Andrew Schrepf1, Michael A O'Donnell2, Yi Luo3, Catherine S Bradley4, Karl J Kreder3, Susan K Lutgendorf5. 1. Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI. 2. Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA. 3. Department of Urology, University of Iowa, Iowa City, IA. 4. Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA; Department of Urology, University of Iowa, Iowa City, IA. 5. Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA; Department of Urology, University of Iowa, Iowa City, IA; Department of Psychological and Brain Science, University of Iowa, Iowa City, IA. Electronic address: Susan-lutgendorf@uiowa.edu.
Abstract
OBJECTIVE: To explore inflammatory factors that influence symptom changes in interstitial cystitis or bladder pain syndrome (IC or BPS). This longitudinal, prospective study examined the association of inflammation elicited by Toll-like receptor (TLR) stimulation in peripheral blood mononuclear cells (PBMCs) and diurnal cortisol rhythms with changes in painful and urinary symptoms of IC or BPS and symptom flares over a 48-week period. MATERIALS AND METHODS: Participants were 24 women meeting criteria for IC or BPS who supplied blood for isolation of PBMCs and 3 days of salivary cortisol samples prior to a baseline visit. Participants completed the Genitourinary Pain Index (pain and urinary subscales) and reported symptom flares every 2 weeks for 48 weeks. Mixed effects longitudinal and regression models were used to determine if inflammatory variables were associated with the changes in IC or BPS symptoms (time × variable interactions), and the probability of a symptom flare. RESULTS: Elevated TLR-4 inflammation (P = .031) and elevated TLR-2 inflammation (P = .045) from PBMCs, and flattened diurnal cortisol slope (P = .012) were each associated with less improvement in genitourinary pain over time. Additionally, elevated TLR-4 inflammation was associated with less improvement in urinary symptoms (P = .018), whereas TLR-2 inflammation and cortisol slopes were not (both P > .16). In contrast, no inflammatory measure was associated with an increased likelihood of reporting a symptom flare (all P > .25). CONCLUSION: TLR-mediated inflammation and diurnal cortisol slope may be useful as markers of symptom changes in IC or BPS.
OBJECTIVE: To explore inflammatory factors that influence symptom changes in interstitial cystitis or bladder pain syndrome (IC or BPS). This longitudinal, prospective study examined the association of inflammation elicited by Toll-like receptor (TLR) stimulation in peripheral blood mononuclear cells (PBMCs) and diurnal cortisol rhythms with changes in painful and urinary symptoms of IC or BPS and symptom flares over a 48-week period. MATERIALS AND METHODS:Participants were 24 women meeting criteria for IC or BPS who supplied blood for isolation of PBMCs and 3 days of salivary cortisol samples prior to a baseline visit. Participants completed the Genitourinary Pain Index (pain and urinary subscales) and reported symptom flares every 2 weeks for 48 weeks. Mixed effects longitudinal and regression models were used to determine if inflammatory variables were associated with the changes in IC or BPS symptoms (time × variable interactions), and the probability of a symptom flare. RESULTS: Elevated TLR-4inflammation (P = .031) and elevated TLR-2inflammation (P = .045) from PBMCs, and flattened diurnal cortisol slope (P = .012) were each associated with less improvement in genitourinary pain over time. Additionally, elevated TLR-4inflammation was associated with less improvement in urinary symptoms (P = .018), whereas TLR-2inflammation and cortisol slopes were not (both P > .16). In contrast, no inflammatory measure was associated with an increased likelihood of reporting a symptom flare (all P > .25). CONCLUSION: TLR-mediated inflammation and diurnal cortisol slope may be useful as markers of symptom changes in IC or BPS.
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Authors: Xiangrong Cui; Xuan Jing; Susan K Lutgendorf; Catherine S Bradley; Andrew Schrepf; Bradley A Erickson; Vincent A Magnotta; Timothy J Ness; Karl J Kreder; Michael A O'Donnell; Yi Luo Journal: Am J Physiol Renal Physiol Date: 2019-05-15
Authors: Suming Xu; Xu Wang; Yaoqin Wang; Susan Lutgendorf; Catherine Bradley; Andrew Schrepf; Karl Kreder; Michael O'Donnell; Yi Luo Journal: PLoS One Date: 2016-09-29 Impact factor: 3.240