Bladder capacity as a benchmark for patient stratification in interstitial cystitis/bladder pain syndrome
Objectives:: In a previous study we reported that molecular profiling of bladder mucosal tissue from a modest number of IC/BPS patients resulted in a clear separation based on anesthetic bladder capacity (BC), with 400 cc representing the apparent breakpoint between low and non-low BC. The purpose o...
| Main Authors: | , , , , , , |
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| פורמט: | Article |
| שפה: | English |
| יצא לאור: |
Elsevier
2023-12-01
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| סדרה: | Continence |
| נושאים: | |
| גישה מקוונת: | http://www.sciencedirect.com/science/article/pii/S2772973723009098 |
| _version_ | 1827584819636207616 |
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| author | Maxwell Sandberg Dylan T. Wolff Wyatt Whitman Gopal Badlani Catherine A. Matthews Robert Evans Stephen J. Walker |
| author_facet | Maxwell Sandberg Dylan T. Wolff Wyatt Whitman Gopal Badlani Catherine A. Matthews Robert Evans Stephen J. Walker |
| author_sort | Maxwell Sandberg |
| collection | DOAJ |
| description | Objectives:: In a previous study we reported that molecular profiling of bladder mucosal tissue from a modest number of IC/BPS patients resulted in a clear separation based on anesthetic bladder capacity (BC), with 400 cc representing the apparent breakpoint between low and non-low BC. The purpose of the current study was to revisit this earlier stratification finding, using a combination of molecular and clinical data, from a large and heterogeneous patient cohort. Materials and Methods:: To provide an updated assessment of IC/BPS patient stratification based on anesthetic BC, whole genome gene expression data from 48 mucosal biopsy samples (41 IC/BPS patients; 7 controls) were analyzed with unsupervised clustering and principal component analysis (PCA) to identify primary clusters of patients. This identified three primary individual clusters: (1) IC/BPS patients with a BC between 200–500 cc (n=19), (2) IC/BPS patients with a BC of 501–1500 cc (n=22), and (3) controls. Next, complete demographic, clinical, and questionnaire data prospectively collected from an additional 450 patients from our patient registry were used to conduct a combined analysis to verify this relationship. Characteristics of all 491 IC/BPS patients were compared between those having the current low BC cutoff (≤400 cc) and the proposed new cutoff (≤500 cc) by utilizing independent samples t-test (continuous variables) and chi square tests (categorical variables; p ≤ 0.05 was considered significant). Results:: A statistical comparison of the demographic and clinical characteristics of the entire 491 IC/BPS patient cohort showed that those with a bladder capacity ≤500 cc were older, were more likely to have Hunner lesions, and had higher symptom scores. This group also had a lower average number of non-urologic associated symptoms, pelvic pain syndromes, and neurologic, immune, or systemic pain syndromes. Conclusion:: By combining newly acquired molecular data with clinical and demographic characteristics in a large cohort of IC/BPS patients, we conclude that anesthetic BC ≤ 500 cc provides a clinically meaningful biomarker for the bladder centric IC/BPS phenotypic subgroup. |
| first_indexed | 2024-03-08T23:36:49Z |
| format | Article |
| id | doaj.art-70d5e3cfc3334f45b5156e4d4f93d53d |
| institution | Directory Open Access Journal |
| issn | 2772-9737 |
| language | English |
| last_indexed | 2024-03-08T23:36:49Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Continence |
| spelling | doaj.art-70d5e3cfc3334f45b5156e4d4f93d53d2023-12-14T05:24:18ZengElsevierContinence2772-97372023-12-018101051Bladder capacity as a benchmark for patient stratification in interstitial cystitis/bladder pain syndromeMaxwell Sandberg0Dylan T. Wolff1Wyatt Whitman2Gopal Badlani3Catherine A. Matthews4Robert Evans5Stephen J. Walker6Department of Urology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, United States of AmericaDepartment of Urology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, United States of AmericaDepartment of Urology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, United States of AmericaDepartment of Urology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, United States of AmericaDepartment of Urology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, United States of AmericaDepartment of Urology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, United States of AmericaDepartment of Urology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America; Wake Forest Institute for Regenerative Medicine, 391 Technology Way NE, Winston-Salem, NC, 27101, United States of America; Corresponding author at: Wake Forest Institute for Regenerative Medicine, 391 Technology Way NE, Winston-Salem, NC, 27101, United States of America.Objectives:: In a previous study we reported that molecular profiling of bladder mucosal tissue from a modest number of IC/BPS patients resulted in a clear separation based on anesthetic bladder capacity (BC), with 400 cc representing the apparent breakpoint between low and non-low BC. The purpose of the current study was to revisit this earlier stratification finding, using a combination of molecular and clinical data, from a large and heterogeneous patient cohort. Materials and Methods:: To provide an updated assessment of IC/BPS patient stratification based on anesthetic BC, whole genome gene expression data from 48 mucosal biopsy samples (41 IC/BPS patients; 7 controls) were analyzed with unsupervised clustering and principal component analysis (PCA) to identify primary clusters of patients. This identified three primary individual clusters: (1) IC/BPS patients with a BC between 200–500 cc (n=19), (2) IC/BPS patients with a BC of 501–1500 cc (n=22), and (3) controls. Next, complete demographic, clinical, and questionnaire data prospectively collected from an additional 450 patients from our patient registry were used to conduct a combined analysis to verify this relationship. Characteristics of all 491 IC/BPS patients were compared between those having the current low BC cutoff (≤400 cc) and the proposed new cutoff (≤500 cc) by utilizing independent samples t-test (continuous variables) and chi square tests (categorical variables; p ≤ 0.05 was considered significant). Results:: A statistical comparison of the demographic and clinical characteristics of the entire 491 IC/BPS patient cohort showed that those with a bladder capacity ≤500 cc were older, were more likely to have Hunner lesions, and had higher symptom scores. This group also had a lower average number of non-urologic associated symptoms, pelvic pain syndromes, and neurologic, immune, or systemic pain syndromes. Conclusion:: By combining newly acquired molecular data with clinical and demographic characteristics in a large cohort of IC/BPS patients, we conclude that anesthetic BC ≤ 500 cc provides a clinically meaningful biomarker for the bladder centric IC/BPS phenotypic subgroup.http://www.sciencedirect.com/science/article/pii/S2772973723009098Interstitial cystitisBladderPainCapacityHydrodistensionPhenotype |
| spellingShingle | Maxwell Sandberg Dylan T. Wolff Wyatt Whitman Gopal Badlani Catherine A. Matthews Robert Evans Stephen J. Walker Bladder capacity as a benchmark for patient stratification in interstitial cystitis/bladder pain syndrome Continence Interstitial cystitis Bladder Pain Capacity Hydrodistension Phenotype |
| title | Bladder capacity as a benchmark for patient stratification in interstitial cystitis/bladder pain syndrome |
| title_full | Bladder capacity as a benchmark for patient stratification in interstitial cystitis/bladder pain syndrome |
| title_fullStr | Bladder capacity as a benchmark for patient stratification in interstitial cystitis/bladder pain syndrome |
| title_full_unstemmed | Bladder capacity as a benchmark for patient stratification in interstitial cystitis/bladder pain syndrome |
| title_short | Bladder capacity as a benchmark for patient stratification in interstitial cystitis/bladder pain syndrome |
| title_sort | bladder capacity as a benchmark for patient stratification in interstitial cystitis bladder pain syndrome |
| topic | Interstitial cystitis Bladder Pain Capacity Hydrodistension Phenotype |
| url | http://www.sciencedirect.com/science/article/pii/S2772973723009098 |
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