Jiang Yuan-Hong, Jhang Jia-Fong, Kuo Hann-Chorng
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan.
J Clin Med. 2023 Mar 17;12(6):2336. doi: 10.3390/jcm12062336.
lower urinary tract dysfunctions (LUTDs) are difficult to diagnose based on symptoms. This study used a cluster of urinary biomarkers, including inflammatory cytokines, neurogenic proteins, and oxidative stress biomarkers, to identify LUTDs in women with frequency and urgency symptoms.
in total, 253 women with video urodynamics (VUDS)- and cystoscopy-confirmed detrusor overactivity (DO), interstitial cystitis/bladder pain syndrome (IC/BPS), dysfunctional voiding (DV), and hypersensitive bladder (HSB), and normal controls were included. Before diagnosis and treatment, urine samples were collected for analysis of biomarkers. The urine levels of biomarkers were compared between groups with bladder dysfunctions and controls and were combined to test the sensitivity in identifying total pathological bladder diseases and specific bladder diseases.
After video urodynamic study, VUDS, and urological examinations, bladder dysfunctions were classified into DO ( = 31), IC/BPS ( = 114), DV ( = 45), HSB ( = 29), and control ( = 34) groups. By using a cystomeric bladder capacity of ≤350 mL, 186/219 (84.9%) of the patients with DO, IC/BPS, DV, and HSB can be discriminated from the controls. Among these urine biomarkers, oxidative stress biomarkers 8-isoprostane, 8-hydroxydeoxyguanosine (8-OHdG), or total antioxidant capacity (TAC) are useful for identifying pathological bladder dysfunction (DO, IC/BPS, and DV) and HSB. With elevated IL-1β and lower IL-2, and elevated TNF-α levels, most patients with DV can be identified. Between DO and IC/BPS, a higher NGF level can identify 58.3% of IC/BPS cases, whereas a lower NGF level can identify 75.0% of DO cases.
by using a cluster of urine biomarkers, DO, IC/BPS, and DV cases can be identified based on elevated levels of urine oxidative stress biomarkers 8-isoprostane, TAC, or 8-OHdG, and HSB cases with a low TAC. These urine biomarkers are useful for identifying specific LUTDs in women with frequency and urgency symptoms.
下尿路功能障碍（LUTD）仅凭症状难以诊断。本研究使用一组尿液生物标志物，包括炎性细胞因子、神经源性蛋白和氧化应激生物标志物，来识别有尿频和尿急症状的女性中的LUTD。
总共纳入了253名经视频尿动力学（VUDS）和膀胱镜检查确诊为逼尿肌过度活动（DO）、间质性膀胱炎/膀胱疼痛综合征（IC/BPS）、排尿功能障碍（DV）和膀胱过敏（HSB）的女性以及正常对照。在诊断和治疗前，收集尿液样本用于生物标志物分析。比较膀胱功能障碍组和对照组之间生物标志物的尿液水平，并综合检测其在识别总病理性膀胱疾病和特定膀胱疾病方面的敏感性。
经过视频尿动力学研究、VUDS和泌尿外科检查后，膀胱功能障碍被分为DO组（n = 31）、IC/BPS组（n = 114）、DV组（n = 45）、HSB组（n = 29）和对照组（n = 34）。通过使用膀胱容量≤350 mL，DO、IC/BPS、DV和HSB患者中有186/219（84.9%）可与对照组区分开来。在这些尿液生物标志物中，氧化应激生物标志物8-异前列腺素、8-羟基脱氧鸟苷（8-OHdG）或总抗氧化能力（TAC）可用于识别病理性膀胱功能障碍（DO、IC/BPS和DV）以及HSB。IL-1β升高、IL-2降低以及TNF-α水平升高可识别出大多数DV患者。在DO和IC/BPS之间，较高的神经生长因子（NGF）水平可识别出58.3%的IC/BPS病例，而较低的NGF水平可识别出75.0%的DO病例。
通过使用一组尿液生物标志物，可根据尿液氧化应激生物标志物8-异前列腺素、TAC或8-OHdG水平升高来识别DO、IC/BPS和DV病例，以及根据TAC水平低来识别HSB病例。这些尿液生物标志物有助于识别有尿频和尿急症状的女性中的特定LUTD。
