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: 8142135
• 负责人: Thomas M Hooton
• 金额: $ 25.37万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8142135
• 关键词: Address; Adult; Age; Appearance; Bacteria; Bacterial Infections; Bacteriuria; Binding; Biological Assay; Biological Markers; Bladder; Characteristics; Chronic; Clinical; Cohort Studies; Conflict (Psychology); Culture Techniques; Data; Detection; Development; Diagnosis; Dysuria; Employee Strikes; Enrollment; Enterobacteriaceae; Epidemiology; Epithelium; Etiology; Female; Frequencies; Functional disorder; Genitourinary system; Goals; Growth; High Prevalence; Immune response; Individual; Infection; Inflammatory; Interstitial Cystitis; Iron; Klebsiella; Laboratories; Lead; Measures; Medical; Microbial Biofilms; Microbiology; Morbidity - disease rate; Nocturia; Pain; 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; Urine; Uropathogen; Uropathogenic E. coli; Vagina; Viral; Virus; Virus Diseases; Woman; antimicrobial; base; cohort; cost; design; diaries; experience; gastrointestinal; improved; longitudinal design; 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/疼痛膀胱综合征（IC/PBS）是未知病因的慢性病。 通过包括膀胱，尿道和/或骨盆疼痛在内的症状星座，刺激性排尿症状 （紧迫性，频率，夜尿，排尿症），并且缺乏已知的病因，例如复发性尿路 感染。据估计，在美国（或可能还有更多），它会折磨37至67个人， 女性偏爱明显，导致大量发病率，工作时间和医疗费用。一个 对IC/PBS基础的致病机制的理解有所提高可能导致新的诊断 以及针对这种使人衰弱的疾病的治疗和预防策略。这个流行病学的目标 项目是通过结合前瞻性来重新检查细菌或病毒剂在IC/PBS女性中的作用 定量微生物学，一种新型的质谱分析和基于微阵列的样品收集研究 病毒筛查技术。这些分析方法是由最新发现提示的动机 该组织粘附的细菌形式可能与低水平或间歇性细菌有关 无法解释的炎症状况可能是由未描述或意外病毒引起的 感染。在这个项目中，我们将前瞻性地关注具有IC/PB的女性队列6个月并进行调整 没有IC/PB的女性3个月。在本研究期间，受试者将每天维持 个人日记并同时收集每周中游尿液和阴道拭子标本。具体 AIM 1。我们假设IC/PBS的一部分是由与低级或相关的细菌感染引起的 间歇性细菌或未经批准的病毒病原体。我们将比较IC/PBS患者的同步 控件。在特定的目标2中。我们假设IC/PBS症状加剧了 具有新的外观，或增加的肝癌细菌或病毒的种群。在这些研究中， 我们将使用研究的纵向设计来确定不同的感染测量是否与 IC/PBS症状的高度和低度的时期。总而言之，有关感染作用的数据 IC/PBS的发病机理仍然分散且矛盾，尽管存在惊人的相似性 在具有IC/PBS的女性和患有RECTURRENT DTI的女性之间。我们提出了一种基于最近的新方法 泌尿外科感染病理生理学的发展，以解决微生物是否存在的重要问题 病原体参与IC/PBS。这项研究的结果将产生有关发病机理的重要信息 IC/PBS的及其可能导致更好的治疗和预防策略。