Duh Kevin, Funaro Michael G, DeGouveia William, Bahlani Sonia, Pappas Dominic, Najjar Souhel, Tabansky Inna, Moldwin Robert, Stern Joel N H
Departments of Neurology, Surgery, Molecular Medicine, and Science Education, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA.
Department of Autoimmunity, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY 11030, USA.
Discov Med. 2018 May;25(139):243-250.
Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a condition causing intense pelvic pain and urinary symptoms. While it is thought to affect millions of people and significantly impair quality of life, difficulty with diagnosis and a lack of reliably effective treatment options leave much progress to be made in managing this condition. We describe what is currently known about the immunological and neurological basis of this disease, focusing on the interactions between the immune and nervous system. Evidence for immune involvement in IC/BPS comes from its high co-occurrence with known autoimmune diseases, altered cytokine profiles, and immune cell infiltration in patients. These cytokines have the ability to cross-talk with the nervous system via NGF signaling, resulting in hyper-sensitization of pain receptors, causing them to release substance P and creating a positive feedback loop of neuroinflammation. While it seems that the crosstalk between the immune and nervous system in IC is understood, much of the information comes from studying other diseases or from animal models, and it remains to be confirmed in patients with the disease. Identifying biomarkers and confirming the mechanism of IC/BPS are ultimately important for selecting drug targets and for improving the lives of patients with this disease.
间质性膀胱炎/膀胱疼痛综合征（IC/BPS）是一种导致强烈盆腔疼痛和泌尿系统症状的疾病。尽管据认为它影响着数百万人并严重损害生活质量，但诊断困难以及缺乏可靠有效的治疗方案使得在管理这种疾病方面仍有很大的进展空间。我们描述了目前已知的关于这种疾病的免疫和神经学基础，重点关注免疫系统和神经系统之间的相互作用。IC/BPS中免疫参与的证据来自于它与已知自身免疫性疾病的高共病率、细胞因子谱的改变以及患者体内免疫细胞浸润。这些细胞因子能够通过神经生长因子（NGF）信号通路与神经系统相互作用，导致疼痛感受器超敏，使其释放P物质并形成神经炎症的正反馈回路。虽然IC中免疫和神经系统之间的相互作用似乎已被了解，但许多信息来自对其他疾病的研究或动物模型，仍有待在该疾病患者中得到证实。识别生物标志物并确认IC/BPS的机制对于选择药物靶点和改善该疾病患者的生活最终至关重要。
