Kiuchi Hiroshi, Tsujimura Akira, Takao Tetsuya, Yamamoto Keisuke, Nakayama Jiro, Miyagawa Yasushi, Nonomura Norio, Takeyama Masami, Okuyama Akihiko
Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
BJU Int. 2009 Sep;104(6):826-31; discussion 831. doi: 10.1111/j.1464-410X.2009.08467.x. Epub 2009 Mar 6.
To determine the angiogenic profiles in the bladder of patients with bladder pain syndrome (BPS)/interstitial cystitis (IC), and to evaluate the relationship between these profiles and associated clinical features including pelvic pain and glomerulations.
Angiogenesis and angiogenic components are important in chronic inflammatory disease. High levels of vascular endothelial growth factor (VEGF) have been shown to induce immature angiogenesis, where microvessels have insufficient coverage of pericytes, resulting in haemorrhagic vessels. Biopsy specimens from 30 patients with BPS/IC and glomerulations, and 10 control patients, were examined immunohistochemically for VEGF expression, microvessel density (MVD) and immature microvessels. Pericyte coverage of microvessels in the specimens was used as an indicator of mature microvessels, and pericytes were identified by double-immunohistochemistry for CD34 and alpha-smooth muscle actin. The microvessel pericyte coverage index (MPI) was calculated as the ratio of mature vessels to total vessels. We also assessed the relationship between these angiogenic profiles and associated clinical features including pain and glomerulations.
VEGF expression in the lamina propria was significantly higher in BPS/IC than in control samples (50% vs 10%, P < 0.05). Among patients with BPS/IC, VEGF expression was significantly higher in those with severe pain than in those with mild pain (78% vs 38%, P < 0.05). The MPI was significantly lower in BPS/IC than in control samples (23% vs 35%, P < 0.05), whereas MVD did not differ significantly between BPS/IC and control samples.
There is increased VEGF and immature vascularization in patients with BPS/IC, and VEGF expression is associated with the degree of pain described by patients. Taken together, VEGF might contribute to pain and promote the formation of immature vessels in BPS/IC, and the increased immature vascularization might have a role in glomerulations in patients with BPS/IC.
确定膀胱疼痛综合征(BPS)/间质性膀胱炎(IC)患者膀胱中的血管生成情况,并评估这些情况与包括盆腔疼痛和点状出血在内的相关临床特征之间的关系。
血管生成和血管生成成分在慢性炎症性疾病中很重要。高水平的血管内皮生长因子(VEGF)已被证明可诱导不成熟的血管生成,即微血管周细胞覆盖不足,导致血管出血。对30例患有BPS/IC和点状出血的患者以及10例对照患者的活检标本进行免疫组织化学检查,以检测VEGF表达、微血管密度(MVD)和不成熟微血管。标本中微血管的周细胞覆盖情况用作成熟微血管的指标,通过CD34和α-平滑肌肌动蛋白的双重免疫组织化学鉴定周细胞。微血管周细胞覆盖指数(MPI)计算为成熟血管与总血管的比率。我们还评估了这些血管生成情况与包括疼痛和点状出血在内的相关临床特征之间的关系。
BPS/IC患者固有层中的VEGF表达明显高于对照样本(50%对10%,P<0.05)。在BPS/IC患者中,重度疼痛患者的VEGF表达明显高于轻度疼痛患者(78%对38%,P<0.05)。BPS/IC患者的MPI明显低于对照样本(23%对35%,P<0.05),而BPS/IC患者与对照样本之间的MVD无明显差异。
BPS/IC患者存在VEGF增加和血管形成不成熟的情况,VEGF表达与患者描述的疼痛程度相关。综上所述,VEGF可能导致疼痛并促进BPS/IC中不成熟血管的形成,而增加的不成熟血管形成可能在BPS/IC患者的点状出血中起作用。