New participant stratification and combination of urinary biomarkers and confounders could improve diagnostic accuracy for overactive bladder

Abstract

Overactive bladder (OAB) is a highly prevalent symptom complex characterised by symptoms of urinary urgency, increased frequency, nocturia, with or without urge incontinence; in the absence of proven infection or other obvious pathology. The underlying pathophysiology of idiopathic OAB is not clearly known and the existence of several phenotypes has been proposed. Current diagnostic approaches are based on discordant measures, suffer from subjectivity and are incapable of detecting the proposed OAB phenotypes. In this study, cluster analysis was used as an objective approach for phenotyping participants based on their OAB characteristic symptoms and led to the identification of a low OAB symptomatic score group (cluster 1) and a high OAB symptomatic score group (cluster 2). Furthermore, the ability of several potential OAB urinary biomarkers including ATP, ACh, nitrite, MCP-1 and IL-5 and participants' confounders, age and gender, in predicting the identified high OAB symptomatic score group was assessed. A combination of urinary ATP and IL-5 plus age and gender was shown to have clinically acceptable and improved diagnostic accuracy compared to urodynamically-observed detrusor overactivity. Therefore, this study provides the foundation for the development of novel non-invasive diagnostic tools for OAB phenotypes that may lead to personalised treatment.

Potential Role of Monocyte Chemoattractant Protein-1 in Monitoring Disease Progression and Response to Treatment in Overactive Bladder Patients

“…Prompt detection will allow the amelioration of OAB development by administering treatment earlier in the inflammatory development process. Conceivably, urinary MCP-1 levels and extensive OAB questionnaires, alone or in combination with adenosine triphosphate and interleukin-5 testing [ 25 ] can lead to novel noninvasive diagnostic tests for different OAB inflammatory phenotypes and may promote a more personalized management approach.…”

Molecular biomarkers for assessing the heat-adapted phenotype: a narrative scoping review

“…However, the use of multivariable modelling approaches has been successful employed in other fields to develop more powerful biomarkers with superior diagnostic ability (e.g. [ 48 ]). Such an approach may be particularly well suited to the multi-system adaptions that are characteristic of HA.…”

“…Such a molecular biomarker may have important utility in circumstances where the assessment of physiological biomarkers is not viable, where reliable molecular markers of adaptation could not only provide assurance of the efficacy of HA, but also reduce heat illnesses and lead to more personalised approaches to adaptation [ 160 ]. Although, to date, such a molecular biomarker has not been identified, technological advances in non-invasive and minimally invasive biosensing [ 60 , 158 ], low-cost easy-to-use analyte measurement approaches [ 88 ], continuous and remote monitoring wearable technology [ 184 ], and multi-molecule biomarker development [ 48 ], make identifying molecular biomarkers of heat adaptation a timely research challenge.…”