ICA @ AUA

IC News Wraps Up with Marker that Could Bring an IC Test Soon

Tuesday wrapped up IC research presentations here at the American Urological Association’s (AUA’s) annual meeting with a potential new marker and more.

Fingerprinting IC

ICA Pilot Research Program funding helped bring about the exciting report in a “late-breaking news” session of potential new tests for IC. Jason Gilleran, MD, from Ohio State University in Columbus, working with Tony Buffington, DVM, PhD, is measuring markers in blood with microspectosopy—a light-sensing technique. All that might be needed for testing is a drop of your blood on a paper card from a quick finger stick, which gets mailed to the lab for analysis. The markers the researchers are looking at may be able to show whether you have IC and how severe it is, which could be very helpful for evaluating new therapies.

Researchers have talked about many different potential markers in the last few years, but none has been developed into a practical test that your doctor could use in the office. But Dr. Gilleran said that he thinks this test is very amenable to commercialization. He said the investigators have a partnership with a business concern at Ohio State, and “We’re going to take this data and some of our updated data to the FDA to see if we can get this approved for marketing and analysis and even sale down the road.”

Treatment Talks: Nerve Growth Factor Inhibitor and Botox

Treatment news Tuesday included more detail on the studies of tanezumab, the nerve growth factor inhibitor, and injection of botulinum toxin A (Botox) injection into just the lower portion of the bladder (trigone) of IC patients. Researchers are looking forward to news from the next trial of tanezumab, which is gearing up now and many of you are enrolling in. Botox given in the trigone looks promising, decreasing pain and frequency for about nine months at a time.

What’s Happening in the IC Bladder?

• Are your food sensitivities related to food acid? An instillation study a few years ago threw doubt on that idea. But this year, Swedish researchers reported that they have found more active acid sensing channels in bladder lining and muscle cells of IC patients than in controls. In the future, these researchers will be looking at how the function of these influence the “leakiness” of the bladder lining.
  
  
• Is IC an inflammatory condition? There’s been plenty of debate that has fed the controversy over what to call IC, since some say there’s no “itis” or inflammation. One study here demonstrated that IC patients have high levels of C-reactive protein in their bloodstream, which is considered evidence of chronic inflammation. That doesn’t pinpoint inflammation to the bladder itself, but the study showed overactive bladder patients had elevated levels as well, pointing to the bladder as a likely culprit. C-reactive protein is often used as a marker of inflammation in cardiovascular disease.
  
  Sometimes, it’s not easy to distinguish between IC and overactive bladder, but the treatments are very different. So, are they really different conditions, and is there any objective way to tell? There might be, based on a study of markers of inflammation indicating that each has its own type of inflammation. The inflammatory protein MCP-1 was much more common in the urine of IC patients, whereas the inflammatory molecules eotaxin and interleukin 5.
  
  
• Pudendal or Sacral Nerve? Some studies have shown that stimulation of the pudendal nerve may be more effective for IC patients than stimulation of the sacral nerve. A study of the pudendal to bladder reflex shows that opioid receptors are involved.
  
  

A Bump in the Night

You may have heard some worrying news from this meeting about a link between getting up to urinate in the night (nocturia) and serious health problems, but the question is far from settled. People who wake up in the night may be urinating, but that may not be the reason they’re waking up. The other reasons may carry the health risks. Furthermore, in a study presented here, the increased for risk heart disease and death was only in men, with a higher risk of coronary heart disease for men under 60 and of mortality for men older than age 60. Based on that, you might expect to see a connection with high blood pressure and diabetes, but there was none. More research needs to be done.

Drive-In Movies

Get out some IC-friendly snacks and park yourself in front of your computer screen. There are lots of online videos letting you experience AUA sessions and events first hand!

ICHelp You Tube Channel—Watch ICA reports from the AUA

Robert Moldwin, MD, highlights clinician "take-home points" from his course ... more





Linda Salin, answers questions and provides advice for young IC patients... more





Jennifer Fariello, a nurse specializing in women's health, explains the importance of including an examination of the pelvic floor... more




Philip Hanno, MD, gives an overview of the newly-announced American Urological Association treatment guidelines for interstitial cystitis (IC)... more

Philip Hanno, MD explains the definition of IC and diagnosis approach outlined in the newly released (preliminary) IC treatment guidelines... more

Check out audio and video interviews with top experts like Dr. Hanno

Posted June 02, 2010