Yamada T, Murayama T, Mita H, Akiyama K, Taguchi H
Department of Urology, National Sagamihara Hospital, Japan.
Int J Urol. 1998 Jul;5(4):329-35; discussion 335-6. doi: 10.1111/j.1442-2042.1998.tb00360.x.
It has been postulated that interstitial cystitis can be induced by an allergy. This is partly based on the observation that many patients with interstitial cystitis also have allergic diseases. In this study, an allergic evaluation was conducted on patients with interstitial cystitis complicated by bronchial asthma, a typical allergic disease.
Clinical histories were obtained and biopsy specimens from the vesical walls of the study patients were examined histologically. Cutaneous tests and IgE radioallergosorbent tests (RAST) were performed. Further, intravesical provocation tests were carried out using IgE RAST-positive antigens, and histamine release assays were performed on the vesical biopsy specimens using anti-IgE antibodies.
Five of 6 patients alternately exhibited symptoms of allergic disease and bladder symptoms. The eosinophil and mast cell counts in the vesical biopsy specimens of these 5 patients were increased. Furthermore, an intravesical provocation test performed using the IgE RAST-positive antigen was positive in 4 patients. The mean vesical biopsy specimen histamine release was 17.7% for patients with interstitial cystitis with bronchial asthma which was significantly higher than that for interstitial cystitis patients without bronchial asthma (8.9%) or the control group (4.5%). The prognosis of patients with interstitial cystitis with allergic complications was relatively good.
Patients with bronchial asthma exhibited hypersensitivity both generally and locally in the bladder. The alternation phenomenon was observed between the hypersensitive organs.
据推测，间质性膀胱炎可由过敏引发。这部分是基于许多间质性膀胱炎患者也患有过敏性疾病这一观察结果。在本研究中，对合并典型过敏性疾病支气管哮喘的间质性膀胱炎患者进行了过敏评估。
获取临床病史，并对研究患者膀胱壁的活检标本进行组织学检查。进行皮肤试验和IgE放射变应原吸附试验（RAST）。此外，使用IgE RAST阳性抗原进行膀胱内激发试验，并使用抗IgE抗体对膀胱活检标本进行组胺释放测定。
6例患者中有5例交替出现过敏性疾病症状和膀胱症状。这5例患者膀胱活检标本中的嗜酸性粒细胞和肥大细胞计数增加。此外，使用IgE RAST阳性抗原进行的膀胱内激发试验在4例患者中呈阳性。合并支气管哮喘的间质性膀胱炎患者膀胱活检标本组胺释放的平均值为17.7%，显著高于无支气管哮喘的间质性膀胱炎患者（8.9%）或对照组（4.5%）。合并过敏并发症的间质性膀胱炎患者的预后相对较好。
支气管哮喘患者在全身和膀胱局部均表现出超敏反应。在超敏器官之间观察到了交替现象。
