Interstitial Cystitis, Chronic Pelvic Pain, and InfectionElevated Urinary Levels and Urothelial Expression of Hepatocarcinoma-intestine-pancreas/Pancreatitis-associated Protein in Patients With Interstitial Cystitis
Section snippets
Patients
We followed our institution's ethics guidelines and the study was approved by the ethics committee of the Osaka City University Hospital. All patients provided informed consent. Patients with IC were diagnosed based on the National Institute of Diabetes and Digestive and Kidney Diseases clinical criteria. The 24-hour urinary frequency and mean voided urine volume were assessed by a voiding diary and bladder pain on a verbal 11-point rating scale (VRS). The VRS is a common pain scale for rating
HIP/PAP Levels in the Urine
Urinary specimens were collected from 27 female IC patients (median age: 58 years, range: 31-83 years) and from 27 female controls (median age: 58 years, range: 30-81 years). No samples had bacterial urinary tract infection. The median urinary HIP/PAP concentration was significantly higher in IC patients than in controls (Fig. 1).
Immunohistochemical Localization of HIP/PAP in the Bladder
Bladder tissues from 17 female IC patients (median age: 58 years, range: 30-82 years) were processed for immunohistochemistry, using an antibody specific to HIP/PAP.
Comment
In this study, we have demonstrated that the urinary HIP/PAP levels in IC patients were apparently higher than those in normal controls. Increased immunoreactivity for HIP/PAP was frequently observed in the umbrella cells of the urothelium in IC patients, suggesting that expression of HIP/PAP is induced in the urothelium and HIP/PAP is released into the urine in IC patients. Intriguingly, the urinary levels of HIP/PAP are correlated with the severity of urinary symptoms, implying that the level
Conclusions
We revealed that HIP/PAP levels in the urine were significantly higher in IC patients than in controls, and HIP/PAP expression in the urothelium was frequently observed in IC patients. Because we found a significant association between urinary HIP/PAP levels and urinary symptoms in IC patients, it is concluded that HIP/PAP may be involved in the pathogenesis of IC.
Acknowledgments
J.L. Iovanna, INSERM U.624, Marseille, France, provided information about PAP enzyme-linked immunosorbent assay system.
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This work was supported by grants from Ministry of Health, Labour and Welfare of Japan, MEXT Japan, and Osaka City University.