869 TREATMENT RESPONSE TO NEUROMODULATION IN INTERSTITIAL CYSTITIS/PAINFUL BLADDER SYNDROME (IC/PBS) PATIENTS ACCOMPANY DECREASE IN URINE CHEMOKINES (2013)

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 2013869 TREATMENT RESPONSE TO NEUROMODULATION IN INTERSTITIAL CYSTITIS/PAINFUL BLADDER SYNDROME (IC/PBS) PATIENTS ACCOMPANY DECREASE IN URINE CHEMOKINES Michael Chancellor, Pradeep Tyagi, Jayabalan Nirmal, Don Bui, and Kenneth Peters Michael ChancellorMichael Chancellor Royal Oak, MI More articles by this author , Pradeep TyagiPradeep Tyagi Pittsburgh, PA More articles by this author , Jayabalan NirmalJayabalan Nirmal Royal Oak, MI More articles by this author , Don BuiDon Bui Royal Oak, MI More articles by this author , and Kenneth PetersKenneth Peters Royal Oak, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.438AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Chemokines are responsible for paracrine signalling within bladder and for also assisting in the communication between bladder and neurons innervating bladder. Therefore, we hypothesized that chronic neuromodulation from InterStim implant at the spinal cord level in IC/PBS patients will cause downstream changes in chemokine signalling, which will be reflected in the differences of chemokine levels measured at the baseline and at end of treatment. METHODS Patients with confirmed diagnosis and long history of IC/PBS undergoing Interstim were consented for this study. Mid- stream urine and symptom scores IC symptom problem index(ICSPI index) were collected at baseline and at 24 weeks after implant. Collected urine was analyzed for presence of cytokines and chemokines by Luminex xMAP analysis. RESULTS Urine chemokine and symptom score data at baseline and at 24-week was obtained from 16 and 7 subjects, respectively. At baseline, urine levels of CXCL-1 positively correlated with pain score (Pearson r=0.63, p=0.009), urgency (r=0.61, p=0.01), ICSPI (r=0.43, p=0.09) and number of daily voids(r=0.44, p=0.08). ICSPI and pain scores also positively correlated with sIL-1RA (r= 0.50, p= 0.04) and CCL2 positively correlated with daily voids (r= 0.45, p= 0.07). The median ICSPI index after interstim implant fell from 28 to 14 at 24 weeks (Student's t test, p=0.008, n=7). Levels of sIL-1ra (1098±452.4 vs 242.2±122pg/ml) and MCP-1 (532.4±140.7 vs 161.7±64.26 pg/ml) were also significantly reduced at 24 weeks relative to baseline (p=0.04). Multivariable analysis of data revealed that sIL-1ra and MCP-1 together explained majority of variance in data. Levels of CXCL-1, CXCL-10, CCL5 (RANTES), IL-8, VEGF, PDGF were also reduced at 24 weeks, but differences were not significant due to variability among patients. Lower chemokine levels correlated negatively with ICSPI index at 24 weeks without any statistical significance. CONCLUSIONS IC/PBS patients responding favorably to neuromodulation showed a corresponding decrease in urine levels chemokines. These results support our hypothesis for the action of chemokines as downstream effectors of neuromodulation response in bladder, which when secreted into urine can serve as non-invasive treatment predictors. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e358-e359 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Chancellor Royal Oak, MI More articles by this author Pradeep Tyagi Pittsburgh, PA More articles by this author Jayabalan Nirmal Royal Oak, MI More articles by this author Don Bui Royal Oak, MI More articles by this author Kenneth Peters Royal Oak, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...