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Lamb LE, Janicki JJ, Bartolone SN, Ward EP, Abraham N, Laudano M, Smith CP, Peters KM, Zwaans BMM, Chancellor MB. Risk Classification for Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) Using Machine Learning Based Predictions. Urology 2024:S0090-4295(24)00285-1. [PMID: 38677373 DOI: 10.1016/j.urology.2024.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVES To improve diagnosis of IC/BPS(IC) we hereby developed an improved IC risk classification using machine learning algorithms. METHODS A national crowdsourcing resulted in 1,264 urine samples consisting of 536 IC (513 female, 21 male, 2 unspecified), and 728 age-matched controls (318 female, 402 male, 8 unspecified) with corresponding PRO pain and symptom scores. In addition, 296 urine samples were collected at three academic centers: 78 IC (71 female, 7 male) and 218 controls (148 female, 68 male, 2 unspecified). Urinary cytokine biomarker levels were determined using Luminex assay. A machine learning predictive classification model, termed the Interstitial Cystitis Personalized Inflammation Symptom (IC-PIS) Score, that utilizes PRO and cytokine levels, was generated and compared to a challenger model. RESULTS The top-performing model using biomarker measurements and PROs (AUC=0.87) was a support vector classifier, which scored better at predicting IC than PROs alone (AUC=0.83). While biomarkers alone (AUC=0.58) did not exhibit strong predictive performance, their combination with PROs produced an improved predictive effect. CONCLUSIONS IC-PIS represents a novel classification model designed to enhance the diagnostic accuracy of IC/BPS by integrating PROs and urine biomarkers. The innovative approach to sample collection logistics, coupled with one of the largest crowdsourced biomarker development studies utilizing ambient shipping methods across the US, underscores the robustness and scalability of our findings.
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Affiliation(s)
- Laura E Lamb
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA; Strata Oncology
| | | | - Sarah N Bartolone
- Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
| | - Elijah P Ward
- Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
| | | | | | | | - Kenneth M Peters
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA; Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA; Underactive Bladder Foundation, Pittsburgh, PA, USA
| | - Bernadette M M Zwaans
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA; Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
| | - Michael B Chancellor
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA; Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA.
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Zwaans BMM, Mota S, Bartolone SN, Ward EP, Peters KM, Chancellor MB. Evaluating symptom severity and urinary cytokine levels in interstitial cystitis/bladder pain syndrome patients, with and without Hunner's lesions. Am J Clin Exp Urol 2024; 12:110-118. [PMID: 38736620 PMCID: PMC11087211 DOI: 10.62347/bled2401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/11/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE Interstitial cystitis/bladder pain syndrome (IC/BPS) is a condition characterized in part by urinary urgency, frequency, and pain. There is a strong interest in gathering more data to compare and assess the differences in characteristics based on the presence of Hunner's lesions in patients with IC/BPS. MATERIALS AND METHODS Using a nationwide crowdsource effort, we collected surveys and urine samples from patients with a history of IC/BPS. Participants completed the Interstitial Cystitis Symptom Index (ICSI) and Problem Index (ICPI), Overactive Bladder questionnaire (OABq SF), and pain scores. In addition, participants reported any co-morbidities and lifestyle modifications. Urinary cytokine levels were measured and compared to symptom severity. RESULTS 491 participants enrolled: 119 with history of ulcerative Hunner's lesions (UIC), 372 reported no lesions (NHIC), and 2 unknowns. 96.3% were female, and prevalence of UIC was equal for both genders. Average age was higher for UIC vs. NHIC group (P = 0.011), as was the duration since diagnosis (P < 0.001). Symptom scores were elevated in UIC patients (P < 0.001). Both groups widely implemented lifestyle modifications, with dietary changes being most prevalent (70.1%), followed by prescription medication usage (63.1%). More UIC compared to NHIC participants experienced co-morbidities (P = 0.010). Urine samples were analyzed for GRO, IL-6, IL-8, and MCP-1. MCP-1 levels were significantly higher in UIC patients (P = 0.044). Weak positive correlation was found between cytokines and symptom scores. CONCLUSIONS Patients with UIC and NHIC from across the United States displayed distinct phenotypic and urine biological characteristics. These findings contribute to increased understanding of IC/BPS and may aid in improving our knowledge of the condition.
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Affiliation(s)
- Bernadette MM Zwaans
- Oakland University William Beaumont School of MedicineRochester, MI, USA
- Corewell Health William Beaumont University HospitalRoyal Oak, MI, USA
| | - Sabrina Mota
- Corewell Health William Beaumont University HospitalRoyal Oak, MI, USA
| | - Sarah N Bartolone
- Corewell Health William Beaumont University HospitalRoyal Oak, MI, USA
| | - Elijah P Ward
- Corewell Health William Beaumont University HospitalRoyal Oak, MI, USA
| | - Kenneth M Peters
- Oakland University William Beaumont School of MedicineRochester, MI, USA
- Corewell Health William Beaumont University HospitalRoyal Oak, MI, USA
| | - Michael B Chancellor
- Oakland University William Beaumont School of MedicineRochester, MI, USA
- Corewell Health William Beaumont University HospitalRoyal Oak, MI, USA
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Mota S, Ward EP, Bartolone SN, Chancellor MB, Zwaans BMM. Identification of Molecular Mechanisms in Radiation Cystitis: Insights from RNA Sequencing. Int J Mol Sci 2024; 25:2632. [PMID: 38473879 PMCID: PMC10932361 DOI: 10.3390/ijms25052632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Pelvic cancer survivors who were treated with radiation therapy are at risk for developing (hemorrhagic) radiation cystitis (RC) many years after completion of radiation therapy. Patients with RC suffer from lower urinary tract symptoms, including frequency, nocturia, pelvic pain, and incontinence. In advanced stages, hematuria can occur, potentially escalating to life-threatening levels. Current therapeutic options for RC are limited, partly due to ethical concerns regarding bladder biopsy in patients with fragile bladder tissue. This study aimed to leverage our established preclinical model to elucidate the molecular pathways implicated in radiation-induced tissue changes in the bladder. Female C57Bl/6 mice received a single dose of 40 Gy using CT-guided imaging and a two-beam irradiation approach using the SARRP irradiator. Bladders from irradiated and age-matched littermate controls were harvested at 1 week [n = 5/group] or 6 months [n = 5/group] after irradiation, RNA was harvested, and mRNA sequencing was performed at paired-end 150bp on the Illumina NovaSeq6000 with a target of 30 million reads per sample. Following RNA sequencing, thorough bioinformatics analysis was performed using iPathwayGuide v2012 (ADVAITA Bioinformatics). Findings of the RNA sequencing were validated using qPCR analysis. At 1 week post-irradiation, altered gene expression was detected in genes involved in DNA damage response, apoptosis, and transcriptional regulation. By 6 months post-irradiation, significant changes in gene expression were observed in inflammation, collagen catabolism, and vascular health. Affected pathways included the p53, JAK-STAT, and PI3K-Akt pathways. These findings were validated in vivo in bladder tissues from our preclinical model. This is the first study to determine the molecular changes in the bladder in response to radiation treatment. We have successfully pinpointed several pathways and specific genes that undergo modification, thereby contributing to the progression of radiation cystitis. These insights enhance our understanding of the pathophysiology of radiation cystitis and may ultimately pave the way to the identification of potential new therapeutic targets.
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Affiliation(s)
- Sabrina Mota
- Department of Urology, William Beaumont University Hospital, Corewell Health System, Royal Oak, MI 48073, USA
- Department of Urology, Oakland University William Beaumont School of Medicine, Rochester Hills, MI 48309, USA
| | - Elijah P. Ward
- Department of Urology, William Beaumont University Hospital, Corewell Health System, Royal Oak, MI 48073, USA
| | - Sarah N. Bartolone
- Department of Urology, William Beaumont University Hospital, Corewell Health System, Royal Oak, MI 48073, USA
| | - Michael B. Chancellor
- Department of Urology, William Beaumont University Hospital, Corewell Health System, Royal Oak, MI 48073, USA
- Department of Urology, Oakland University William Beaumont School of Medicine, Rochester Hills, MI 48309, USA
| | - Bernadette M. M. Zwaans
- Department of Urology, William Beaumont University Hospital, Corewell Health System, Royal Oak, MI 48073, USA
- Department of Urology, Oakland University William Beaumont School of Medicine, Rochester Hills, MI 48309, USA
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Hoang Roberts L, Zwaans BM, Jabbar K, Bartolone SN, Padmanabhan P, Peters KM. Fibrin microthrombi in bladder urothelium after SARS-CoV-2 infection: Case report. Urol Case Rep 2023; 51:102575. [PMID: 37829494 PMCID: PMC10565678 DOI: 10.1016/j.eucr.2023.102575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023] Open
Abstract
A 45-year-old male with diabetes, hypertension and hyperlipidemia was referred to urology due to persistent symptoms of urinary frequency, urgency, nocturia, erectile dysfunction, and constant pain localized to the bladder, pelvis, and perineal area, 3-4 months after SARS-CoV-2 infection. A bladder biopsy showed urothelial mucosa and submucosa with hemorrhage and fibrin microthrombi in blood vessels. Hydrodistention of the bladder and pelvic floor physical therapy resolved symptoms, though bladder and pain symptoms returned upon reinfection with SARS-CoV-2. Urinalysis revealed elevated urinary interleukin-8, which may indicate localized bladder inflammation.
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Affiliation(s)
| | - Bernadette M.M. Zwaans
- Department of Urology, Corewell Health, Royal Oak, MI, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Kausar Jabbar
- Department of Pathology, Beaumont Health, Royal Oak, MI, USA
| | | | - Priya Padmanabhan
- Department of Urology, Corewell Health, Royal Oak, MI, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Kenneth M. Peters
- Department of Urology, Corewell Health, Royal Oak, MI, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
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Janicki JJ, Ward EP, Bartolone SN, Lamb LE, Abraham N, Laudano M, Smith CP, Peters KM, Zwaans BM, Chancellor MB. Comparing online crowdsourcing with clinic patient enrollment: Findings from the IP4IC Study on interstitial cystitis/bladder pain syndrome. Digit Health 2023; 9:20552076231216280. [PMID: 38025103 PMCID: PMC10664419 DOI: 10.1177/20552076231216280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Interstitial cystitis/bladder pain syndrome (IC/BPS) manifests as urinary symptoms including urgency, frequency, and pain. The IP4IC Study aimed to establish a urine-based biomarker score for diagnosing IC/BPS. To accomplish this objective, we investigated the parallels and variances between patients enrolled via physician/hospital clinics and those recruited through online crowdsourcing. Methods Through a nationwide crowdsource effort, we collected surveys from patients with history of IC/BPS. Study participants were asked to complete the validated instruments of Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI), as well as provide demographic information. We then compared the survey responses of patients recruited through crowdsourcing with those recruited from three specialized tertiary care urology clinics engaged in clinical research. Results Survey responses of 1300 participants were collected from all 50 states of the USA via crowdsourcing and 319 from a clinical setting. ICSI and ICPI were similar for IC/BPS patients diagnosed by the physicians in clinic and self-reported by subjects via crowdsourcing stating they have a history of previous physician diagnosis of IC/BPS. Surprisingly, ICSI and ICPI were significantly lower in crowdsourced control than in-clinic control subjects. Conclusion The IP4IC Study provides valuable insights into the similarities and differences between patients recruited through clinics and those recruited through online crowdsourcing. There were no significant differences in disease symptoms among these groups. Individuals who express an interest in digital health research and self-identify as having been previously diagnosed by physicians with IC/BPS can be regarded as reliable candidates for crowdsourcing research.
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Affiliation(s)
- Joseph J. Janicki
- Department of Urology, Underactive Bladder Foundation, Pittsburgh, PA, USA
| | - Elijah P. Ward
- Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
| | - Sarah N. Bartolone
- Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
| | - Laura E. Lamb
- Department of Urology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Nitya Abraham
- Department of Urology, Montefiore Medical Center, The Bronx, NY, USA
| | - Melissa Laudano
- Department of Urology, Montefiore Medical Center, The Bronx, NY, USA
| | | | - Kenneth M. Peters
- Department of Urology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
- Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
| | - Bernadette M.M. Zwaans
- Department of Urology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
- Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
| | - Michael B. Chancellor
- Department of Urology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
- Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
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Sharma P, Lamb LE, Bartolone SN, Ward EP, Janicki JJ, Peters KM, Abraham N, Laudano M, Smith CP, Zwaans B, Chancellor MB. A Cost, Time, and Demographic Analysis of Participant Recruitment and Urine Sample Collection Through Social Media Optimization. Urol Pract 2022; 9:561-566. [PMID: 37145804 DOI: 10.1097/upj.0000000000000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Clinical research can be expensive and time consuming due to high associated costs and/or duration of the study. We hypothesized that urine sample collection using online recruitment and engagement of research participants via social medial has the potential to reach a large population in a small timeframe, at a reasonable cost. METHODS We performed a retrospective cost analysis of a cohort study comparing cost per sample and time per sample for both online and clinically recruited participants for urine sample collection. During this time, cost data were collected based on study associated costs from invoices and budget spreadsheets. The data were subsequently analyzed using descriptive statistics. RESULTS Each sample collection kit contained 3 urine cups, 1 for the disease sample and 2 for control samples. Out of the 3,576 (1,192 disease + 2,384 control) total sample cups mailed, 1,254 (695 control) samples were returned. Comparatively, the 2 clinical sites collected 305 samples. Although the initial startup cost of online recruitment was higher, cost per sample for online recruited was found to be $81.45 compared to $398.14 for clinic sample. CONCLUSIONS We conducted a nationwide, contactless, urine sample collection through online recruitment in the midst of the COVID-19 pandemic. Results were compared with the samples collected in the clinical setting. Online recruitment can be utilized to collect urine samples rapidly, efficiently, and at a cost per sample that was 20% of an in-person clinic, and without risk of COVID-19 exposure.
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Affiliation(s)
- Prasun Sharma
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Laura E Lamb
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | | | - Elijah P Ward
- Beaumont Health Spectrum Health System, Royal Oak, Michigan
| | | | | | - Nitya Abraham
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Melissa Laudano
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Christopher P Smith
- Baylor College of Medicine, Houston, Texas
- Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Bernadette Zwaans
- Beaumont Health Spectrum Health System, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Michael B Chancellor
- Beaumont Health Spectrum Health System, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
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Ward EP, Bartolone SN, Sharma P, Chancellor MB, Lamb LE. Using social media to crowdsource collection of urine samples during a national pandemic. Int Urol Nephrol 2022; 54:493-498. [PMID: 35080680 PMCID: PMC8790544 DOI: 10.1007/s11255-022-03108-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/09/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic and subsequent lockdown had a substantial impact on normal research operations. Researchers needed to adapt their methods to engage at-home participants. One method is crowdsourcing, in which researchers use social media to recruit participants, gather data, and collect samples. We utilized this method to develop a diagnostic test for Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). Participants were recruited via posts on popular social-media platforms, and enrolled via a website. Participants received and returned a mail kit containing bladder symptom surveys and a urine sample cup containing room-temperature preservative. Using this method, we collected 1254 IC/BPS and control samples in 3 months from all 50 United States. Our data demonstrate that crowdsourcing is a viable alternative to traditional research, with the ability to reach a broad patient population rapidly. Crowdsourcing is a powerful tool for at-home participation in research, particularly during the lockdown caused by the COVID-19 pandemic.
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Affiliation(s)
| | | | - Prasun Sharma
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Michael B Chancellor
- Beaumont Health, Royal Oak, MI, USA.,Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Laura E Lamb
- Beaumont Health, Royal Oak, MI, USA. .,Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
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Bartolone SN, Sharma P, Chancellor MB, Lamb LE. Urinary Incontinence and Alzheimer's Disease: Insights From Patients and Preclinical Models. Front Aging Neurosci 2022; 13:777819. [PMID: 34975457 PMCID: PMC8718555 DOI: 10.3389/fnagi.2021.777819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Alzheimer's disease effects a large percentage of elderly dementia patients and is diagnosed on the basis of amyloid plaques and neurofibrillary tangles (NFTs) present in the brain. Urinary incontinence (UI) is often found in the elderly populations and multiple studies have shown that it is more common in Alzheimer's disease patients than those with normal cognitive function. However, the link between increased UI and Alzheimer's disease is still unclear. Amyloid plaques and NFTs present in micturition centers of the brain could cause a loss of signal to the bladder, resulting in the inability to properly void. Additionally, as Alzheimer's disease progresses, patients become less likely to recognize the need or understand the appropriate time and place to void. There are several treatments for UI targeting the muscarinic and β3 adrenergic receptors, which are present in the bladder and the brain. While these treatments may aid in UI, they often have effects on the brain with cognitive impairment side-effects. Acetylcholine esterase inhibitors are often used in treatment of Alzheimer's disease and directly oppose effects of anti-muscarinics used for UI, making UI management in Alzheimer's disease patients difficult. There are currently over 200 pre-clinical models of Alzheimer's disease, however, little research has been done on voiding disfunction in these models. There is preliminary data suggesting these models have similar voiding behavior to Alzheimer's disease patients but much more research is needed to understand the link between UI and Alzheimer's disease and discover better treatment options for managing both simultaneously.
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Affiliation(s)
- Sarah N Bartolone
- Department of Urology, Beaumont Health, Royal Oak, MI, United States
| | - Prasun Sharma
- Oakland University William Beaumont School of Medicine, Rochester Hills, MI, United States
| | - Michael B Chancellor
- Department of Urology, Beaumont Health, Royal Oak, MI, United States.,Oakland University William Beaumont School of Medicine, Rochester Hills, MI, United States
| | - Laura E Lamb
- Department of Urology, Beaumont Health, Royal Oak, MI, United States.,Oakland University William Beaumont School of Medicine, Rochester Hills, MI, United States
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Ward EP, Bartolone SN, Chancellor MB, Peters KM, Lamb LE. Proteomic analysis of bladder biopsies from interstitial cystitis/bladder pain syndrome patients with and without Hunner's lesions reveals differences in expression of inflammatory and structural proteins. BMC Urol 2020; 20:180. [PMID: 33160333 PMCID: PMC7648270 DOI: 10.1186/s12894-020-00751-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/26/2020] [Indexed: 11/10/2022] Open
Abstract
Background Interstitial cystitis/bladder pain syndrome is a bladder disease usually characterized by pain, urgency, and frequency. Interstitial cystitis is currently classified into two subtypes, with and without Hunner’s lesions. However, the underlying etiology of interstitial cystitis and its subtypes are largely unknown. Methods To better understand the biological changes in the bladder of interstitial cystitis/bladder pain syndrome patients, we directly analyzed bladder tissue of interstitial cystitis patients, both those with Hunner’s lesions and those without. Proteins in the bladder biopsies were analyzed using nanoscale high-performance liquid chromatography-tandem mass spectrometry. Disease subgroups were compared and significantly expressed proteins were mapped using STRING to determine protein associations and functions. Results We found that patients with Hunner’s lesions had significant increases in inflammatory and endoplasmic reticulum stress proteins, with a decrease in cellular adhesive proteins, compared to patients without Hunner’s lesions. These patients also exhibited a decrease in proteins associated with the Rap1 signaling pathway, which regulates cell proliferation and wound healing. When comparing diseased and non-disease-apparent tissue in patients with Hunner’s lesions, diseased tissue exhibited a decrease in ubiquitination proteins. Conclusions In summary, there are significant differences in protein expression found in the bladders of interstitial cystitis patients with and without Hunner’s lesions, indicating a disturbance in proteins associated with cellular adhesion, proliferation, protein processing, and wound healing.
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Affiliation(s)
- Elijah P Ward
- Department of Urology, Beaumont Health System, 3811 W. 13 Mile Road, Suite 504, Royal Oak, MI, 48073, USA
| | - Sarah N Bartolone
- Department of Urology, Beaumont Health System, 3811 W. 13 Mile Road, Suite 504, Royal Oak, MI, 48073, USA
| | - Michael B Chancellor
- Department of Urology, Beaumont Health System, 3811 W. 13 Mile Road, Suite 504, Royal Oak, MI, 48073, USA.,Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Kenneth M Peters
- Department of Urology, Beaumont Health System, 3811 W. 13 Mile Road, Suite 504, Royal Oak, MI, 48073, USA.,Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Laura E Lamb
- Department of Urology, Beaumont Health System, 3811 W. 13 Mile Road, Suite 504, Royal Oak, MI, 48073, USA. .,Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
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Bartolone SN, Ward EP, Wang Z, Zwaans BMM, Chancellor MB, Bjorling DE, Lamb LE. Micturition defects and altered bladder function in the klotho mutant mouse model of aging. Am J Clin Exp Urol 2020; 8:81-92. [PMID: 32699807 PMCID: PMC7364365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION AND OBJECTIVES Symptoms associated with detrusor underactivity (DU) or underactive bladder (UAB) can severely impact a person's quality of life, and growing old is the main etiological factor of DU and UAB. The gene Klotho has been associated with suppression of several aging phenotypes, and there is moderate klotho expression in the bladder. Given this, we hypothesized that the klotho gene is involved in regulation of bladder function. Thus, we examined a premature aging rodent genetic model with hypomorphic klotho expression for alterations in bladder function. METHODS Klotho mutant mice are established as a preclinical model of aging. Male and female klotho mice had micturition measured at weeks 4, 6, and 8 through metabolic cage and void spot assays. Histology was assessed at 4, 6, and 8 weeks. Lastly, bladder contraction was assessed using bladder strip tissue bath. All animals were gender- and age-matched with wild-type littermates for analysis. RESULTS Void spot and bladder contraction assays revealed that klotho mutant mice, similar to other aging models, have increased voiding frequency and decreased voiding volume per micturition event. The in vitro contractile response to electrical stimulation was weaker and muscarinic receptor subtype expression was reduced in the in klotho mutant mouse bladders. These data suggest that klotho mutant mouse bladders had impaired bladder function. CONCLUSIONS Klotho mutant mice recapitulate many characteristics of an older dysfunctional bladder, including altered bladder function. Given the short time frame to bladder dysfunction and robustness of the model, this model will provide new insights to drive aging bladder research.
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Affiliation(s)
| | - Elijah P Ward
- Department of Urology, Beaumont Health SystemRoyal Oak, MI, USA
| | - Zunyi Wang
- Department of Surgical Services, School of Veterinary Medicine, University of Wisconsin-MadisonMadison, WI, USA
| | - Bernadette MM Zwaans
- Department of Urology, Beaumont Health SystemRoyal Oak, MI, USA
- Oakland University William Beaumont School of MedicineRochester Hills, MI, USA
| | - Michael B Chancellor
- Department of Urology, Beaumont Health SystemRoyal Oak, MI, USA
- Oakland University William Beaumont School of MedicineRochester Hills, MI, USA
| | - Dale E Bjorling
- Department of Surgical Services, School of Veterinary Medicine, University of Wisconsin-MadisonMadison, WI, USA
| | - Laura E Lamb
- Department of Urology, Beaumont Health SystemRoyal Oak, MI, USA
- Oakland University William Beaumont School of MedicineRochester Hills, MI, USA
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Lamb LE, Bartolone SN, Ward E, Chancellor MB. Rapid detection of novel coronavirus/Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by reverse transcription-loop-mediated isothermal amplification. PLoS One 2020; 15:e0234682. [PMID: 32530929 PMCID: PMC7292379 DOI: 10.1371/journal.pone.0234682] [Citation(s) in RCA: 203] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/01/2020] [Indexed: 01/12/2023] Open
Abstract
Novel Corona virus/Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2 or 2019-nCoV), and the subsequent disease caused by the virus (coronavirus disease 2019 or COVID-19), is an emerging global health concern that requires a rapid diagnostic test. Quantitative reverse transcription PCR (qRT-PCR) is currently the standard for SARS-CoV-2 detection; however, Reverse Transcription Loop-Mediated Isothermal Amplification (RT-LAMP) may allow for faster and cheaper field based testing at point-of-risk. The objective of this study was to develop a rapid screening diagnostic test that could be completed in 30-45 minutes. Simulated patient samples were generated by spiking serum, urine, saliva, oropharyngeal swabs, and nasopharyngeal swabs with a portion of the SARS-CoV-2 nucleic sequence. RNA isolated from nasopharyngeal swabs collected from actual COVID-19 patients was also tested. The samples were tested using RT-LAMP as well as by conventional qRT-PCR. Specificity of the RT-LAMP was evaluated by also testing against other related coronaviruses. RT-LAMP specifically detected SARS-CoV-2 in both simulated patient samples and clinical specimens. This test was performed in 30-45 minutes. This approach could be used for monitoring of exposed individuals or potentially aid with screening efforts in the field and potential ports of entry.
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Affiliation(s)
- Laura E. Lamb
- Department of Urology, Beaumont Health System, Royal Oak, Michigan, United States of America
- Oakland University William Beaumont School of Medicine, Rochester Hills, Michigan, United States of America
| | - Sarah N. Bartolone
- Department of Urology, Beaumont Health System, Royal Oak, Michigan, United States of America
| | - Elijah Ward
- Department of Urology, Beaumont Health System, Royal Oak, Michigan, United States of America
| | - Michael B. Chancellor
- Department of Urology, Beaumont Health System, Royal Oak, Michigan, United States of America
- Oakland University William Beaumont School of Medicine, Rochester Hills, Michigan, United States of America
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Zwaans BMM, Wegner KA, Bartolone SN, Vezina CM, Chancellor MB, Lamb LE. Radiation cystitis modeling: A comparative study of bladder fibrosis radio-sensitivity in C57BL/6, C3H, and BALB/c mice. Physiol Rep 2020; 8:e14377. [PMID: 32109348 PMCID: PMC7048381 DOI: 10.14814/phy2.14377] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/29/2020] [Accepted: 01/30/2020] [Indexed: 12/12/2022] Open
Abstract
A subset of patients receiving radiation therapy for pelvic cancer develop radiation cystitis, a complication characterized by mucosal cell death, inflammation, hematuria, and bladder fibrosis. Radiation cystitis can reduce bladder capacity, cause incontinence, and impair voiding function so severely that patients require surgical intervention. Factors influencing onset and severity of radiation cystitis are not fully known. We tested the hypothesis that genetic background is a contributing factor. We irradiated bladders of female C57BL/6, C3H, and BALB/c mice and evaluated urinary voiding function, bladder shape, histology, collagen composition, and distribution of collagen-producing cells. We found that the genetic background profoundly affects the severity of radiation-induced bladder fibrosis and urinary voiding dysfunction. C57BL/6 mice are most susceptible and C3H mice are most resistant. Irradiated C57BL/6 mouse bladders are misshapen and express more abundant collagen I and III proteins than irradiated C3H and BALB/c bladders. We localized Col1a1 and Col3a1 mRNAs to FSP1-negative stromal cells in the bladder lamina propria and detrusor. The number of collagen I and collagen III-producing cells can predict the average voided volume of a mouse. Collectively, we show that genetic factors confer sensitivity to radiation cystitis, establish C57BL/6 mice as a sensitive preclinical model, and identify a potential role for FSP1-negative stromal cells in radiation-induced bladder fibrosis.
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Affiliation(s)
- Bernadette M. M. Zwaans
- Department of UrologyWilliam Beaumont HospitalRoyal OakMIUSA
- Oakland University William Beaumont School of MedicineRoyal OakMIUSA
| | - Kyle A. Wegner
- Molecular and Environmental Toxicology CenterSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWIUSA
- Department of Comparative BiosciencesSchool of Veterinary MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
| | | | - Chad M. Vezina
- Molecular and Environmental Toxicology CenterSchool of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWIUSA
- Department of Comparative BiosciencesSchool of Veterinary MedicineUniversity of Wisconsin‐MadisonMadisonWIUSA
| | - Michael B. Chancellor
- Department of UrologyWilliam Beaumont HospitalRoyal OakMIUSA
- Oakland University William Beaumont School of MedicineRoyal OakMIUSA
| | - Laura E. Lamb
- Department of UrologyWilliam Beaumont HospitalRoyal OakMIUSA
- Oakland University William Beaumont School of MedicineRoyal OakMIUSA
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Lamb LE, Bartolone SN, Ward E, Chancellor MB. Rapid detection of novel coronavirus/Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by reverse transcription-loop-mediated isothermal amplification. PLoS One 2020; 15:e0234682. [PMID: 32530929 DOI: 10.1101/2020.02.19.20025155] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/01/2020] [Indexed: 05/18/2023] Open
Abstract
Novel Corona virus/Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2 or 2019-nCoV), and the subsequent disease caused by the virus (coronavirus disease 2019 or COVID-19), is an emerging global health concern that requires a rapid diagnostic test. Quantitative reverse transcription PCR (qRT-PCR) is currently the standard for SARS-CoV-2 detection; however, Reverse Transcription Loop-Mediated Isothermal Amplification (RT-LAMP) may allow for faster and cheaper field based testing at point-of-risk. The objective of this study was to develop a rapid screening diagnostic test that could be completed in 30-45 minutes. Simulated patient samples were generated by spiking serum, urine, saliva, oropharyngeal swabs, and nasopharyngeal swabs with a portion of the SARS-CoV-2 nucleic sequence. RNA isolated from nasopharyngeal swabs collected from actual COVID-19 patients was also tested. The samples were tested using RT-LAMP as well as by conventional qRT-PCR. Specificity of the RT-LAMP was evaluated by also testing against other related coronaviruses. RT-LAMP specifically detected SARS-CoV-2 in both simulated patient samples and clinical specimens. This test was performed in 30-45 minutes. This approach could be used for monitoring of exposed individuals or potentially aid with screening efforts in the field and potential ports of entry.
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Affiliation(s)
- Laura E Lamb
- Department of Urology, Beaumont Health System, Royal Oak, Michigan, United States of America
- Oakland University William Beaumont School of Medicine, Rochester Hills, Michigan, United States of America
| | - Sarah N Bartolone
- Department of Urology, Beaumont Health System, Royal Oak, Michigan, United States of America
| | - Elijah Ward
- Department of Urology, Beaumont Health System, Royal Oak, Michigan, United States of America
| | - Michael B Chancellor
- Department of Urology, Beaumont Health System, Royal Oak, Michigan, United States of America
- Oakland University William Beaumont School of Medicine, Rochester Hills, Michigan, United States of America
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Zwaans BMM, Wegner KA, Bartolone SN, Chancellor MB, Vezina CM, Lamb LE. Radiation Cystitis Modeling: a Comparative Study of Bladder Radiation‐Induced Fibrosis in Different Mouse Strains. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.366.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bernadette MM Zwaans
- UrologyBeaumont HealthRoyal OakMI
- Oakland University William Beaumont School of MedicineRochesterMI
| | - Kyle A Wegner
- Molecular and Environmental Toxicology CenterUniversity of WisconsinMadisonWI
| | | | - Michael B Chancellor
- UrologyBeaumont HealthRoyal OakMI
- Oakland University William Beaumont School of MedicineRochesterMI
| | - Chad M Vezina
- Comparative BiosciencesUniversity of WisconsinMadisonWI
- George M. O'Brien Center for Benign Urologic ResearchUniversity of WisconsinMadisonWI
| | - Laura E Lamb
- UrologyBeaumont HealthRoyal OakMI
- Oakland University William Beaumont School of MedicineRochesterMI
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Bartolone SN, Tree MO, Conway MJ, Chancellor MB, Lamb LE. Reverse Transcription-Loop-mediated Isothermal Amplification (RT-LAMP) Assay for Zika Virus and Housekeeping Genes in Urine, Serum, and Mosquito Samples. J Vis Exp 2018. [PMID: 30272674 DOI: 10.3791/58436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Infection with Zika virus (ZIKV) can be asymptomatic in adults, however, infection during pregnancy can lead to miscarriage and severe neurological birth defects. The goal of this protocol is to quickly detect ZIKV in both human and mosquito samples. The current gold standard for ZIKV detection is quantitative reverse transcription PCR (qRT-PCR); reverse transcription loop-mediated isothermal amplification (RT-LAMP) may allow for a more efficient and low-cost testing without the need for expensive equipment. In this study, RT-LAMP is used for ZIKV detection in various biological samples within 30 min, without first isolating the RNA from the sample. This technique is demonstrated using ZIKV infected patient urine and serum, and infected mosquito samples. 18S ribosomal ribonucleic acid and actin are used as controls in human and mosquito samples, respectively.
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Affiliation(s)
| | - Maya O Tree
- Foundational Sciences, College of Medicine, Central Michigan University
| | - Michael J Conway
- Foundational Sciences, College of Medicine, Central Michigan University
| | - Michael B Chancellor
- Department of Urology, Beaumont Health System; Oakland University William Beaumont School of Medicine
| | - Laura E Lamb
- Department of Urology, Beaumont Health System; Oakland University William Beaumont School of Medicine;
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Zwaans BMM, Bartolone SN, Chancellor MB, Nicolai HE, Lamb LE. Altered Angiogenic Growth Factors in Urine of Prostate Cancer Survivors With Radiation History and Radiation Cystitis. Urology 2018; 120:180-186. [PMID: 30059715 DOI: 10.1016/j.urology.2018.07.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/13/2018] [Accepted: 07/17/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine if the vascular damage in bladders of prostate cancer (PCa) survivors with radiation cystitis can be detected through altered angiogenic growth factors in urine. METHODS Urine samples from PCa survivors with a history of external beam radiation therapy were tested for a panel of angiogenic growth factors by Luminex assay. Urine creatinine levels were measured through high performance liquid chromatography. Through a patient survey, data on patient demographics, radiation history, and urinary symptoms were collected. RESULTS Hepatocyte growth factor (HGF), placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) were altered in urine of PCa survivors with a history of radiation therapy. HGF and PlGF were elevated in response to irradiation, while VEGF had a decreasing trend. Within the irradiated population, HGF was also increased in patients diagnosed with radiation cystitis and patients with hematuria. PlGF and VEGF were only increased in the first year postirradiation, and VEGF was elevated in patients with hematuria. Finally, creatinine levels were increased in PCa survivors with a history of radiation therapy. CONCLUSION Radiation cystitis is a debilitating bladder condition that cancer survivors are at risk of developing after pelvic radiation. In this study, we identified 3 pro-angiogenic factors that may be urine biomarkers and, if validated in future studies, could indicate new strategy approaches to treat radiation cystitis.
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Affiliation(s)
- Bernadette M M Zwaans
- Department of Urology, William Beaumont Hospital, MI; Oakland University William Beaumont School of Medicine, Royal Oak, MI
| | | | - Michael B Chancellor
- Department of Urology, William Beaumont Hospital, MI; Oakland University William Beaumont School of Medicine, Royal Oak, MI
| | - Heinz E Nicolai
- Urology Department, University of Chile, Santiago, Chile; Clinical Hospital San Borja Arriarán, Santiago, Chile
| | - Laura E Lamb
- Department of Urology, William Beaumont Hospital, MI; Oakland University William Beaumont School of Medicine, Royal Oak, MI.
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Chancellor MB, Bartolone SN, DeVries EM, Diokno AC, Gibbons M, Jankowski R, Lamb LE, Pruchnic R, Thor K, Dmochowski R. New technology assessment and current and upcoming therapies for underactive bladder. Neurourol Urodyn 2018; 37:2932-2937. [DOI: 10.1002/nau.23738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/29/2018] [Indexed: 01/17/2023]
Affiliation(s)
- Michael B. Chancellor
- Department of Urology, Beaumont Health System; Oakland University William Beaumont School of Medicine; Royal Oak Michigan
| | - Sarah N. Bartolone
- Department of Urology, Beaumont Health System; Oakland University William Beaumont School of Medicine; Royal Oak Michigan
| | | | - Ananias C. Diokno
- Department of Urology, Beaumont Health System; Oakland University William Beaumont School of Medicine; Royal Oak Michigan
| | | | | | - Laura E. Lamb
- Department of Urology, Beaumont Health System; Oakland University William Beaumont School of Medicine; Royal Oak Michigan
| | | | - Karl Thor
- Dignify Therapeutics; Research Triangle Park North Carolina
| | - Roger Dmochowski
- Department of Urologic Surgery; Vanderbilt University Medical Center; Nashville Tennessee
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Lamb LE, Bartolone SN, Tree MO, Conway MJ, Rossignol J, Smith CP, Chancellor MB. Rapid Detection of Zika Virus in Urine Samples and Infected Mosquitos by Reverse Transcription-Loop-Mediated Isothermal Amplification. Sci Rep 2018; 8:3803. [PMID: 29491389 PMCID: PMC5830622 DOI: 10.1038/s41598-018-22102-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 02/13/2018] [Indexed: 02/03/2023] Open
Abstract
Infection with Zika virus (ZIKV) is of growing concern since infection is associated with the development of congenital neurological disease. Quantitative reverse transcription PCR (qRT-PCR) has been the standard for ZIKV detection; however, Reverse Transcription Loop-Mediated Isothermal Amplification (RT-LAMP) may allow for faster and cheaper testing. Studies have suggested that ZIKV detection in urine is more sensitive and has a longer window of detection compared to serum and saliva. The objective of this study was to develop a urine diagnostic test that could be completed in under 30 minutes. Urine samples spiked with ZIKV or dengue virus were tested using RT-LAMP as well as by conventional quantitative qRT-PCR. These techniques were then validated using crude lysates made from ZIKV infected mosquitoes in addition to urine and serum samples from ZIKV infected patients. RT-LAMP specifically detected ZIKV in urine and serum for ZIKV infected patients and crude mosquito lysates. This test was performed in under 30 minutes and did not require RNA extraction from urine nor mosquitos. This approach could be used for monitoring of exposed individuals, especially pregnant women, couples wanting to conceive, or individuals with suspicious symptoms as well as surveillance of mosquito populations.
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Affiliation(s)
- Laura E Lamb
- Department of Urology, Beaumont Health System, Royal Oak, MI, United States of America.
- Oakland University William Beaumont School of Medicine, Rochester Hills, MI, United States of America.
| | - Sarah N Bartolone
- Department of Urology, Beaumont Health System, Royal Oak, MI, United States of America
| | - Maya O Tree
- Foundational Sciences, Central Michigan University, College of Medicine, Mt. Pleasant, MI, United States of America
| | - Michael J Conway
- Foundational Sciences, Central Michigan University, College of Medicine, Mt. Pleasant, MI, United States of America
| | - Julien Rossignol
- Foundational Sciences, Central Michigan University, College of Medicine, Mt. Pleasant, MI, United States of America
- Field Neurosciences Laboratory for Restorative Neurology, Central Michigan University, Mt. Pleasant, MI, United States of America
- Program in Neuroscience, Central Michigan University, Mt. Pleasant, MI, United States of America
| | - Christopher P Smith
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States of America
| | - Michael B Chancellor
- Department of Urology, Beaumont Health System, Royal Oak, MI, United States of America
- Oakland University William Beaumont School of Medicine, Rochester Hills, MI, United States of America
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Abstract
PURPOSE Biomarker discovery is limited by readily assessable, cost efficient human samples available in large numbers that represent the entire heterogeneity of the disease. We developed a novel, active participation crowdsourcing method to determine BP-RS (Bladder Permeability Defect Risk Score). It is based on noninvasive urinary cytokines to discriminate patients with interstitial cystitis/bladder pain syndrome who had Hunner lesions from controls and patients with interstitial cystitis/bladder pain syndrome but without Hunner lesions. MATERIALS AND METHODS We performed a national crowdsourcing study in cooperation with the Interstitial Cystitis Association. Patients answered demographic, symptom severity and urinary frequency questionnaires on a HIPAA (Health Insurance Portability and Accountability Act) compliant website. Urine samples were collected at home, stabilized with a preservative and sent to Beaumont Hospital for analysis. The expression of 3 urinary cytokines was used in a machine learning algorithm to develop BP-RS. RESULTS The IP4IC study collected a total of 448 urine samples, representing 153 patients (147 females and 6 males) with interstitial cystitis/bladder pain syndrome, of whom 54 (50 females and 4 males) had Hunner lesions. A total of 159 female and 136 male controls also participated, who were age matched. A defined BP-RS was calculated to predict interstitial cystitis/bladder pain syndrome with Hunner lesions or a bladder permeability defect etiology with 89% validity. CONCLUSIONS In this novel participation crowdsourcing study we obtained a large number of urine samples from 46 states, which were collected at home, shipped and stored at room temperature. Using a machine learning algorithm we developed BP-RS to quantify the risk of interstitial cystitis/bladder pain syndrome with Hunner lesions, which is indicative of a bladder permeability defect etiology. To our knowledge BP-RS is the first validated urine biomarker assay for interstitial cystitis/bladder pain syndrome and one of the first biomarker assays to be developed using crowdsourcing.
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Affiliation(s)
- Michael B Chancellor
- Oakland University William Beaumont School of Medicine, Rochester Hills, Michigan.
| | | | - Andrew Veerecke
- Department of Urology, Beaumont Health System, Royal Oak, Michigan
| | - Laura E Lamb
- Oakland University William Beaumont School of Medicine, Rochester Hills, Michigan
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Lamb LE, Janicki JJ, Bartolone SN, Peters KM, Chancellor MB. Development of an interstitial cystitis risk score for bladder permeability. PLoS One 2017; 12:e0185686. [PMID: 29088231 PMCID: PMC5663335 DOI: 10.1371/journal.pone.0185686] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 09/18/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Interstitial cystitis/bladder pain syndrome (IC) is a multifactorial syndrome of severe pelvic and genitalia pain and compromised urinary function; a subset of IC patients present with Hunner's lesions or ulcers on their bladder walls (UIC). UIC is diagnosed by cystoscopy, which may be quite painful. The objective of this study was to determine if a calculated Bladder Permeability Defect Risk Score (BP-RS) based on non-invasive urinary cytokines could discriminate UIC patients from controls and IC patients without Hunner's ulcers. METHODS A national crowdsourcing effort targeted IC patients and age-matched controls to provide urine samples. Urinary cytokine levels for GRO, IL-6, and IL-8 were determined using a Luminex assay. RESULTS We collected 448 urine samples from 46 states consisting of 153 IC patients (147 female, 6 male), of which 54 UIC patients (50 females, 4 male), 159 female controls, and 136 male controls. A defined BP-RS was calculated to classify UIC, or a bladder permeability defect etiology, with 89% validity. CONCLUSIONS The BP-RS Score quantifies UIC risk, indicative of a bladder permeability defect etiology in a subset of IC patients. The Bladder Permeability Defect Risk Score is the first validated urine biomarker assay for interstitial cystitis/bladder pain syndrome.
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Affiliation(s)
- Laura E. Lamb
- Department of Urology, Beaumont Health System, Royal Oak, MI, United States of America
- Oakland University William Beaumont School of Medicine, Rochester Hills, MI, United States of America
| | - Joseph J. Janicki
- Underactive Bladder Foundation, Pittsburgh, PA, United States of America
| | - Sarah N. Bartolone
- Department of Urology, Beaumont Health System, Royal Oak, MI, United States of America
| | - Kenneth M. Peters
- Department of Urology, Beaumont Health System, Royal Oak, MI, United States of America
- Oakland University William Beaumont School of Medicine, Rochester Hills, MI, United States of America
| | - Michael B. Chancellor
- Department of Urology, Beaumont Health System, Royal Oak, MI, United States of America
- Oakland University William Beaumont School of Medicine, Rochester Hills, MI, United States of America
- * E-mail:
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Lamb LE, Bartolone SN, Kutluay SB, Robledo D, Porras A, Plata M, Chancellor MB. Reply to the letter: Urine based molecular diagnosis of Zika virus by Viroj Wiwanitkit. Int Urol Nephrol 2016; 48:2025. [PMID: 27687554 DOI: 10.1007/s11255-016-1424-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Laura E Lamb
- Department of Urology, William Beaumont Hospital, 3811 West 13 Mile Road, Suite 187, Royal Oak, MI, 48073, USA. .,Department of Urology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA.
| | - Sarah N Bartolone
- Department of Urology, William Beaumont Hospital, 3811 West 13 Mile Road, Suite 187, Royal Oak, MI, 48073, USA
| | - Sebla B Kutluay
- Department of Molecular Microbiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Daniela Robledo
- Department of Urology, Fundación Santa Fe de Bogotá University Hospital, Bogotá, D.C., Colombia.,School of Medicine, Universidad de Los Andes, Bogotá, D.C., Colombia
| | - Alexandra Porras
- Subdireccion de Estudios Clínicos, Fundación Santa Fe de Bogotá University Hospital, Bogotá, D.C., Colombia
| | - Mauricio Plata
- Department of Urology, Fundación Santa Fe de Bogotá University Hospital, Bogotá, D.C., Colombia.,School of Medicine, Universidad de Los Andes, Bogotá, D.C., Colombia
| | - Michael B Chancellor
- Department of Urology, William Beaumont Hospital, 3811 West 13 Mile Road, Suite 187, Royal Oak, MI, 48073, USA.,Department of Urology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
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Lamb LE, Bartolone SN, Kutluay SB, Robledo D, Porras A, Plata M, Chancellor MB. Advantage of urine based molecular diagnosis of Zika virus. Int Urol Nephrol 2016; 48:1961-1966. [DOI: 10.1007/s11255-016-1406-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 08/19/2016] [Indexed: 10/21/2022]
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Abstract
Purpose Radiation cystitis (RC), a severe inflammatory bladder condition, develops as a side effect of pelvic radiation therapy in cancer patients. There are currently no effective therapies to treat RC, in part from the lack of preclinical model systems. In this study, we developed a mouse model for RC and used a Small Animal Radiation Research Platform to simulate the targeted delivery of radiation as used with human patients. Methods and materials To induce RC, C3H mice received a single radiation dose of 20 Gy delivered through 2 beams. Mice were subjected to weekly micturition measurements to assess changes in urinary frequency. At the end of the study, bladder tissues were processed for histology. Results Radiation was well-tolerated; no change in weight was observed in the weeks after treatment, and there was no hair loss at the irradiation sites. Starting at 17 weeks after treatment, micturition frequency was significantly higher in irradiated mice versus control animals. Pathological changes include fibrosis, inflammation, urothelial thinning, and necrosis. At a site of severe insult, we observed telangiectasia, absence of uroplakin-3 and E-cadherin relocalization. Conclusions We developed an RC model that mimics the human pathology and functional changes. Furthermore, radiation exposure attenuates the urothelial integrity long-term, allowing for potential continuous irritability of the bladder wall from exposure to urine. Future studies will focus on the underlying molecular changes associated with this condition and investigate novel treatment strategies.
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Affiliation(s)
| | - Sarah Krueger
- Beaumont Health System, Royal Oak, MI; Oakland University William Beaumont School of Medicine, Auburn Hills, MI
| | | | - Michael B Chancellor
- Beaumont Health System, Royal Oak, MI; Oakland University William Beaumont School of Medicine, Auburn Hills, MI; Lipella Pharmaceuticals, Pittsburgh, PA
| | - Brian Marples
- Beaumont Health System, Royal Oak, MI; Oakland University William Beaumont School of Medicine, Auburn Hills, MI
| | - Laura E Lamb
- Beaumont Health System, Royal Oak, MI; Oakland University William Beaumont School of Medicine, Auburn Hills, MI
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Helms AS, Davis FM, Coleman D, Bartolone SN, Glazier AA, Pagani F, Yob JM, Sadayappan S, Pedersen E, Lyons R, Westfall MV, Jones R, Russell MW, Day SM. Sarcomere mutation-specific expression patterns in human hypertrophic cardiomyopathy. ACTA ACUST UNITED AC 2014; 7:434-43. [PMID: 25031304 DOI: 10.1161/circgenetics.113.000448] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Heterozygous mutations in sarcomere genes in hypertrophic cardiomyopathy (HCM) are proposed to exert their effect through gain of function for missense mutations or loss of function for truncating mutations. However, allelic expression from individual mutations has not been sufficiently characterized to support this exclusive distinction in human HCM. METHODS AND RESULTS Sarcomere transcript and protein levels were analyzed in septal myectomy and transplant specimens from 46 genotyped HCM patients with or without sarcomere gene mutations and 10 control hearts. For truncating mutations in MYBPC3, the average ratio of mutant:wild-type transcripts was ≈1:5, in contrast to ≈1:1 for all sarcomere missense mutations, confirming that nonsense transcripts are uniquely unstable. However, total MYBPC3 mRNA was significantly increased by 9-fold in HCM samples with MYBPC3 mutations compared with control hearts and with HCM samples without sarcomere gene mutations. Full-length MYBPC3 protein content was not different between MYBPC3 mutant HCM and control samples, and no truncated proteins were detected. By absolute quantification of abundance with multiple reaction monitoring, stoichiometric ratios of mutant sarcomere proteins relative to wild type were strikingly variable in a mutation-specific manner, with the fraction of mutant protein ranging from 30% to 84%. CONCLUSIONS These results challenge the concept that haploinsufficiency is a unifying mechanism for HCM caused by MYBPC3 truncating mutations. The range of allelic imbalance for several missense sarcomere mutations suggests that certain mutant proteins may be more or less stable or incorporate more or less efficiently into the sarcomere than wild-type proteins. These mutation-specific properties may distinctly influence disease phenotypes.
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Affiliation(s)
- Adam S Helms
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Frank M Davis
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - David Coleman
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Sarah N Bartolone
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Amelia A Glazier
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Francis Pagani
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Jaime M Yob
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Sakthivel Sadayappan
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Ellen Pedersen
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Robert Lyons
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Margaret V Westfall
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Richard Jones
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Mark W Russell
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.)
| | - Sharlene M Day
- From the Departments of Internal Medicine (A.S.H., F.D., D.C., S.B., J.M.Y., S.M.D.), Molecular and Integrative Physiology (A.A.G., M.V.W.), Cardiac Surgery (F.P., M.V.W.), Sequencing Core (E.P., R.L.), and Pediatrics (M.W.R.), University of Michigan, Ann Arbor; Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, IL (S.S.); and MS Bioworks, Ann Arbor, MI (R.J.).
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