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IgE Antibodies Play a Role in Development of Ulcerative IC, Research Suggests

Jhang JF, Hsu YH, Jiang YH, Kuo HC. The Role of Immunoglobulin E in the Pathogenesis of Ketamine Related Cystitis and Ulcerative Interstitial Cystitis: An Immunohistochemical Study. Pain Physician. 2016 May;19(4):E581-7.
Immunoglobulin E (IgE) is a type of antibody associated with inflammatory reactions that is elevated in patients with autoimmune diseases such as rheumatoid arthritis, psoriasis, and lupus. Some researchers have also detected IgE in the blood of individuals who have cystitis related to abuse of the pain drug ketamine; this follow-up study was designed to look for IgE in the bladder tissue of patients with both interstitial cystitis (IC) and ketamine-related cystitis. Researchers in the study assessed expression of IgE in the bladder using a standard technique called immunohistochemical staining, which allows them to visualize elevated IgE in a section of tissue through a chemical reaction that produces color. They found that almost all the patients with ulcerative IC were positive for bladder IgE (9 out of 10, or 90%), Bladder IgE was also positive in most of the ketamine-induced cystitis patients (15 out of 16, or 93.8%). In contrast, almost no patients with non-ulcerative IC were positive and likewise, out of a series of 12 healthy control subjects, only 2 were positive. Interestingly, the presence of bladder IgE was associated with clinical symptoms, including pain and maximum bladder capacity. Based on these findings, the researchers suspect that IgE plays a key role in the development of ulcerative IC and ketamine-related cystitis, but not non-ulcerative IC.

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