% of HIC cases, whereas none of non-IC cystitis cases showed LCR (Fig. 2). CONCLUSIONS HIC is a distinct inflammatory disorder characterized by epithelial denudation and frequent expansion of clonal B cells, suggesting involvement of immune responses in the pathogenesis. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e952 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Yoshiyuki Akiyama More articles by this author Daichi Maeda More articles by this author Teppei Morikawa More articles by this author Aya Niimi More articles by this author Akira Nomiya More articles by this author Yukio Yamada More articles by this author Jun Kamei More articles by this author Naoki Aizawa More articles by this author Yasuhiko Igawa More articles by this author Masashi Fukayama More articles by this author Yukio Homma More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...