Tsumura Kampo Research Laboratories, Kampo Research & Development Division, Tsumura & Co., Tokyo, Japan.
Southern Knights' Laboratory, Okinawa, Japan.
Neurourol Urodyn. 2023 Jan;42(1):56-64. doi: 10.1002/nau.25095. Epub 2022 Nov 15.
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic inflammatory condition of the bladder. However, there are only a few medicines that are of pharmaceutical grade and reliably effective for IC/BPS symptoms. Choreito (CRT) is a pharmaceutical-grade Kampo medicine and has been widely prescribed for patients of lower urinary tract symptoms (LUTS) and BPS in Japan. In this study, we exploratory investigated the effects of CRT on the IC/BPS-like symptoms induced by tranilast.
The rat IC/BPS-like model was induced by feeding administration with 0.4% tranilast. The rats were divided into the three following treatment groups: normal diet (Normal), tranilast treatment (Control), and the groups of 1% CRT (CRT) treatment for IC/BPS-like model. After 4 weeks, continuous cystmetry, locomotor, and vascular permeability was assessed. Furthermore, the cytokine levels in bladder were analyzed by the Bio-Plex suspension array system and plasma monoamine were measured.
Control group exhibited 14.3% decrease of locomotor activity in the dark period, and which were 20.3% increase by 1%CRT treatment. The voiding interval was shorter in control than in other groups. 1%CRT suppressed the shortening of voiding interval. Evans blue leakage of bladder wall observed 44.8% higher in control group than in the normal group. The leakage of 1%CRT group was 33.3% less than in the control group. The cytokine level of IFNγ and VEGF were elevated in the control, and CRT treatment suppressed the elevation of IFNγ in the bladder. Plasma noradrenaline was significantly reduced by CRT treatment compared normal group.
These results suggest that CRT can be an effective therapeutic agent for the treatment of IC/BPS-like symptoms.
间质性膀胱炎/膀胱疼痛综合征(IC/BPS)是一种慢性膀胱炎症性疾病。然而,仅有少数药物对 IC/BPS 症状具有药物级别的可靠疗效。朝比奈(CRT)是一种药物级别的汉方药,在日本已广泛用于治疗下尿路症状(LUTS)和 BPS 患者。在这项研究中,我们探索性地研究了 CRT 对曲尼司特诱导的 IC/BPS 样症状的影响。
通过给予 0.4%曲尼司特的饮食给药来诱导大鼠 IC/BPS 样模型。将大鼠分为以下三组进行治疗:正常饮食(Normal)、曲尼司特治疗(Control)和 1%CRT(CRT)治疗 IC/BPS 样模型组。4 周后,连续进行膀胱测压、运动和血管通透性评估。此外,通过 Bio-Plex 悬浮阵列系统分析膀胱中的细胞因子水平,并测量血浆单胺。
Control 组在黑暗期的运动活性下降了 14.3%,而 1%CRT 治疗组增加了 20.3%。Control 组的排尿间隔较短,1%CRT 抑制了排尿间隔的缩短。Control 组膀胱壁 Evans 蓝漏出量比正常组高 44.8%,1%CRT 组漏出量比 Control 组低 33.3%。Control 组 IFNγ 和 VEGF 的细胞因子水平升高,CRT 治疗抑制了膀胱中 IFNγ 的升高。与正常组相比,CRT 治疗组血浆去甲肾上腺素显著降低。
这些结果表明,CRT 可能是治疗 IC/BPS 样症状的有效治疗剂。