Jiang Yuan-Hong, Liu Hsin-Tzu, Kuo Hann-Chorng
Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan; Institute of Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan.
PLoS One. 2014 Mar 10;9(3):e91609. doi: 10.1371/journal.pone.0091609. eCollection 2014.
To investigate urinary nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) levels in interstitial cystitis/bladder pain syndrome (IC/BPS) patients after hyaluronic acid (HA) therapy.
Thirty-three patients with IC/BPS were prospectively studied; a group of 45 age-matched healthy subjects served as controls. All IC/BPS patients received nine intravesical HA instillations during the 6-month treatment regimen. Urine samples were collected for measuring urinary NGF and BDNF levels at baseline and 2 weeks after the last HA treatment. The clinical parameters including visual analog scale (VAS) of pain, daily frequency nocturia episodes, functional bladder capacity (FBC) and global response assessment (GRA) were recorded. Urinary NGF and BDNF levels were compared between IC/BPS patients and controls at baseline and after HA treatment.
Urinary NGF, NGF/Cr, BDNF, and BDNF/Cr levels were significantly higher in IC/BPS patients compared to controls. Both NGF and NGF/Cr levels significantly decreased after HA treatment. Urinary NGF and NGF/Cr levels significantly decreased in the responders with a VAS pain reduction by 2 (both p < 0.05) and the GRA improved by 2 (both p < 0.05), but not in non-responders. Urinary BDNF and BDNF/Cr did not decrease in responders or non-responders after HA therapy.
Urinary NGF, but not BDNF, levels decreased significantly after HA therapy; both of these factors remained higher than in controls even after HA treatment. HA had a beneficial effect on IC/BPS, but it was limited. The reduction of urinary NGF levels was significant in responders, with a reduction of pain and improved GRA.
研究透明质酸（HA）治疗后间质性膀胱炎/膀胱疼痛综合征（IC/BPS）患者尿神经生长因子（NGF）和脑源性神经营养因子（BDNF）水平。
前瞻性研究33例IC/BPS患者；45例年龄匹配的健康受试者作为对照组。所有IC/BPS患者在6个月的治疗方案中接受9次膀胱内HA灌注。在基线和最后一次HA治疗后2周收集尿液样本，以测量尿NGF和BDNF水平。记录包括疼痛视觉模拟量表（VAS）、每日夜间尿频发作次数、功能性膀胱容量（FBC）和总体反应评估（GRA）等临床参数。比较IC/BPS患者与对照组在基线和HA治疗后的尿NGF和BDNF水平。
与对照组相比，IC/BPS患者的尿NGF、NGF/Cr、BDNF和BDNF/Cr水平显著更高。HA治疗后，NGF和NGF/Cr水平均显著降低。VAS疼痛评分降低2分（均p<0.05）且GRA改善2分（均p<0.05）的反应者尿NGF和NGF/Cr水平显著降低，而非反应者则未降低。HA治疗后，反应者和非反应者的尿BDNF和BDNF/Cr均未降低。
HA治疗后尿NGF水平显著降低，而BDNF水平未降低；即使在HA治疗后，这两种因子仍高于对照组。HA对IC/BPS有有益作用，但有限。反应者尿NGF水平的降低显著，同时疼痛减轻且GRA改善。
