Ashraf Salman, Clarkson Taylor, Malykhina Anna P
Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
J Pharmacol Exp Ther. 2024 Jul 18;390(2):222-232. doi: 10.1124/jpet.123.002081.
Urologic chronic pelvic pain syndrome (UCPPS) is a painful chronic condition with persistent pain originating from the pelvis that often leads to detrimental lifestyle changes in the affected patients. The syndrome develops in both sexes, with an estimated prevalence of 5.7% to 26.6% worldwide. This narrative review summarizes currently recommended therapies for UCPPS, followed by the latest animal model findings and clinical research advances in the field. The diagnosis of UCPPS by clinicians has room for improvement despite the changes in the past decade aiming to decrease the time to treatment. Therapeutic approaches targeting growth factors (i.e., nerve growth factor, vascular endothelial growth factor), amniotic bladder therapy, and stem cell treatments gain more attention as experimental treatment options for UCPPS. The development of novel diagnostic tests based on the latest advances in urinary biomarkers would be beneficial to assist with the clinical diagnosis of UCPPS. Future research directions should address the role of chronic psychologic stress and the mechanisms of pain refractory to conventional management strategies in UCPPS etiology. Testing the applicability of cognitive behavioral therapy in this cohort of UCPPS patients might be promising to increase their quality of life. The search for novel lead compounds and innovative drug delivery systems requires clinically relevant translational animal models. The role of autoimmune responses triggered by environmental factors is another promising research direction to clarify the impact of the immune system in UCPPS pathophysiology. SIGNIFICANCE STATEMENT: This minireview provides an up-to-date summary of the therapeutic approaches for UCPPS with a focus on recent advancements in the clinical diagnosis and treatments of the disease, pathophysiological mechanisms of UCPPS, signaling pathways, and molecular targets involved in pelvic nociception.
泌尿外科慢性盆腔疼痛综合征（UCPPS）是一种慢性疼痛疾病，疼痛持续源于盆腔，常导致受影响患者的生活方式发生不良改变。该综合征在男女中均有发生，全球估计患病率为5.7%至26.6%。本叙述性综述总结了目前推荐的UCPPS治疗方法，随后介绍了该领域最新的动物模型研究结果和临床研究进展。尽管在过去十年中为缩短治疗时间做出了改变，但临床医生对UCPPS的诊断仍有改进空间。针对生长因子（即神经生长因子、血管内皮生长因子）的治疗方法、羊膜膀胱治疗和干细胞治疗作为UCPPS的实验性治疗选择受到了更多关注。基于尿液生物标志物最新进展开发新型诊断测试将有助于UCPPS的临床诊断。未来的研究方向应解决慢性心理压力的作用以及UCPPS病因中对传统管理策略难治的疼痛机制。测试认知行为疗法在这组UCPPS患者中的适用性可能有望提高他们的生活质量。寻找新型先导化合物和创新药物递送系统需要具有临床相关性的转化动物模型。环境因素引发的自身免疫反应的作用是另一个有前景的研究方向，以阐明免疫系统在UCPPS病理生理学中的影响。意义声明：本小型综述提供了UCPPS治疗方法的最新总结，重点关注该疾病临床诊断和治疗的最新进展、UCPPS的病理生理机制、信号通路以及参与盆腔伤害感受的分子靶点。
