Trama Francesco, Illiano Ester, Marchesi Alessandro, Brancorsini Stefano, Crocetto Felice, Pandolfo Savio Domenico, Zucchi Alessandro, Costantini Elisabetta
Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, Umbria, IT Viale Tristano di Joannuccio, 05100 Terni, Italy.
Department of Experimental Medicine, University of Perugia, 05100 Terni, Italy.
Antibiotics (Basel). 2021 Oct 1;10(10):1194. doi: 10.3390/antibiotics10101194.
Bladder pain syndrome/interstitial cystitis (BPS/IC) or primary bladder pain syndrome (PBPS) is a complex and poorly understood condition. This comprehensive review aimed to discuss the potential application of platelet-rich plasma (PRP) in the treatment of BPS/IC. The pathophysiology of BPS/IC is characterized by urothelial damage that triggers a chain of events leading to chronic inflammation and other conditions. Frequently, in subjects affected by BPS/IC, recurrent urinary tract infection (rUTI) is associated with difficult therapeutic management. For these reasons, many oral and intravesical treatments (e.g., antibiotic therapy and intravesical anesthetic instillations) have been proposed to alleviate the symptoms of IC/BPS. However, the limitation of these treatments is the short duration of improvement. The purpose of this review is to analyze the efficacy of intravesical PRP injections in subjects with PBS/IC and to try to understand the potential therapeutic effects on the pathophysiology of this disease.
A nonsystematic literature search using Pubmed, EMBASE, Scopus, Web of Science, Medline was performed from January 2000 to August 2021. The following terms were combined to capture relevant publications: "platelet-rich plasma", "interstitial cystitis", "PRP", "bladder pain syndrome", and "painful bladder syndrome".
After exclusion of non-pertinent studies/articles, we have analyzed 5 studies. In detail, 2 articles concerned preclinical studies in which animal models were used. The authors showed an improvement in the histological pattern with less bleeding in treated subjects, a lower presence of inflammatory cytokines and an increase in the mitotic index of urothelial cells in animals treated with intravesical PRP. In the three prospective clinical trials analyzed, patients with BPS/IC who underwent monthly intravesical PRP injections were found to have a statistically significant improvement in symptoms with modulation of growth factors and inflammatory proteins.
New evidence suggests that treatment with intravesical PRP could improve urothelial regeneration and reduces chronic inflammation in BPS/IC, modifying the clinical history of its pathology.
膀胱疼痛综合征/间质性膀胱炎（BPS/IC）或原发性膀胱疼痛综合征（PBPS）是一种复杂且了解甚少的病症。本综述旨在探讨富血小板血浆（PRP）在BPS/IC治疗中的潜在应用。BPS/IC的病理生理学特征为尿路上皮损伤，引发一系列导致慢性炎症和其他病症的事件。在受BPS/IC影响的患者中，复发性尿路感染（rUTI）常与治疗管理困难相关。因此，人们提出了许多口服和膀胱内治疗方法（如抗生素治疗和膀胱内麻醉剂灌注）来缓解IC/BPS的症状。然而，这些治疗方法的局限性在于改善时间短暂。本综述的目的是分析膀胱内注射PRP对PBS/IC患者的疗效，并试图了解其对该疾病病理生理学的潜在治疗作用。
于2000年1月至2021年8月使用PubMed、EMBASE、Scopus、科学网、Medline进行了非系统性文献检索。将以下术语组合以获取相关出版物：“富血小板血浆”、“间质性膀胱炎”、“PRP”、“膀胱疼痛综合征”和“疼痛性膀胱综合征”。
排除不相关的研究/文章后，我们分析了5项研究。具体而言，2篇文章涉及使用动物模型的临床前研究。作者表明，接受膀胱内PRP治疗的动物，其组织学模式有所改善，出血减少，炎性细胞因子水平降低，尿路上皮细胞有丝分裂指数增加。在分析的三项前瞻性临床试验中，接受每月一次膀胱内PRP注射的BPS/IC患者，其症状在生长因子和炎性蛋白调节方面有统计学意义的改善。
新证据表明，膀胱内PRP治疗可改善BPS/IC患者的尿路上皮再生并减轻慢性炎症，改变其病理临床病程。
