Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan.
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan.
Int J Mol Sci. 2024 Aug 29;25(17):9359. doi: 10.3390/ijms25179359.
Sensory bladder disorders encompass several distinct conditions with overlapping symptoms, which pose diagnostic challenges. This study aimed to evaluate urine biomarkers for differentiating between various sensory bladder disorders, including non-Hunner's interstitial cystitis (NHIC), detrusor overactivity (DO), hypersensitive bladder (HSB), and urodynamically normal women. A retrospective analysis of 191 women who underwent a videourodynamic study (VUDS) was conducted, with some also receiving cystoscopic hydrodistention to confirm the presence of NHIC. Participants were categorized into four groups: DO (n = 51), HSB (n = 29), NHIC (n = 81), and normal controls (n = 30). The urine levels of inflammatory and oxidative stress biomarkers were measured. The DO patients exhibited elevated IP-10 levels, while the HSB patients had decreased TAC and 8-OHdG levels. The NHIC patients showed lower IL-2 and higher TNF-α levels. A TNF-α ≥ 1.05 effectively identified NHIC, with an AUROC of 0.889, a sensitivity of 98.8%, and a specificity of 81.3%. An IP-10 ≥ 6.31 differentiated DO with an AUROC of 0.695, a sensitivity of 56.8%, and a specificity of 72.3%. An 8-OHdG ≤ 14.705 and a TAC ≤ 528.7 identified HSB with AUROCs of 0.754 and 0.844, respectively. The combination of 8-OHdG and TAC provided an AUROC of 0.853 for HSB. These findings suggest that TNF-α, IP-10, TAC, 8-OHdG, and IL-2 are promising non-invasive biomarkers for distinguishing between these conditions, which may improve diagnosis and management.
感觉性膀胱障碍包括几种具有重叠症状的不同疾病，这给诊断带来了挑战。本研究旨在评估尿液生物标志物，以区分各种感觉性膀胱障碍，包括非 Hunner 间质性膀胱炎 (NHIC)、逼尿肌过度活动症 (DO)、高敏感膀胱 (HSB) 和尿动力学正常的女性。对 191 名接受视频尿动力学研究 (VUDS) 的女性进行了回顾性分析，其中一些还接受了膀胱镜下注水扩张以确认 NHIC 的存在。参与者被分为四组：DO (n = 51)、HSB (n = 29)、NHIC (n = 81) 和正常对照组 (n = 30)。测量了炎症和氧化应激生物标志物的尿液水平。DO 患者的 IP-10 水平升高，而 HSB 患者的 TAC 和 8-OHdG 水平降低。NHIC 患者的 IL-2 水平较低，TNF-α 水平较高。TNF-α ≥ 1.05 可有效识别 NHIC，AUROC 为 0.889，灵敏度为 98.8%，特异性为 81.3%。IP-10 ≥ 6.31 可区分 DO，AUROC 为 0.695，灵敏度为 56.8%，特异性为 72.3%。8-OHdG ≤ 14.705 和 TAC ≤ 528.7 可分别识别 HSB，AUROC 分别为 0.754 和 0.844。8-OHdG 和 TAC 的组合对 HSB 的 AUROC 为 0.853。这些发现表明，TNF-α、IP-10、TAC、8-OHdG 和 IL-2 是区分这些疾病的有前途的非侵入性生物标志物，可能改善诊断和管理。
