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Evaluation of several botulinum toxins-A delivering systems into the bladder in interstitial cystitis/painful bladder syndrome (IC/PBS).

ABSTRACT: Botulinum toxins were primary suggested for the neurogenic lower urinary tract dysfunction (LUTD) treatment about thirty years ago. The application of BTX-A in LUTD have just developed and the approval of BTX-A injection confirmed in for patients with both overactive bladders (OAB) and neurogenic detrusor overactivity (NDO). Actually the BTX-A medication in interstitial cystitis/bladder pain syndrome (IC/BPS) is not licensed, but there is under consideration. Despite BTX-A is recommended to treat patients with interstitial cystitis/bladder pain syndrome (ICBPS) under different occasions, its efficacy and safety in the cure of (IC/BPS) is under consideration. One difficulty is related to the toxin delivering systems. It is shown that there is no difference in BTX-A injection to body or trigone but there is a need on further large-scale studies over this subject. Moreover, Hydro distention can boost the therapeutic effect of BTX-A for IC/BPS patients. Additional studies should consider the safety and efficacy of BTX-A injection in the treatment of BTX-A.

SUBMITTER: Torkamand F

PROVIDER: S-EPMC6872472 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Evaluation of several botulinum toxins-A delivering systems into the bladder in interstitial cystitis/painful bladder syndrome (IC/PBS).

Torkamand Farbod F Mirjavadi Seyed Javad SJ Khatami Fatemeh F Guitynavard Fateme F Aghamir Seyed Mohammad Kazem SMK

American journal of clinical and experimental urology 20191025 5

Botulinum toxins were primary suggested for the neurogenic lower urinary tract dysfunction (LUTD) treatment about thirty years ago. The application of BTX-A in LUTD have just developed and the approval of BTX-A injection confirmed in for patients with both overactive bladders (OAB) and neurogenic detrusor overactivity (NDO). Actually the BTX-A medication in interstitial cystitis/bladder pain syndrome (IC/BPS) is not licensed, but there is under consideration. Despite BTX-A is recommended to trea ...[more]

PMID: 31763366

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Project description:IntroductionInterstitial Cystitis (IC) is a chronic condition diagnosed based on the presence of symptoms, such as suprapubic/ pelvic pain, pressure or discomfort in association with urgency and increased urinary frequency. Confusable diseases must be excluded. However, there is no objective test or marker to establish the presence of the disease. Diagnosis and patient management is often difficult, given the poor understanding of IC pathogenesis and its unknown etiology and genetics. As an attempt to find biomarkers related to IC, we assessed the association between 20 selected single nucleotide polymorphism (SNPs) with IC and pain severity.ObjectivesTo assess the presence of SNPs in IC patients' blood samples and correlate them with the disease and chronic pain condition.MethodsA case-control study was conducted. We selected 34 female patients with IC diagnosed according to NIDDK criteria and 23 patients in the control group (previously healthy women with only stress urinary incontinence). IC patients were allocated into two groups according to reported chronic pain severity. We selected the following SNPs for analysis: rs1800871, rs1800872, rs1800896, rs1800471, rs1800629, rs361525, rs1800497, rs6311, rs6277, rs6276, rs6313, rs2835859, rs11127292, rs2243248, rs6887695, rs3212227, rs1799971, rs12579350, rs3813034, and rs6746030. Genotyping was performed by real-time PCR (q-PCR).ResultsThe polymorphic allele of SNP rs11127292 exhibited a higher frequency in subjects with IC than in controls (p:0.01). The polymorphic allele of SNP rs6311 was more frequent in patients with severe pain (p:0.03). The frequency of the wild-type allele of SNP rs1799971 was higher in patients with mild to moderate pain (p:0.04).ConclusionThe results indicated differences in SNP frequency among subjects, suggesting that SNPs could serve either as a marker of IC or as a marker of pain severity in IC patients. The study showed promising results regarding IC and polymorphism associations. These associations have not been previously reported.

Project description:Purpose of the Meeting:Bladder pain syndrome/interstitial cystitis is a prevalent but underserved disease. At the Global Interstitial Cystitis/Bladder Pain Syndrome Society (GIBS) meeting, the organization and participants were committed to delivering word-class expertise and collaboration in research and patient care. Under the umbrella of GIBS, leading research scholars from different backgrounds and specialties, as well as clinicians, from across the globe interested in the science and art of practice of Bladder Pain Syndrome (BPS)/Interstitial Cystitis (IC) were invited to deliberate on various dimensions of this disease. The meeting aimed to have global guidelines to establish firm directions to practicing clinicians and patients alike on the diagnosis and treatment of this disease entity. Chronic Pelvic Pain Syndrome (CPPS) is defined by pain in the pelvic area that can have different etiologies. This can be due to urologic, gynecologic, musculoskeletal, gastrointestinal, neurologic, and autoimmune or rheumatologic diseases. At the GIBS meeting held in Mumbai, India, in August 2019, a multidisciplinary expert panel of international urologists, gynecologists, pain specialists, and dietitians took part in a think tank to discuss the development of evidence-based diagnostic and treatment algorithms for BPS/IC. Summary of Presented Findings:The diagnosis of BPS/IC is difficult in daily clinical practice. Patients with BPS/IC present with a variety of signs and symptoms and clinical test results. Hence, they might be misdiagnosed or underdiagnosed, and the correct diagnosis might take a long time. A good history and physical examination, along with cystoscopy, is a must for the diagnosis of IC/BPS. For the treatment, besides lifestyle management and dietary advice, oral medication and bladder instillation therapy, botulinum toxin, and sacral neuromodulation were discussed. The innovation in bladder instillation applicators, as well as battery-free neuromodulation through the tibial nerve, was discussed, as well. Recommendation for Future Research:As BPS/IC is complex, for many patients, several treatments are necessary at the same time. This was presented at GIBS 2019 as the piano model. In this way, a combination of treatments is tailored to an individual patient depending on the symptoms, age, and patients' characteristics. In the art of medicine, especially when dealing with BPS/IC patients, pressing the right key at the right time makes the difference.

Dataset Information

Evaluation of several botulinum toxins-A delivering systems into the bladder in interstitial cystitis/painful bladder syndrome (IC/PBS).

Publications

Evaluation of several botulinum toxins-A delivering systems into the bladder in interstitial cystitis/painful bladder syndrome (IC/PBS).

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