Role of Infection in Interstitial Cystitis/Painful Bladder Syndrome

感染在间质性膀胱炎/膀胱疼痛综合征中的作用

• 批准号: 7571226
• 负责人: Thomas M Hooton
• 金额: $ 23.55万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7571226
• 关键词: Address; Adult; Age; Appearance; Bacteria; Bacterial Infections; Bacteriuria; Binding; Biological Assay; Biological Markers; Bladder; Characteristics; Chronic; Clinical; Cohort Studies; Condition; Conflict (Psychology); Count; Culture Techniques; Daily; Data; Detection; Development; Diagnosis; Dysuria; Employee Strikes; Enrollment; Enterobacteriaceae; Epithelium; Etiology; Female; Frequencies; Functional disorder; Genitourinary system; Goals; Growth; High Prevalence; Immune response; Individual; Infection; Inflammatory; Interstitial Cystitis; Iron; Klebsiella; Laboratories; Lead; Longitudinal Studies; Measures; Medical; Microbial Biofilms; Microbiology; Morbidity - disease rate; Nocturia; Numbers; Pain; Pan Genus; Pathogenesis; Pathologic; Patients; Pelvic Pain; Population; Prevention strategy; Recurrence; Reporting; Research Personnel; Resolution; Role; Sampling; Screening procedure; Severities; Specimen; Study Subject; Swab; Symptoms; Syndrome; Techniques; Testing; Therapeutic; Time; Tissues; Urethra; Urinary tract; Urinary tract infection; Urination; Urine; Uropathogen; Uropathogenic E. coli; Vagina; Viral; Virus; Virus Diseases; Week; Woman; antimicrobial; base; cohort; cost; design; diaries; experience; gastrointestinal; improved; lost work time; microbial; novel; novel diagnostics; novel strategies; novel virus; painful bladder syndrome; pathogen; personal log/diary; prospective; respiratory; sample collection; success; urinary; urologic

Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic condition of unknown etiology manifested by a constellation of symptoms including bladder, urethral, and/or pelvic pain, irritative voiding symptoms (urgency, frequency, nocturia, dysuria), and the absence of known etiologies such as recurrent urinary tract infection. It is estimated to afflict 37 to 67 per 100,000 individuals in the US (or possibly many more), with a marked female predilection, resulting in substantial morbidity, time lost from work, and medical costs. An improved understanding of the pathogenic mechanisms underlying IC/PBS could lead to new diagnostics and therapeutic and preventive strategies directed at this debilitating illness. The goal of this epidemiologic project is to reexamine the role of bacterial or viral agents in women with IC/PBS by combining a prospective sample-collection study with quantitative microbiology, a novel mass spectrometric assay, and a microarraybased viral screening technique. These analytical approaches are motivated by recent findings suggesting that tissue-adherent bacterial forms may be associated with low-level or intermittent bacteriuria and that a number of unexplained inflammatory conditions may be caused by as yet undescribed or unexpected viral infections. In this project, we will prospectively follow cohorts of women with IC/PBS for 6 months and agematched women without IC/PBS for 3 months. During this study period, subjects will maintain a daily personal diary and collect simultaneous weekly midstream urine and vaginal swab specimens. In Specific Aim 1. we hypothesize that a subset of IC/PBS is caused by bacterial infections associated with low-grade or intermittent bacteriuria or by unappreciated viral pathogens. We will compare IC/PBS patients with agematched controls. In Specific Aim 2. we hypothesize that IC/PBS symptom exacerbations are associated with the new appearance, or an increased population, of uropathogenic bacteria or viruses. In these studies, we will use the study's longitudinal design to determine whether different measures of infection correlate with periods of high and low degrees of IC/PBS symptoms. In summary, data concerning the role of infection in the pathogenesis of IC/PBS remains fragmented and contradictory, even though there are striking similarities between women with IC/PBS and those with recurrent DTI. We propose a novel approach based on recent developments in urological infection pathophysiology to address the important question of whether microbial pathogens are involved in IC/PBS. Results of this study will yield important information on the pathogenesis of IC/PBS and potentially result in better therapeutic and preventive strategies.

间质性膀胱炎/膀胱疼痛综合征（IC/PBS）是一种病因不明的慢性疾病 一系列症状，包括膀胱、尿道和/或骨盆疼痛、排尿刺激症状 （尿急、尿频、夜尿、排尿困难），以及缺乏已知病因，例如尿路复发 感染。据估计，美国每 10 万人中就有 37 至 67 人（或可能更多）患有此病， 明显的女性偏爱，导致大量的发病率、工作时间损失和医疗费用。一个 加深对 IC/PBS 致病机制的了解可能会带来新的诊断方法 针对这种使人衰弱的疾病的治疗和预防策略。本流行病学研究的目标 该项目旨在通过结合前瞻性研究，重新审视细菌或病毒制剂对患有 IC/PBS 的女性的作用。 使用定量微生物学、新型质谱分析和基于微阵列的样本收集研究 病毒筛查技术。这些分析方法的动机是最近的研究结果表明 组织粘附细菌形式可能与低水平或间歇性菌尿有关，并且 许多无法解释的炎症可能是由尚未描述或意外的病毒引起的 感染。在这个项目中，我们将前瞻性地跟踪患有 IC/PBS 的女性队列 6 个月，并且年龄匹配 女性 3 个月内没有 IC/PBS。在此研究期间，受试者将保持每日 个人日记并每周同时收集中段尿液和阴道拭子样本。具体来说 目标 1. 我们假设 IC/PBS 的一个子集是由与低级别或低级别相关的细菌感染引起的 间歇性菌尿或未被识别的病毒病原体引起。我们将比较 IC/PBS 患者与年龄匹配的患者 控制。在具体目标 2 中，我们假设 IC/PBS 症状恶化与 随着尿路致病细菌或病毒的新出现或数量的增加。在这些研究中， 我们将利用该研究的纵向设计来确定不同的感染指标是否与 IC/PBS 症状的高度和低度时期。总之，有关感染作用的数据 IC/PBS 的发病机制仍然支离破碎且矛盾，尽管存在惊人的相似之处 患有 IC/PBS 的女性和患有复发性 DTI 的女性之间的比较。我们提出了一种基于最近的新方法 泌尿系统感染病理生理学的发展，以解决微生物是否影响这一重要问题 病原体参与 IC/PBS。这项研究的结果将提供有关发病机制的重要信息 IC/PBS 的研究可能会产生更好的治疗和预防策略。