Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan.
Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
Int J Urol. 2021 Aug;28(8):823-830. doi: 10.1111/iju.14585. Epub 2021 May 8.
To explore the expression of cytoskeletal and cell proliferation proteins in urothelial cells of patients diagnosed with various clinical subtypes of interstitial cystitis/bladder pain syndrome.
Biopsy specimens from 85 interstitial cystitis/bladder pain syndrome patients were classified according to findings on cystoscopy. Cytokeratins and cell proliferation proteins detected in the specimens were evaluated with immunofluorescence staining and quantified with western blotting. A total of 22 patients diagnosed with pure stress urinary incontinence were enrolled as controls.
Interstitial cystitis/bladder pain syndrome patients with Hunner's lesion and with grade 3 glomerulation hemorrhage had smaller bladder capacities than the other interstitial cystitis/bladder pain syndrome patients without Hunner's lesion. Diminished expression of CK14, CK20, cell proliferation protein tumor protein 63, sonic hedgehog, and fibroblast growth factor receptors 3 and 4, and increased expression of CK5 and BCL2-associated X protein were observed in biopsy specimens from patients with Hunner's lesion compared with those from patients without Hunner's lesion and controls. In the patients with grade 3 glomerulation hemorrhage, lower expression levels of urothelial CK20, tumor protein 63 and fibroblast growth factor receptor 4, and lower expression of CK5 and BCL2-associated X protein were detected compared with other types of NHIC.
A diminished expression of proliferation proteins tumor protein 63 and the mature urothelium marker CK20, and increased expression of the immature marker CK5 in specimens from both Hunner's lesion and grade 3 glomerulation hemorrhage patients can be observed. The urothelium of patients with interstitial cystitis/bladder pain syndrome might be in a state of persistent or chronic injury that could relate to the limited expression of cell proliferation proteins.
探讨不同临床亚型间质性膀胱炎/膀胱疼痛综合征患者尿路上皮细胞中细胞骨架和细胞增殖蛋白的表达情况。
根据膀胱镜检查结果对 85 例间质性膀胱炎/膀胱疼痛综合征患者的活检标本进行分类。采用免疫荧光染色法检测标本中细胞角蛋白和细胞增殖蛋白，并采用 Western blot 法进行定量分析。共纳入 22 例单纯压力性尿失禁患者作为对照。
与无 Hunner 病变的间质性膀胱炎/膀胱疼痛综合征患者相比，有 Hunner 病变和 3 级肾小球出血的患者膀胱容量较小。与无 Hunner 病变的患者和对照组相比，Hunner 病变患者的活检标本中 CK14、CK20、肿瘤蛋白 63、刺猬信号通路、成纤维细胞生长因子受体 3 和 4 的表达减少，CK5 和 BCL2 相关 X 蛋白的表达增加。在 3 级肾小球出血患者中，与其他类型的非 Hunner 间质性膀胱炎相比，尿路上皮 CK20、肿瘤蛋白 63 和成纤维细胞生长因子受体 4 的表达水平较低，CK5 和 BCL2 相关 X 蛋白的表达也较低。
在 Hunner 病变和 3 级肾小球出血患者的标本中，可观察到增殖蛋白肿瘤蛋白 63 和成熟尿路上皮标志物 CK20 的表达减少，不成熟标志物 CK5 的表达增加。间质性膀胱炎/膀胱疼痛综合征患者的尿路上皮可能处于持续或慢性损伤状态，这可能与细胞增殖蛋白表达受限有关。
