Biology
Bladder pain syndrome, or interstitial cystitis, is a chronic condition characterised by a number of symptoms, including unexplained bladder pain and the feeling of constantly needing to urinate. Two researchers from the University Hospital of Bern have been investigating the roots of this common affliction at a molecular level in an attempt to work out what causes the many symptoms associated with this problem
The molecular causes of
bladder pain syndrome
Our work in basic research is focused on non-cancer
issues in the bladder,” says
Professor Fiona Burkhard of the Bern University Hospital. “This includes things such as obstruction and incontinence, with my original
changes in the bladder caused by outlet obstruction
because of an enlarged
prostate. My work now with Dr. Katia Monastyrskaya is focused on bladder pain syndrome, otherwise known as interstitial cystitis.” Bladder pain syndrome (BPS) was once
considered to be a rare condition, but recent statistics have shown it be far more common than previously thought, with at least 230 confirmed cases per 100,000 females and an estimated occurrence of up to 20% of all women. Symptoms include pain in the bladder region, often waking up to urinate and having to go to the toilet a lot in
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general. BPS is far more common in women, with a ratio of approximately five to one female to male sufferers. “The full blown disease can be quite
research looking at
debilitating,” says Burkhard. “If you have to go the toilet
every fifteen minutes
despite having an almost empty bladder, then you have a problem which can majorly impact on your quality of life.” As a clinician, Burkhard often meets with
patients the typical symptom
complex symptom associated with BPS. A biopsy is then used to confirm that
the
problem is indeed BPS and not something else such as an infection or obstruction. The biopsy is then handed to molecular biologist Dr. Katia Monastyrskaya. “We observed changes in gene expression of several
signalling and structural
molecules in BPS compared to the control group. These changes are indicative of
inflammatory processes and might account for increased nociception in BPS patients,” explains Monastyrskaya. One hypothesis for BPS concerns the lining
epithelial that surrounds the
bladder. This layer of cells has a number of functions,
including stretching to allow
for different volumes of urine, sensing and excreting proteins, and forming a barrier that stops any urine - which has high salt levels and thus can have a caustic effect on tissue – from escaping the bladder. “When looking at patients with BPS, we
often see microscopic ulcers throughout the epithelial
layer, which suggest that
the layer has been compromised as a barrier. If this theory is correct, and the pain is being caused by this,
then you
might expect to see changes in expression of components that make these epithelial cells impermeable to urine.”
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