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Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction Winter Meeting

The Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) held its winter meeting in Scottsdale, AZ last week. During the meeting, a panel presentation on bladder pain lead by Drs. Linda Watkins, Catherine Bushnell, and Anthony Ford was conducted. In it, they presented their data on various aspects of the basic science behind pain. Some highlights from the discussion include:

  • Targeting glial activation for treating chronic pain and improving opioid efficacy by Dr. Watkins of the University of Colorado at Boulder. Her research has found that glial cells, part of the nervous system, can create and maintain enhanced pain, and that glial cell activation is linked to opioid tolerance, dependence/withdrawal, and opioid reward. Therefore, targeting glial cells may suppress opioid-induced respiratory depression and constipation as well as provide a novel approach to pain control and increase the effectiveness of opioid analgesics. What’s more, these findings could apply to more than just opioids as the effects of alcohol, cocaine, and methamphetamine are all also amplified by glial cells. If you’d like to see the application of this research in action, watch the news report about Dr. Watkins’s study.
  • Dr. Catherine Bushnell of the National Center for Complementary and Integrative Health presented The brain’s role in perceiving and modifying chronic pain. Using MRI scans, she has found confirmation of increased function in specific regions of the brain in both interstitial cystitis and vulvodynia patients. In addition, through MRI, she has discovered the resting brain state in patients with chronic pain disorders often is altered from normal controls. Interestingly, this data has shown that perceived severity of pain is not influenced by patient emotional status, but rather it affects the impacts of their pain. Furthermore, this research has shown that distraction from pain often diminishes the perception of the severity of pain. MRI findings of those in chronic pain have been shown to improve with distractions such as cognitive behavioral therapy and yoga.
  • Dr. Anthony Ford of Afferent Pharmaceuticals, Inc. presented P2X3 antagonism in treatment of interstitial cystitis and bladder pain syndrome. Initial animal studies with mice utilizing P2X to counteract P2X3 demonstrated hyperalgesia (increased sensitivity to pain) which allowed the bladder to fill to larger volumes. AF-219, a non-narcotic, non-sedating drug without addictive potential, is a first in class drug selective oral inhibitor of P2X3, which would possibly need to be taken twice a day in order to receive relief. Preliminary data of their randomized controlled trial for treatment of moderate-to-severe IC/BPS are planned to be reported at a later time.