Repeated intravesical injections of platelet-rich plasma improve symptoms and alter urinary functional proteins in patients with refractory interstitial cystitis

Jiang, Yuan‐Hong; Kuo, Yuh‐Chen; Jhang, Jia‐Fong; Lee, Cheng‐Ling; Hsu, Yung‐Hsiang; Ho, Han‐Chen

doi:10.1038/s41598-020-72292-0

Cited by 40 publications

(45 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, the authors compared the results obtained with those of a control group whose subjects did not have bladder symptoms. Only the urinary VEGF level was higher in patients with IC/BPS at baseline; however, it was lower after PRP injection in patients with IC/BPS than in the controls (all, p < 0.0001) [21].…”

Section: Clinical Trialmentioning

confidence: 76%

See 1 more Smart Citation

Use of Intravesical Injections of Platelet-Rich Plasma for the Treatment of Bladder Pain Syndrome: A Comprehensive Literature Review

et al. 2021

View full text Add to dashboard Cite

Background: Bladder pain syndrome/interstitial cystitis (BPS/IC) or primary bladder pain syndrome (PBPS) is a complex and poorly understood condition. This comprehensive review aimed to discuss the potential application of platelet-rich plasma (PRP) in the treatment of BPS/IC. The pathophysiology of BPS/IC is characterized by urothelial damage that triggers a chain of events leading to chronic inflammation and other conditions. Frequently, in subjects affected by BPS/IC, recurrent urinary tract infection (rUTI) is associated with difficult therapeutic management. For these reasons, many oral and intravesical treatments (e.g., antibiotic therapy and intravesical anesthetic instillations) have been proposed to alleviate the symptoms of IC/BPS. However, the limitation of these treatments is the short duration of improvement. The purpose of this review is to analyze the efficacy of intravesical PRP injections in subjects with PBS/IC and to try to understand the potential therapeutic effects on the pathophysiology of this disease. Methods: A nonsystematic literature search using Pubmed, EMBASE, Scopus, Web of Science, Medline was performed from January 2000 to August 2021. The following terms were combined to capture relevant publications: “platelet-rich plasma”, “interstitial cystitis”, “PRP”, “bladder pain syndrome”, and “painful bladder syndrome”. Results: After exclusion of non-pertinent studies/articles, we have analyzed 5 studies. In detail, 2 articles concerned preclinical studies in which animal models were used. The authors showed an improvement in the histological pattern with less bleeding in treated subjects, a lower presence of inflammatory cytokines and an increase in the mitotic index of urothelial cells in animals treated with intravesical PRP. In the three prospective clinical trials analyzed, patients with BPS/IC who underwent monthly intravesical PRP injections were found to have a statistically significant improvement in symptoms with modulation of growth factors and inflammatory proteins. Conclusions: New evidence suggests that treatment with intravesical PRP could improve urothelial regeneration and reduces chronic inflammation in BPS/IC, modifying the clinical history of its pathology.

show abstract

Section: Clinical Trialmentioning

confidence: 76%

“…Jiang et al [21]. searched for objective evidence regarding the efficacy of PRP injections in a subsequent study.…”

Section: Clinical Trialmentioning

confidence: 99%

Use of Intravesical Injections of Platelet-Rich Plasma for the Treatment of Bladder Pain Syndrome: A Comprehensive Literature Review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…A previous pilot study by the authors applying PRP in the treatment of IC has revealed that repeat intravesical PRP injections could improve clinical symptoms in patients with IC/bladder pain syndrome (BPS) 19 . The urine biomarkers such as NGF, PDGF‐AB, matrix metalloproteinase‐13 (MMP‐13), and vascular endothelial growth factor (VEGF) showed significant changes after three PRP injections 28 . These results provided evidence of the changes in urinary protein expressions to support the therapeutic effects of PRP in the treatment of IC/BPS, suggesting intravesical PRP treatment could improve urothelial health in patients with IC/BPS refractory to conventional therapy through promoting cell proliferation, migration, differentiation, and angiogenesis 29,30 .…”

Section: Discussionmentioning

confidence: 99%

Urothelial health after platelet‐rich plasma injection in intractable recurrent urinary tract infection: Improved cell proliferation, cytoskeleton, and barrier function protein expression

Jiang

Jhang

Hsu

et al. 2020

LUTS

View full text Add to dashboard Cite

Objective This clinical study used autologous intravesical platelet‐rich plasma (PRP) injections to treat patients with recurrent urinary tract infection (rUTI). Changes in urothelial proliferation, cytoskeleton, and barrier function protein expression after treatment were investigated. Materials All patients underwent 4‐monthly intravesical PRP injections with 1‐year follow‐up. Successful treatment was defined as ≤2 UTI episodes within the preceding 1 year. Bladder biopsies were performed at the first and fourth PRP injection, and specimens were investigated by Western blot for the proteins sonic hedgehog (Shh), CD34, cytokeratin 5 (CK5), CK14, CK20, zonula occludens‐1 (ZO‐1), E‐cadherin, inflammatory proteins tryptase and p38, apoptotic protein BAX (BCL2‐associated X protein) and caspase‐3, functional proteins M2 (muscarinic receptor 2) and M3, and beta‐adrenoceptor‐3, with glyceraldehyde phosphate dehydrogenase used as normalizing protein for quantification. Results The study enrolled 22 patients with rUTI and 17 controls, with successful outcome in 14 of 22 (63.6%) patients. Compared with controls, Western blot quantification results showed that rUTI patients had lower CD34, CK20, M3, and ZO‐1, but higher CK5, BAX, and caspase‐3 at baseline. The reduced CD34, CK20, M2, and M3 expressions at baseline were significantly increased after repeat PRP injections. Patients with a successful outcome had significant increase of CD34, Shh, CK20, M2, and M3 expressions after PRP injections. Conclusion Intravesical PRP repeat injections improve the urothelial cell proliferation and increase the CK 20 expression in umbrella cells. PRP repeat injections have a beneficial effect on bladder urothelium‐associated changes in rUTI. Thus, PRP injection may restore urothelial health and prevent UTI recurrence in intractable rUTI.

show abstract

“…The etiology and pathogenesis of IC/BPS are multifactorial and several studies have attributed to the exhibited symptoms to an increase in inflammatory cells infiltration, hypoxia-inducible factor-1α, VEGF, and apoptosis 3 , 4 noted on histopathological and molecular studies. Thus, the treatment of IC/BPS aiming at regulation of inflammatory reaction and regeneration or repair of urothelium defect could be an attractive option for the management of refractory IC/BPS.…”

Section: Introductionmentioning

confidence: 99%

Improves symptoms and urinary biomarkers in refractory interstitial cystitis/bladder pain syndrome patients randomized to extracorporeal shock wave therapy versus placebo

Shen

Tyagi

Lee

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Extracorporeal shock wave therapy (ESWT) has been shown to improve symptoms in patients with interstitial cystitis/bladder pain syndrome (IC/BPS); however, there is a lack of objective evidence. We measured change of urinary biomarker levels in 25 patients with IC/BPS received ESWT or placebo once a week for 4 weeks. Urines were collected from participants at baseline, 4 and 12 weeks post treatment. A representative 41 inflammatory growth factors, cytokines, and chemokines in urine were measured using a MILLIPLEX immunoassay kit. Symptom bother was assessed by O’Leary-Sant symptom scores (OSS), and visual analog scale (VAS) for pain. The ESWT group exhibited a significant reduction in the OSS and VAS compared to the placebo group 4 weeks post-treatment (P < 0.05), and the effects were persistent at 12 weeks. The difference in urinary markers change in ESWT versus placebo was P = 0.054 for IL4, P = 0.013 for VEGF, and P = 0.039 for IL9 at 4 weeks. The change of urine biomarker was not significant in other biomarkers or all the measured proteins at 12 weeks. The current data suggest that IL4, IL9, and VEGF mediation may be involved in its pathophysiologic mechanisms and response to LESW treatment.

show abstract

Repeated intravesical injections of platelet-rich plasma improve symptoms and alter urinary functional proteins in patients with refractory interstitial cystitis

Cited by 40 publications

References 33 publications

Use of Intravesical Injections of Platelet-Rich Plasma for the Treatment of Bladder Pain Syndrome: A Comprehensive Literature Review

Use of Intravesical Injections of Platelet-Rich Plasma for the Treatment of Bladder Pain Syndrome: A Comprehensive Literature Review

Urothelial health after platelet‐rich plasma injection in intractable recurrent urinary tract infection: Improved cell proliferation, cytoskeleton, and barrier function protein expression

Improves symptoms and urinary biomarkers in refractory interstitial cystitis/bladder pain syndrome patients randomized to extracorporeal shock wave therapy versus placebo

Contact Info

Product

Resources

About