Zeng Yu, Wu Xiu-Xian, Homma Yukio, Yoshimura Naoki, Iwaki Hideaki, Kageyama Susumu, Yoshiki Tatsuhiro, Kakehi Yoshiyuki
Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan.
J Urol. 2007 Oct;178(4 Pt 1):1322-7; discussion 1327. doi: 10.1016/j.juro.2007.05.125. Epub 2007 Aug 14.
Interstitial cystitis remains a poorly understood urological condition characterized by chronic pelvic pain and increased urinary frequency in the absence of any known etiology. Urothelial dysfunction and other abnormalities are presumed to be involved in the disease. Uroplakins that are expressed by urothelial cells are thought to have an important role as major barrier proteins on the apical surface of the urothelium.
Gene expression of uroplakin Ia, Ib, II, III and III-delta4 was quantitatively measured in bladder biopsy samples from 29 patients with interstitial cystitis and 16 control subjects using real-time reverse transcriptase-polymerase chain reaction.
The mRNA levels of the uroplakin Ia, Ib and II genes were relatively low and uroplakin III was relatively high in interstitial cystitis bladders compared to normal controls, although not significantly. Uroplakin III-delta4, a splicing variant of uroplakin III, was significantly up-regulated in interstitial cystitis samples (p <0.001). When patients with interstitial cystitis were divided into those with and without ulcerative changes, the uroplakin III and III-delta4 genes were significantly up-regulated only in patients with nonulcerative interstitial cystitis. Even more interesting was the finding that up-regulation of uroplakin III-delta4 was much more prominent than that of uroplakin III, that is 26.5 vs 5.6-fold compared to the median values of normal subjects.
Although the clinical implications of the over expression of uroplakin III and III-delta4 in nonulcerative interstitial cystitis bladders remains to be clarified, from the diagnostic viewpoint uroplakin III-delta4 is a potential marker for identifying nonulcerative interstitial cystitis.
间质性膀胱炎仍是一种了解甚少的泌尿系统疾病，其特征为慢性盆腔疼痛和尿频增加，且无任何已知病因。推测尿路上皮功能障碍和其他异常与该疾病有关。尿路上皮细胞表达的uroplakins被认为作为尿路上皮顶端表面的主要屏障蛋白发挥重要作用。
使用实时逆转录聚合酶链反应对29例间质性膀胱炎患者和16例对照受试者的膀胱活检样本中uroplakin Ia、Ib、II、III和III-δ4的基因表达进行定量测量。
与正常对照相比，间质性膀胱炎膀胱中uroplakin Ia、Ib和II基因的mRNA水平相对较低，uroplakin III相对较高，尽管差异不显著。uroplakin III的剪接变体uroplakin III-δ4在间质性膀胱炎样本中显著上调（p<0.001）。当将间质性膀胱炎患者分为有溃疡改变和无溃疡改变两组时，uroplakin III和III-δ4基因仅在无溃疡间质性膀胱炎患者中显著上调。更有趣的是发现uroplakin III-δ4的上调比uroplakin III更显著，与正常受试者中位数相比分别为26.5倍和5.6倍。
尽管uroplakin III和III-δ4在无溃疡间质性膀胱炎膀胱中过表达的临床意义尚待阐明，但从诊断角度来看，uroplakin III-δ4是识别无溃疡间质性膀胱炎的潜在标志物。
