Pedro L Vera1, David M Preston2, Robert M Moldwin3, Deborah R Erickson4, Behzad Mowlazadeh5, Fei Ma6, Dimitrios E Kouzoukas7, Katherine L Meyer-Siegler8, Magnus Fall9. 1. Lexington VA Medical Center, Lexington, KY; Department of Physiology, University of Kentucky, Lexington, KY; Department of Surgery, University of Kentucky, Lexington, KY. Electronic address: Pedro.Vera@va.gov. 2. Lexington VA Medical Center, Lexington, KY; Department of Urology, University of Kentucky, Lexington, KY. 3. The Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra-Northwell, Lake Success, NY. 4. Department of Urology, University of Kentucky, Lexington, KY. 5. The Bay Pines VA Healthcare System, Bay Pines, FL. 6. Lexington VA Medical Center, Lexington, KY; Department of Physiology, University of Kentucky, Lexington, KY. 7. Lexington VA Medical Center, Lexington, KY; Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY. 8. Department of Natural Sciences, St. Petersburg College, St Petersburg, FL; The Bay Pines VA Healthcare System, Bay Pines, FL. 9. Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
Abstract
OBJECTIVE: To investigate whether urinary levels of macrophage migration inhibitory factor (MIF) are elevated in interstitial cystitis/bladder pain syndrome (IC/BPS) patients with Hunner lesions and also whether urine MIF is elevated in other forms of inflammatory cystitis. METHODS: Urine samples were assayed for MIF by enzyme-linked immunosorbent assay. Urine samples from 3 female groups were examined: IC/BPS patients without (N = 55) and with Hunner lesions (N = 43), and non-IC/BPS patients (N = 100; control group; no history of IC/BPS; cancer or recent bacterial cystitis). Urine samples from 3 male groups were examined: patients with bacterial cystitis (N = 50), radiation cystitis (N = 18) and noncystitis patients (N = 119; control group; negative for bacterial cystitis). RESULTS: Urine MIF (mean MIF pg/mL ± standard error of the mean) was increased in female IC/BPS patients with Hunner lesions (2159 ± 435.3) compared with IC/BPS patients without Hunner lesions (460 ± 114.5) or non-IC/BPS patients (414 ± 47.6). Receiver operating curve analyses showed that urine MIF levels discriminated between the 2 IC groups (area under the curve = 72%; confidence interval 61%-82%). Male patients with bacterial and radiation cystitis had elevated urine MIF levels (2839 ± 757.1 and 4404 ± 1548.1, respectively) compared with noncystitis patients (681 ± 75.2). CONCLUSION: Urine MIF is elevated in IC/BPS patients with Hunner lesions and also in patients with other bladder inflammatory and painful conditions. MIF may also serve as a noninvasive biomarker to select IC/BPS patients more accurately for endoscopic evaluation and possible anti-inflammatory treatment.
OBJECTIVE: To investigate whether urinary levels of macrophage migration inhibitory factor (MIF) are elevated in interstitial cystitis/bladder pain syndrome (IC/BPS) patients with Hunner lesions and also whether urine MIF is elevated in other forms of inflammatory cystitis. METHODS: Urine samples were assayed for MIF by enzyme-linked immunosorbent assay. Urine samples from 3 female groups were examined: IC/BPSpatients without (N = 55) and with Hunner lesions (N = 43), and non-IC/BPSpatients (N = 100; control group; no history of IC/BPS; cancer or recent bacterial cystitis). Urine samples from 3 male groups were examined: patients with bacterial cystitis (N = 50), radiation cystitis (N = 18) and noncystitis patients (N = 119; control group; negative for bacterial cystitis). RESULTS: Urine MIF (mean MIF pg/mL ± standard error of the mean) was increased in female IC/BPSpatients with Hunner lesions (2159 ± 435.3) compared with IC/BPSpatients without Hunner lesions (460 ± 114.5) or non-IC/BPSpatients (414 ± 47.6). Receiver operating curve analyses showed that urine MIF levels discriminated between the 2 IC groups (area under the curve = 72%; confidence interval 61%-82%). Male patients with bacterial and radiation cystitis had elevated urine MIF levels (2839 ± 757.1 and 4404 ± 1548.1, respectively) compared with noncystitis patients (681 ± 75.2). CONCLUSION: Urine MIF is elevated in IC/BPSpatients with Hunner lesions and also in patients with other bladder inflammatory and painful conditions. MIF may also serve as a noninvasive biomarker to select IC/BPSpatients more accurately for endoscopic evaluation and possible anti-inflammatory treatment.
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