Int Neurourol J.
2022 Feb;26(Suppl 1):S57-67. 10.5213/inj.2142100.050.
Improved Urothelial Cell Proliferation, Cytoskeleton and Barrier Function Protein Expression in the Patients With Interstitial Cystitis/Bladder Pain Syndrome After Intravesical Platelet-Rich Plasma Injection
- Affiliations
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- 1Department of Urology, Hualien Tzu Chi Hospital, Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan
- 2Department of Pathology, Hualien Tzu Chi Hospital, Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan
- 3Department of Anatomy, Tzu Chi University, Hualien, Taiwan
- 4Departments of Medicine, Pharmacology, and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA
- 5Department Laboratory Medicine, Hualien Tzu Chi Hospital and Buddhist Tzu Chi Medical Foundation, Buddhist Tzu Chi University, Hualien, Taiwan
- KMID: 2526665
- DOI: http://doi.org/10.5213/inj.2142100.050
Abstract
- Purpose
To investigate urothelial cell proliferation, cytoskeleton, inflammation, and barrier function protein expressions in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) after intravesical platelet-rich plasma (PRP) injections
Methods
A total of 19 patients with IC/BPS underwent 4 monthly intravesical PRP injections. Bladder biopsies were taken at the first and fourth PRP treatment. The bladder specimens were analyzed using the Western blot and immunochemical staining for progenitor cell markers for sonic hedgehog (Shh), CD34, and cytoskeleton proteins cytokeratin 5 (CK5), CK14, CK20; barrier function markers for zonula occludens-1 (ZO-1), E-cadherin, and intercellular adhesive molecule-1, tryptase and transforming growth factor-β (TGF-β). Global response assessment (GRA) was used to evaluate treatment outcomes.
Results
The mean age of patients was 55.6 years. After PRP injections, the functional bladder capacity and maximum flow rate increased, and the visual analogue scale (VAS) of pain, interstitial cystitis (IC) symptom index, IC problem index, O’Leary-Sant symptom score, and GRA improved in all patients. Urothelium Shh, CK5, ZO-1, E-cadherin, and TGF-β expressions increased significantly after repeated PRP injections. By subgrouping, according to PRP treatment outcomes, significant increases in Shh, E-cadherin, and ZO-1 expressions were noted only in patients with GRA ≥1 or improved VAS, but not in patients with GRA=0 and no improvement in VAS.
Conclusions
The level of urothelial barrier function protein and cell proliferation protein expression in the patients with IC/BPS was increased after repeat intravesical PRP injections. Intravesical repeat PRP injections may have potential to improve urothelial health and result in symptoms improvement in the patients with IC/BPS.
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