Urinary Epidermal Growth Factor and Interleukin-6 Levels in Patients with Painful Bladder Syndrome/Interstitial Cystitis Treated with Cyclosporine or Pentosan Polysulfate Sodium

Abstract

To measure urinary epidermal growth factor (EGF) and interleukin-6 (IL-6) levels in painful bladder syndrome/interstitial cystitis (PBS/IC) patients randomized to either cyclosporine A (CyA) or pentosan polysulfate sodium (PPS) treatment for 6 months and compare the results with treatment response. Urine samples from PBS/IC patients were collected before (n = 37) and after treatment (n = 34). The concentration of EGF was determined by an in-house immunofluorometric assay and that of IL-6 by the Immulite assay. The clinical response to treatment was determined by the subjective global response analysis (GRA, scale 1 to 6). Participants who reported categories 5 (much better) or 6 (cured) were considered responders. According to GRA, 72% of CyA patients and 16% of PPS patient responded to their treatment (P <0.001). In the CyA group, post-treatment urinary EGF levels were significantly reduced (from 35 +/- 15.8 to 28.3 +/- 17.9 ng/mg creatinine; P <0.034), whereas the urinary IL-6 levels were not affected by CyA or PPS treatment in the whole group. In older patients (aged more than 52 years) who had higher IL-6 levels and longer duration of disease, these were reduced by successful CyA therapy. Treatment of PBS/IC patients with CyA resulted in significantly decreased urinary levels of EGF. Interleukin-6 levels did not change significantly in all treated patients after either CyA or PPS treatment, but in older patients the levels were reduced after CyA treatment.