New Urine Test Shows High Confidence in Correctly Diagnosing IC
Researchers continue to seek new ways to diagnose Hunner’s lesions without resorting to painful hydrodistention and/or biopsy. The search for a new, accurate urine test, has been the goal for many research teams over the years. In the IP4IC study, researchers at Beaumont Hospital measured urinary cytokine levels 146 IC patients and 262 asymptomatic controls. A separate smaller dataset, P3, was collected in the clinic with physician documented diagnosis. This method correctly classified 146 of 146 (100%) IC participants, both with and without Hunner’s lesions, and 262 of 262 (100%) control participants in the training set. For the validation set, 100% (N=26/26) IC patients and 96.3% (N=26/27) controls were cor- rectly identified. A combination of both non-invasive urinary cytokines as well as pain and symptom scores was required for a classifier with strong validity. This may be the holy grail of new diagnostic testing for IC. It is high confidence urine test that could drive a personalized medical diagnosis of patients with suspicion of IC based on inflammation and pain and symptoms.
Source: Lamb L, et al. MP39-11 TOWARD PERSONALIZED MEDICINE FOR AN INTERSTITIAL CYSTITIS INDIVIDUALIZED DIAGNOSIS USING A NEW BLADDER INFLAMMATION SCORE
Epstein-Barr Virus Implicated In Hunner’s Lesions
Researchers in Taiwan suspected that the Epstein Barr virus could play a role in chronic IC/BPS and long- term, persistent bladder inflammation. They studied 16 patients with Hunner’s lesions, 23 with non- Hunner’s IC/BPS and ten patient controls. Their results were stunning. They discovered that 87.5% of patients with Hunner’s lesions in their study had active Epstein Barr
infection. A total of 46.2% of patients with IC/BPS had evidence of EBV infection in the bladder. Those with EBV infection had more severe clinical symptoms, more severe bladder pain and a smaller bladder capacity.
Source: Jia-Fong J, et al. MP39-07 THE ROLE OF EPSTEIN-BARR VIRUS INFECTION IN BLADDER OF INTER- STITIAL CYSTITIS/BLADDER PAIN SYNDROME
Next Generation Sequencing Reveals Distinct Genomic Profiles in IC/BPS
Bladder pain syndrome/interstitial cystitis (BPS/IC) comprises a diverse variety of clinical subtypes/pheno- types. Among them, BPS/IC with Hunner’s lesions has been implied to be a distinct entity, histologically characterized by inflammatory infil- trates and urothelial denudation. In this study, researchers performed sequencing-based whole transcrip- tome analysis to identify differentially expressed genes (DEGs) and charac- terize the genomic landscape in BPS/IC.
A total of 54 urinary bladder biopsy samples were taken from 33 patients with BPS/IC with (12) (one each from the lesion and a non- lesion area; n = 24 in total) or without (21) Hunner lesions, and 9 non-IC patients without bladder symptoms and pathology, and sub- jected to whole RNA-sequencing. A total of 17,363 DEGs were identified among the groups. Two clusters emerged. Cluster 1: BPS/IC with Hunner lesions. Cluster 2: BPS/IC without Hunner lesions and non-IC control (Fig. 1).
DEGs upregulated in BPS/IC with Hunner lesions were significantly enriched in the T/B cell receptor sig- naling, chemokine signaling, Th17 cell differentiation, VEGF signaling, NF-κB signaling, NOD-like receptor signaling, Toll-like receptor signaling, inflammatory mediator regulation of TRP channels, and GAG degradation pathways, while those downregulated in BPS/IC with Hunner lesions were significantly related to the adher- ence/tight junction and estrogen sig- naling pathways (all P<0.05). On the other hand, DEGs in BPS without Hunner lesions were only 104 genes, which analysis could not find any significant biological pathways.
The results demonstrated a distinct genomic profile of BPS/IC with Hunner lesions. Urothelial deficiency, inflammatory/immune responses, aberrant vascularization, and abnor- mal estrogen signaling pathway may
be involved in the pathophysiology of BPS/IC with Hunner lesions.
Source: Yoshiyuki, A. MP39-02
WHOLE-TRANSCRIPTOME PROFILING IN BLADDER PAIN SYNDROME/INTERSTITIAL CYSTITIS BY NEXT-GENERATION SEQUENCING: A DISTINCT GENOMIC LANDSCAPE BY THE PHENOTYPES