Search for biomarkers aimed at improving treatment of painful bladder condition

August 11, 2014

Taking advantage of technology that can analyze tissue samples and measure the activity of thousands of genes at once, scientists at Wake Forest Baptist Medical Center are on a mission to better understand and treat interstitial cystitis (IC), a painful and difficult-to-diagnose bladder condition.

"We are looking for molecular biomarkers for IC, which basically means we are comparing bladder biopsy tissue from with suspected to patients without the disease. The goal is to identify factors that will lead to a more definitive diagnosis, and then use this information to tailor treatments to the patient," said senior author Stephen J. Walker, Ph.D., associate professor at Wake Forest Baptist's Institute for Regenerative Medicine.

The team's initial work, published online ahead of print in the Journal of Urology, found that tissue from IC patients with low bladder capacity had a significantly different gene expression profile than both IC patients with normal bladder capacity and study participants without IC. The findings suggest there may be a sub-type of IC.

"This is the first study to document functional genomic variation based solely on bladder capacity," said Robert J. Evans, M.D., a co-author and IC specialist in Wake Forest Baptist Urology. "Interstitial cystitis is notoriously difficult to diagnose. In fact, one report found that it takes the average patient eight years and seeing five doctors to be correctly diagnosed. The identification of biomarkers to improve diagnosis or treatment would be a significant breakthrough for patients and physicians."

IC, also known as syndrome, is a condition in which the bladder lining is tender and easily irritated. Symptoms can include severe pelvic pain, urinary urgency and frequency and painful sexual intercourse. IC is often misdiagnosed as other conditions such as endometriosis, kidney stones or chronic urinary tract infections. The condition affects an estimated three to eight million women and one to four million men in the United States.

For the study, researchers analyzed bladder biopsies from 13 patients diagnosed with IC and three patients without the condition. The biopsies were sorted into three groups: low bladder capacity (less than 13 fluid ounces as tested under anesthesia); bladder capacity above 13 ounces; and non-IC patients. Using microarray analysis, which allows gene expression profiling on a "whole genome" scale, the researchers looked for similarities and differences in gene expression between groups. The analysis tells researchers which genes are turned "on" and which are turned "off."

The results showed a highly significant difference between low capacity patients and both the normal capacity and control patients. The low capacity patients had genes related to inflammation and immune signaling turned "on." The results may reflect a fundamental difference in disease processes.

"These differences may explain why clinical trials for IC are so variable in effectiveness and have a large number of non-responders," said Evans. "There may be subtypes of the disease that respond best to particular treatments."

Based on these early results, the team is conducting further research with the aim of identifying and validating a biomarker to aid in diagnosis and treatment of IC.

"Diseases are rarely seen as single entities anymore," said Walker. "Patients demonstrating a specific disease subtype may respond more quickly and or more favorably to treatments that target that specific subtype. Having the ability to identify the right treatment for the right patient is the ultimate goal."

Explore further: Prevalence of interstitial cystitis/chronic prostatitis ID'd

Related Stories

Prevalence of interstitial cystitis/chronic prostatitis ID'd

January 7, 2013
(HealthDay)—The symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are widespread among men in the United States, according to research published ...

Intravesical chondroitin sulfate of little benefit in cystitis

June 6, 2012
(HealthDay) -- Intravesical sodium chondroitin sulfate is not recommended for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) in women as it produces only minor improvements in symptoms and pain, according ...

New study shows promise for analyzing bladder pain syndrome

February 23, 2012
A pilot study led by University of Kentucky researchers shows that the gene expression analysis of urine sediment could provide a noninvasive way to analyze interstitial cystitis in some patients.

Scientists pinpoint bladder cancer patients to benefit from 'tumour-softening'

July 30, 2014
Scientists in Manchester have identified a protein that could help doctors decide which bladder cancer patients would benefit from a treatment that makes radiotherapy more effective, according to a study published in the ...

Certain genetic variants may put bladder cancer patients at increased risk of recurrence

March 26, 2014
In the Western world, bladder cancer is the fourth most common cancer in men and the eighth most common in women, with many patients experiencing recurrence after treatment. A new study published in BJU International indicates ...

Recommended for you

Finish your antibiotics course? Maybe not, experts say

July 27, 2017
British disease experts on Thursday suggested doing away with the "incorrect" advice to always finish a course of antibiotics, saying the approach was fuelling the spread of drug resistance.

Phase 3 trial confirms superiority of tocilizumab to steroids for giant cell arteritis

July 26, 2017
A phase 3 clinical trial has confirmed that regular treatment with tocilizumab, an inhibitor of interleukin-6, successfully reduced both symptoms of and the need for high-dose steroid treatment for giant cell arteritis, the ...

A large-scale 'germ trap' solution for hospitals

July 26, 2017
When an infectious airborne illness strikes, some hospitals use negative pressure rooms to isolate and treat patients. These rooms use ventilation controls to keep germ-filled air contained rather than letting it circulate ...

Researchers report new system to study chronic hepatitis B

July 25, 2017
Scientists from Princeton University's Department of Molecular Biology have successfully tested a cell-culture system that will allow researchers to perform laboratory-based studies of long-term hepatitis B virus (HBV) infections. ...

Male hepatitis B patients suffer worse liver ailments, regardless of lifestyle

July 25, 2017
Why men with hepatitis B remain more than twice as likely to develop severe liver disease than women remains a mystery, even after a study led by a recent Drexel University graduate took lifestyle choices and environments ...

Mind-body therapies immediately reduce unmanageable pain in hospital patients

July 25, 2017
Mindfulness training and hypnotic suggestion significantly reduced acute pain experienced by hospital patients, according to a new study published in the Journal of General Internal Medicine.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.