Department of Urology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Neurourol Urodyn. 2018 Mar;37(3):1113-1119. doi: 10.1002/nau.23431. Epub 2017 Oct 19.
To investigate the feasibility of chemokines and cytokines potentially elevated in the bladder tissue of Hunner type interstitial cystitis (HIC) as urinary markers for distinguishing HIC from non-Hunner type interstitial cystitis (NHIC) METHODS: Urine specimens were collected from 41 HIC patients, 25 NHIC patients, and 31 healthy volunteers (control). The supernatants of urine specimens were subjected to ELISA kits for measurements of 10 cytokines and chemokines, whose gene expression was known to be elevated in HIC bladder tissue. Urinary levels normalized by urinary creatinine (Cr) concentration were compared among three groups. Efficiency in differentiating IC and IC subtypes was explored by ROC analysis. The correlation of marker levels with symptom severity, assessed by O'Leary-Sant's symptom index (OSSI) and problem index (OSPI), was examined.
The urinary levels of CXCL10 and NGF were significantly higher in HIC than NHIC. CXCL10 and NGF differentiated HIC against NHIC with AUC of 0.78 and 0.68, respectively. Combination of CXCL10 and NGF levels yielded an AUS of 0.81. The CXCL10 cut-off of 53.2 pg/mg Cr had sensitivity of 46.1%, specificity of 93.7%, positive predictive value of 97.7%, and negative predictive value of 60.0%. The urinary level of other cytokines showed no significant difference between HIC and NHIC. Significant correlation with symptoms was detected for CXCL10 alone.
The results suggested that increased urinary level of CXCL10 combined with or without high NGF level could be a promising supplementary biomarker for differentiating HIC from NHIC with modest sensitivity and high specificity.
探讨在 Hunner 型间质性膀胱炎（HIC）膀胱组织中潜在升高的趋化因子和细胞因子是否可作为尿标志物，用于区分 HIC 与非 Hunner 型间质性膀胱炎（NHIC）。
收集 41 例 HIC 患者、25 例 NHIC 患者和 31 例健康志愿者（对照组）的尿标本。采用 ELISA 试剂盒检测尿液标本上清液中已知在 HIC 膀胱组织中表达升高的 10 种细胞因子和趋化因子。通过尿肌酐（Cr）浓度对尿液水平进行归一化，并比较三组之间的差异。通过 ROC 分析探讨标志物水平在区分 IC 和 IC 亚型中的效率。检查标志物水平与 O'Leary-Sant 症状指数（OSSI）和问题指数（OSPI）评估的症状严重程度之间的相关性。
与 NHIC 相比，HIC 患者的尿 CXCL10 和 NGF 水平显著升高。CXCL10 和 NGF 分别以 AUC 为 0.78 和 0.68 区分 HIC 与 NHIC。联合检测 CXCL10 和 NGF 水平的 AUC 为 0.81。CXCL10 的截断值为 53.2pg/mg Cr，其敏感性为 46.1%，特异性为 93.7%，阳性预测值为 97.7%，阴性预测值为 60.0%。HIC 与 NHIC 之间其他细胞因子的尿液水平无显著差异。仅 CXCL10 与症状显著相关。
结果表明，CXCL10 尿水平升高结合或不结合高 NGF 水平可能是一种有前途的辅助生物标志物，用于区分 HIC 与 NHIC，其敏感性适中，特异性较高。
