免疫球蛋白E在氯胺酮相关性膀胱炎和溃疡性间质性膀胱炎发病机制中的作用：一项免疫组织化学研究

The Role of Immunoglobulin E in the Pathogenesis of Ketamine Related Cystitis and Ulcerative Interstitial Cystitis: An Immunohistochemical Study.

作者信息

Jhang Jia-Fong, Hsu Yung-Hsiang, Jiang Yuan-Hong, Kuo Hann-Chorng

机构信息

Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.

Department of Pathology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.

出版信息

Pain Physician. 2016 May;19(4):E581-7.

PMID:27228524

Abstract

BACKGROUND

A previous study revealed elevated serum Immunoglobulin E (IgE) in ketamine related cystitis (KC) patients. IgE might participate the pathogenesis of different types of bladder pain syndromes, including KC and interstitial cystitis (IC).

OBJECTIVES

To investigate the IgE expression in KC and IC bladder tissue.

STUDY DESIGN

Prospective evaluation.

SETTING

The study was conducted in a tertiary teaching hospital, Hualien Tzu Chi Hospital.

METHODS

We investigated the bladder IgE with immunofluorescence staining and quanti?cation. The active mast cells were measuring using tryptase. The symptoms and urodynamic study results were recorded. Double immunofluorescence staining of tryptase and IgE was also performed. Sixteen KC patients, 10 ulcerative IC patients, and 20 non-ulcerative IC patients participated. The history and urodynamic parameters were investigated in these patients. The bladder mucosa was biopsied during cystoscopic hydrodistention. Bladder biopsies were also taken from 22 patients with bacterial cystitis and 12 healthy controls.

RESULTS

Bladder IgE was positive in 15 (93.8%) KC patients, 9 (90%) ulcerative IC patients, one (5%) non-ulcer IC patient, 8 (36.4%) bacterial cystitis patients, and 2 (16.7%) controls (P < .001). The bladder IgE was greater in the patients with KC than in the others (P < .001). After excluding KC patients, bladder IgE was significantly higher in the patients with ulcerative IC than the others (P < .001). The bladder IgE was significantly correlated with pain on a visual analogue scale (r2 = 0.156, P = .017) and maximum bladder capacity (r2 = 0.423, P < .001). Tryptase expression did not show a significant difference between KC, ulcer IC, and non-ulcer IC (P = 0.222). Double immunofluorescence staining showed co-expression of tryptase and IgE.

CONCLUSIONS

IgE-mediated inflammation played a significant role in the pathogenesis of KC and ulcerative IC.

KEY WORDS

Immunoglobulin E, ketamine cystitis, interstitial cystitis.

摘要

背景

先前的一项研究显示，氯胺酮相关性膀胱炎（KC）患者的血清免疫球蛋白E（IgE）升高。IgE可能参与了包括KC和间质性膀胱炎（IC）在内的不同类型膀胱疼痛综合征的发病机制。

目的

研究KC和IC膀胱组织中IgE的表达情况。

研究设计

前瞻性评估。

研究地点

该研究在花莲慈济医院这所三级教学医院进行。

方法

我们采用免疫荧光染色和定量分析来研究膀胱IgE。使用类胰蛋白酶检测活化的肥大细胞。记录症状和尿动力学研究结果。还进行了类胰蛋白酶和IgE的双重免疫荧光染色。16例KC患者、10例溃疡性IC患者和20例非溃疡性IC患者参与了研究。对这些患者的病史和尿动力学参数进行了调查。在膀胱镜水扩张术期间取膀胱黏膜活检。还从22例细菌性膀胱炎患者和12例健康对照者中获取了膀胱活检组织。

结果

15例（93.8%）KC患者、9例（90%）溃疡性IC患者、1例（5%）非溃疡性IC患者、8例（36.4%）细菌性膀胱炎患者和2例（16.7%）对照者的膀胱IgE呈阳性（P <.001）。KC患者的膀胱IgE水平高于其他患者（P <.001）。排除KC患者后，溃疡性IC患者的膀胱IgE显著高于其他患者（P <.001）。膀胱IgE与视觉模拟量表上的疼痛显著相关（r2 = 0.156，P =.017），与最大膀胱容量也显著相关（r2 = 0.423，P <.001）。类胰蛋白酶表达在KC、溃疡性IC和非溃疡性IC之间未显示出显著差异（P = 0.222）。双重免疫荧光染色显示类胰蛋白酶和IgE共表达。