scholarly journals Small Fiber Polyneuropathy May Be a Nexus Between Autonomic Nervous System Dysregulation and Pain in Interstitial Cystitis/Bladder Pain Syndrome

2022 ◽  
Vol 2 ◽  
Author(s):  
Dylan T. Wolff ◽  
Stephen J. Walker
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Interstitial Cystitis ◽  
Sympathetic Innervation ◽  
Pain Syndrome ◽  
The United States ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Autonomic Nervous ◽  
Small Fiber

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a highly heterogeneous chronic and debilitating condition which effects millions of women and men in the United States. While primarily defined by urinary symptoms and pain perceived to be emanating from the bladder, IC/BPS patients frequently have co-occurring conditions and symptoms, many of which affect diverse body systems related to autonomic nervous system function. The impact on the autonomic system appears to stem from increased sympathetic innervation of the urinary tract, along with increased systemic sympathetic tone and decreased parasympathetic tone. Concurrent with these findings is evidence for destruction of peripheral sympathetic innervation to the sweat glands which may relate to small fiber polyneuropathy. It is unknown to what degree the wider alterations in autonomic function are also related to destruction/alterations in the small fibers carrying autonomic innervation. This potential nexus is an important point of investigation to better understand the unclarified pathophysiology of interstitial cystitis/bladder pain syndrome, the numerous co-occurring symptoms and syndromes, and for the identification of novel targeted therapeutic strategies.

scholarly journals Small fiber polyneuropathy as a potential therapeutic target in interstitial cystitis/bladder pain syndrome

2019 ◽  
Vol 30 (11) ◽  
pp. 1817-1820 ◽  
Author(s):  
Catherine A. Matthews ◽  
Shaun P. Deveshwar ◽  
Robert J. Evans ◽  
Gopal Badlani ◽  
Stephen J. Walker
Keyword(s):  
Interstitial Cystitis ◽  
Therapeutic Target ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Potential Therapeutic Target ◽  
Bladder Pain ◽  
Small Fiber

scholarly journals Integrated mRNA-miRNA transcriptome analysis of bladder biopsies from patients with bladder pain syndrome identifies signaling alterations contributing to the disease pathogenesis

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ali Hashemi Gheinani ◽  
Akshay Akshay ◽  
Mustafa Besic ◽  
Annette Kuhn ◽  
Irene Keller ◽  
...  
Keyword(s):  
Gene Expression ◽  
Nervous System ◽  
Interstitial Cystitis ◽  
Transcriptome Analysis ◽  
System Organization ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Biological Processes ◽  
Bladder Pain

Abstract Background Interstitial cystitis, or bladder pain syndrome (IC/BPS), is a chronic bladder disorder characterized by lower abdominal pain associated with the urinary bladder and accompanied by urinary frequency and urgency in the absence of identifiable causes. IC/PBS can be separated into the classic Hunner’s ulcerative type and the more prevalent non-ulcerative disease. Our aim was to unravel the biological processes and dysregulated cell signaling pathways leading to the bladder remodeling in non-ulcerative bladder pain syndrome (BPS) by studying the gene expression changes in the patients’ biopsies. Methods We performed paired microRNA (miRNA) and mRNA expression profiling in the bladder biopsies of BPS patients with non-Hunner interstitial cystitis phenotype, using comprehensive Next-generation sequencing (NGS) and studied the activated pathways and altered biological processes based on the global gene expression changes. Paired mRNA-miRNA transcriptome analysis delineated the regulatory role of the dysregulated miRNAs by identifying their targets in the disease-induced pathways. Results EIF2 Signaling and Regulation of eIF4 and p70S6K Signaling, activated in response to cellular stress, were among the most significantly regulated processes during BPS. Leukotriene Biosynthesis nociceptive pathway, important in inflammatory diseases and neuropathic pain, was also significantly activated. The biological processes identified using Gene Ontology over-representation analysis were clustered into six main functional groups: cell cycle regulation, chemotaxis of immune cells, muscle development, muscle contraction, remodeling of extracellular matrix and peripheral nervous system organization and development. Compared to the Hunner’s ulcerative type IC, activation of the immune pathways was modest in non-ulcerative BPS, limited to neutrophil chemotaxis and IFN-γ-mediated signaling. We identified 62 miRNAs, regulated and abundant in BPS and show that they target the mRNAs implicated in eIF2 signalling pathway. Conclusions The bladders of non-ulcerative BPS patients recruited in this study had alterations consistent with a strong cell proliferative response and an up-regulation of smooth muscle contractility, while the contribution of inflammatory processes was modest. Pathway analysis of the integrated mRNA-miRNA NGS dataset pinpointed important regulatory miRNAs whose dysregulation might contribute to the pathogenesis. Observed molecular changes in the peripheral nervous system organization and development indicate the potential role of local bladder innervation in the pain perceived in this type of BPS.

scholarly journals PD01-10 SMALL FIBER POLYNEUROPATHY: A NEXUS LINKING CO-OCCURRING PAIN SYNDROMES IN WOMEN WITH INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME?

2021 ◽  
Vol 206 (Supplement 3) ◽  
Author(s):  
Raymond Xu ◽  
Tyler Overholt ◽  
Catherine A. Matthews ◽  
Robert Evans ◽  
Gopal Badlani ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Pain Syndromes ◽  
Small Fiber

scholarly journals Prevalence of Symptoms of Bladder Pain Syndrome/Interstitial Cystitis Among Adult Females in the United States

2011 ◽  
Vol 186 (2) ◽  
pp. 540-544 ◽  
Author(s):  
Sandra H. Berry ◽  
Marc N. Elliott ◽  
Marika Suttorp ◽  
Laura M. Bogart ◽  
Michael A. Stoto ◽  
...  
Keyword(s):  
United States ◽  
Interstitial Cystitis ◽  
Pain Syndrome ◽  
The United States ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Adult Females

Small Fiber Polyneuropathy Is Associated With Non–Bladder-Centric Interstitial Cystitis/Bladder Pain Syndrome Patients

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Tyler L. Overholt ◽  
Catherine A. Matthews ◽  
Robert J. Evans ◽  
Gopal Badlani ◽  
Christine Ahn ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Small Fiber

Small Fiber Polyneuropathy in Hunner Lesion and Non-Hunner Lesion Interstitial Cystitis/Bladder Pain Syndrome

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Esther Han ◽  
Kim A. Killinger ◽  
Katherine M. Turner ◽  
Jason Gilleran ◽  
Danielle Tenney ◽  
...  
Keyword(s):  
Interstitial Cystitis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Small Fiber

scholarly journals Bladder Pain Syndome/Interstitial Cystitis due to Pudendal Nerve Compression: Described in 1915—A Reminder for Treating Pelvic Pain a Century Later

2020 ◽  
Vol 15 (01) ◽  
pp. e5-e8
Author(s):  
Andreas Gohritz ◽  
Arnold Lee Dellon
Keyword(s):  
Interstitial Cystitis ◽  
Pudendal Nerve ◽  
Pain Syndrome ◽  
The United States ◽  
Bladder Pain Syndrome ◽  
Nerve Compression ◽  
Perineal Pain ◽  
Diabetes Research ◽  
Urinary Urgency ◽  
Bladder Pain

Abstract Background Interstitial cystitis (IC) or bladder pain syndrome (BPS) is highly painful and disabling and probably the most misdiagnosed urologic condition. Its classic symptoms of perineal pain, urinary urgency, and frequency despite sterile urine cultures were already described more than a century ago in a report on soldiers during World War (WW) I due to chronic pudendal nerve compression. Objectives This article translates a report from 1915 on pudendal neuropathy and discusses its author Georg Zülzer (1870–1949). Methods An English translation of the German original is provided with the biography and work of Zülzer, his clinical observations are discussed regarding modern diagnosis and therapy of pudendal nerve compression. Results In his article entitled “Irritation of the Pudendal Nerve (Neuralgia). A Frequent Clinical Picture during War Feigning Bladder Catarrh,” Zülzer describes his observation of soldiers during WW I, presenting with a triad of perineal pain, urinary urgency, and frequency despite sterile urine cultures excluding urinary infections. He also documented a characteristic skin hypersensibility of the perineum in a rhomboid shape which corresponds to the innervation area of the pudendal nerve with its two branches deriving from the “pudendal plexus.” He regards this symptomology as rare during peace, but as disease of trench warfare which can be easily diagnosed regarding clear urine and a painful skin island overlying the area of the pudendal nerve as tested by simple needle examination. Zülzer, born in Germany, was forced to emigrate to the United States in 1934, was also an important pioneer of diabetes research using pancreas extracts from dogs as early as 1907. Conclusion In this historical description, dating from about a century ago, Georg Zülzer probably gave the first exact clinical description of symptoms due to pudendal nerve compression. Pudendal nerve compression should always be taken into account when examining and treating patients with symptoms of IC/BPS.

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