The Diagnosis of Interstitial Cystitis Revisited

Interstitial cystitis (IC) is a chronic disorder diagnosed by symptomatology of pelvic pain and urinary frequency, which are extremely variable and unpredictable fluctuating among patients. IC has recently been found combined with some allergic disorders and histopathologic abnormalities resembling that of allergic disorders, including mast cell activation, histamine release and eosinophil infiltration. Therefore, it could be cautiously postulated that IC is one of the allergic disorders of the urogenital system. A 28-year-old Caucasian female patient, who was diagnosed with asthma and allergic rhinitis, suffered from bladder symptoms of frequency, urgency and pelvic pain for the past 3 years. The symptoms disturbed her every day and were intractable for treatment. Urologists concluded that she had interstitial cystitis. Specific immunotherapy (SIT) was recommended for her allergic symptoms. While taking specific immunotherapy, she had anaphylaxis. She still had the reaction even with the 1000-fold diluted shot of SIT. Omalizumab was used for her allergic symptoms and possible prevention of anaphylactic reaction to SIT. Interestingly, she reported that her urogenital symptoms had subsided since omalizumab had been started. According to the published literature, we postulate that interstitial cystitis might be one of the IgE mediated, mast cell driven allergic disorders of the urogenital system. Therefore, in this case, the patient's bladder symptoms are successfully controlled primarily by anti-IgE therapy and the improvement could be maintained by SIT. We report, for the first time, a case of interstitial cystitis with allergic rhinitis and asthma, successfully treated by anti-IgE therapy and specific immunotherapy.

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Oral treatment with a vitamin D3 analogue (BXL628) has anti‐inflammatory effects in rodent model of interstitial cystitis

Benigni

Baroni

Zecevic

et al. 2006

BJU International

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interleukin-13, Fc ε RI α and mast cells-derived proteases, a massive inflammatory reaction in the bladder tissue, and augmented levels of mast cell-derived protease 1 (MMCP1) detected in mouse sera. RESULTSOral administration of BXL628 significantly reduced the expression of interleukin-13, Fc ε RI α and MMCP1 in the bladder. Furthermore, histological analysis showed a decrease in oedema and leukocyte infiltration in the bladder wall. BXL628 treatment reduced serum MMCP1 levels, indicating an effect on mast cell degranulation in vivo . CONCLUSIONSVitamin D3 analogues may successfully be used as anti-inflammatory agents in allergenmediated inflammatory reactions. Moreover, the modulatory effect shown on mast cell activation by the BXL628 analogue strongly supports its potential therapeutic use in a possibly mast cell-dependent disease such as human interstitial cystitis. KEYWORDS interstitial cystitis, vitamin D3 analogue, antiinflammatory effect, mouse, mast cells, antigen-induced cystitis OBJECTIVETo investigate the effects of a vitamin D3 analogue (BXL628) in a model of chronic cystitis, as calcitriol analogues might be an interesting new therapeutic option for interstitial cystitis, for although the cause of the disease remains unclear, the increase in mast cells in the mucosa and detrusor muscle are significant. MATERIALS AND METHODSWe devised a mouse model of allergeninduced allergic cystitis that is associated with the up-regulation of genes for

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The Diagnosis of Interstitial Cystitis Revisited

Abstract: The NIDDK criteria are too restrictive to be used by clinicians as the diagnostic definition of interstitial cystitis.

Cited by 8 publications

References 11 publications

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Is interstitial cystitis an allergic disorder?: A case of interstitial cystitis treated successfully with anti‐IgE

Oral treatment with a vitamin D3 analogue (BXL628) has anti‐inflammatory effects in rodent model of interstitial cystitis

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