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Brandolini L, Aramini A, Bianchini G, Ruocco A, Bertini R, Novelli R, Angelico P, Valsecchi AE, Russo R, Castelli V, Cimini A, Allegretti M. Inflammation-Independent Antinociceptive Effects of DF2755A, a CXCR1/2 Selective Inhibitor: A New Potential Therapeutic Treatment for Peripheral Neuropathy Associated to Non-Ulcerative Interstitial Cystitis/Bladder Pain Syndrome. Front Pharmacol 2022; 13:854238. [PMID: 35571079 PMCID: PMC9096165 DOI: 10.3389/fphar.2022.854238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/29/2022] [Indexed: 11/23/2022] Open
Abstract
Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a chronic bladder disease of unknown etiology characterized by urinary frequency and episodic and chronic pain. Analgesic treatments for IC/BPS are limited, especially for patients with non-Hunner (non-ulcerative) type IC who usually have poor overall outcomes. Here, we demonstrate that oral treatment with DF2755A, a potent and selective inhibitor of chemokine receptors CXCR1/2, can prevent and reverse peripheral neuropathy associated to non-Hunner IC/BPS by directly inhibiting chemokine-induced excitation of sensory neurons. We tested DF2755A antinociceptive effects in a cyclophosphamide (CYP)-induced non-ulcerative IC rat model characterized by severe peripheral neuropathy in the absence of bladder inflammatory infiltrate, urothelial hyperplasia, and hemorrhage. Treatment with DF2755A prevented the onset of peripheral neuropathy and reversed its development in CYP-induced IC rats, showing a strong and long-lasting anti-hyperalgesic effect. Ex vivo and in vitro studies showed that DF2755A treatment strongly inhibited the expression of CXCR2 agonists, CXCL1/KC, and CXCL5 and of transient receptor potential vanilloid 1 (TRPV1) compared to vehicle, suggesting that its effects can be due to the inhibition of the nociceptive signaling passing through the CXCL1/CXCR1-2 axis and TRPV1. In conclusion, our results highlight the key pathophysiological role played by the CXCL1/CXCR1-2 axis and TRPV1 in the onset and development of peripheral neuropathy in non-Hunner IC and propose DF2755A as a potential therapeutic approach for the treatment of not only inflammatory painful conditions but also neuropathic ones and in particular non-Hunner IC/BPS.
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Affiliation(s)
- Laura Brandolini
- Research and Early Development, Dompé Farmaceutici S.p.A., L’Aquila, Italy
| | - Andrea Aramini
- Research and Early Development, Dompé Farmaceutici S.p.A., L’Aquila, Italy
| | - Gianluca Bianchini
- Research and Early Development, Dompé Farmaceutici S.p.A., L’Aquila, Italy
| | - Anna Ruocco
- Research and Early Development, Dompé Farmaceutici S.p.A., Naples, Italy
| | | | - Rubina Novelli
- Research and Early Development, Dompé Farmaceutici S.p.A., Milan, Italy
| | | | | | - Roberto Russo
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Vanessa Castelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Annamaria Cimini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Marcello Allegretti
- Research and Early Development, Dompé Farmaceutici S.p.A., L’Aquila, Italy
- *Correspondence: Marcello Allegretti,
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Thompson A, Siegel AE, Thompson Z, Tramont JM. Interstitial Cystitis or Painful Bladder Syndrome in a Premenopausal Female Precipitated by Oral Combined Contraceptives. Cureus 2020; 12:e8348. [PMID: 32617221 PMCID: PMC7325412 DOI: 10.7759/cureus.8348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
It has been well documented that female sex is a significant risk factor for the development of various autoimmune diseases. While the reason for this has been debated, one well-regarded theory is that increased estrogen and decreased testosterone play a role in this predisposition. Interstitial cystitis (IC), also known as painful bladder syndrome (PBS), is an autoimmune disorder that affects over nine million women in the United States. It presents with pelvic and bladder pain and urinary symptoms, both of which significantly and negatively affect the quality of life. Even so, very few studies have examined the pathophysiologic relationship between autoimmune disorders and hormonal contraceptives. In this report, we present a case of IC likely precipitated by oral contraceptives (OCPs) in a premenopausal female. Shortly after beginning OCPs, this patient developed symptoms of severe pelvic pain and increased urinary frequency. Over the course of a year, the patient was diagnosed and treated for a variety of conditions, such as urinary tract infection (UTI), fungal vaginitis, and nephrolithiasis. After consultation with a gynecologist, a normal abdominal CT scan, and unsuccessful cystoscopy due to pain, she was finally diagnosed with IC. The patient independently learned of a potential link between hormonal contraceptive pills and IC and decided to discontinue this method of birth control. Following this, her symptoms completely resolved within several months. The timing of her initiation and discontinuation of OCPs, alongside her symptomatology, suggest a connection to the development of IC. A literature review was performed, which supports this association. We, therefore, highlight this case as an important example of IC precipitated by OCPs.
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Affiliation(s)
- Anna Thompson
- Pediatrics, University of Central Florida College of Medicine, Orlando, USA
| | - Ashley E Siegel
- Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - Zachery Thompson
- Pediatrics, University of Central Florida College of Medicine, Orlando, USA
| | - John M Tramont
- Clinical Sciences, University of Central Florida College of Medicine, Orlando, USA
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Grzybowska ME. Commentary: The Vaginal and Urinary Microbiomes in Premenopausal Women With Interstitial Cystitis/Bladder Pain Syndrome as Compared to Unaffected Controls: A Pilot Cross-Sectional Study. Front Cell Infect Microbiol 2020; 10:64. [PMID: 32158703 PMCID: PMC7052285 DOI: 10.3389/fcimb.2020.00064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 02/07/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Magdalena Emilia Grzybowska
- Department of Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdansk, Gdańsk, Poland
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Opioid prescription use in patients with interstitial cystitis. Int Urogynecol J 2020; 31:1215-1220. [DOI: 10.1007/s00192-019-04214-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/12/2019] [Indexed: 12/11/2022]
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Han E, Nguyen L, Sirls L, Peters K. Current best practice management of interstitial cystitis/bladder pain syndrome. Ther Adv Urol 2018; 10:197-211. [PMID: 30034539 DOI: 10.1177/1756287218761574] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/02/2018] [Indexed: 12/29/2022] Open
Abstract
Introduction Over the last 100 years, the terminology and diagnosis criteria for interstitial cystitis have evolved. Many therapeutic options have changed, but others have endured. This article will review the idea of separating 'classic' Hunner lesion interstitial cystitis (HL IC) from non-Hunner lesion interstitial cystitis and bladder pain syndrome (N-HL IC/BPS) and their respective treatment algorithms. Methods/Results A literature search was performed to identify articles and research on HL IC and N-HL IC/BPS including definitions, etiological theories, and treatments. This article is an overview of the existing literature. We also offer insight into how HL IC and N-HL IC/BPS are approached at our tertiary referral center. Additionally, American Urological Association guidelines have been integrated and newer treatment modalities and research will be introduced at the conclusion. Conclusion The AUA guidelines have mapped out a stepwise fashion to treat IC/BPS; at our institution we separate patients with HL IC from those with N-HL IC/BPS prior to them entering a treatment pathway. We identify the rarer patient with HL as having classic 'IC'; this cystoscopic finding is critical in guiding treatment. We believe HL IC is a distinct disease from N-HL IC/BPS and therapy should focus on the bladder. The vast majority of patients with N-HL IC/BPS need management of their pelvic floor muscles as the primary therapy, complemented by bladder-directed therapies as needed as well as a multidisciplinary team to manage a variety of other regional/systemic symptoms. Ongoing research into IC/BPS will help us better understand the pathophysiology and phenotypes of this complex disease while exciting and novel research studies are developing promising treatments.
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Affiliation(s)
- Esther Han
- Beaumont Health, 3535 W. Thirteen Mild Road, Ste 438, Royal Oak, MI 48073, USA
| | | | - Larry Sirls
- Beaumont Health, Royal Oak, MI, USA Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Kenneth Peters
- Beaumont Health, Royal Oak, MI, USA Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
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Tonyali S, Yilmaz M. Sexual Dysfunction in Interstitial Cystitis. Curr Urol 2018; 11:1-3. [PMID: 29463969 DOI: 10.1159/000447186] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/03/2017] [Indexed: 11/19/2022] Open
Abstract
Background/Aims Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a debilitating disease characterized with urgency, frequency, and pelvic pain affecting especially women. Sexual dysfunction in female patients with IC/BPS consists of dyspareunia, altered sexual desire and orgasm frequency and insufficient lubrication is reported to negatively affect the patient's quality of life. In the present study, we aimed to determine the association between IC/BPS and sexual dysfunction and improvement in sexual dysfunction related to given treatments. Methods A PubMed/Medline and EMBASE search was conducted using keywords: "interstitial cystitis", "sexual dysfunction", and "bladder pain syndrome". Conclusion Several studies have been conducted to determine the relation between IC/BPS and sexual dysfunction. And also limited studies focusing on IC/BPS specific treatments reported significant improvements in sexual function after either oral or intravesical treatment. However, given the used different questionnaires, study protocols, patient characteristics, previous treatments and follow-up period, it is not possible to make a head-to-head comparison of the treatment effects on sexual function. Further, randomized controlled studies are needed to confirm these results and make a comparison between effects of various treatment modalities on sexual functioning in IC/BPS.
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Affiliation(s)
- Senol Tonyali
- Department of Urology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Mehmet Yilmaz
- Department of Urology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
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Hwang SK. Advances in the Treatment of Chronic Pelvic Pain: A Multidisciplinary Approach to Treatment. MISSOURI MEDICINE 2017; 114:47-51. [PMID: 30233101 PMCID: PMC6143566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The treatment of chronic pelvic pain can often be difficult, as many times after visits to multiple providers, patients can carry multiple diagnoses. Even with appropriate treatments, patients often have continued pain that can result in frustrations for both patients and their providers. Utilizing a multidisciplinary and multimodal approach to chronic pelvic pain is beneficial, especially when including evaluation for musculoskeletal dysfunction or other contributors to chronic pelvic pain.
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Affiliation(s)
- Sarah K. Hwang
- Sarah K. Hwang, MD, is Assistant Professor of Clinical PM&R, Department of Physical Medicine and Rehabilitation, University of Missouri Health Care
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