Decreased urothelial cytoskeleton and cell proliferation protein expression suggest interstitial cystitis/bladder pain syndrome patients with Hunner’s lesion and grade 3 glomerulation might be different from other types of patients

• Published in: International journal of urology 2021-08, Vol.28 (8), p.823-830
• Main Authors: Jhang, Jia‐Fong, Jiang, Yuan‐Hong, Hsu, Yung‐Hsiang, Ho, Han‐Chen, Kuo, Hann‐Chorng
• Format: Article
• Language: English
• Subjects: Biopsy; Bladder; Cell growth; Cell proliferation; Cystitis; Cytoskeleton; Fibroblast growth factor receptor 4; Fibroblast growth factor receptors; Fibroblasts; Growth factor receptors; Growth factors; Hemorrhage; Immunofluorescence; Kinases; Lesions; Pain; Patients; proliferation; Proteins; transcription factor; Urinary incontinence; Urothelium; Western blotting
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.14585

Objectives To explore the expression of cytoskeletal and cell proliferation proteins in urothelial cells of patients diagnosed with various clinical subtypes of interstitial cystitis/bladder pain syndrome. Methods Biopsy specimens from 85 interstitial cystitis/bladder pain syndrome patients were classified according to findings on cystoscopy. Cytokeratins and cell proliferation proteins detected in the specimens were evaluated with immunofluorescence staining and quantified with western blotting. A total of 22 patients diagnosed with pure stress urinary incontinence were enrolled as controls. Results Interstitial cystitis/bladder pain syndrome patients with Hunner’s lesion and with grade 3 glomerulation hemorrhage had smaller bladder capacities than the other interstitial cystitis/bladder pain syndrome patients without Hunner’s lesion. Diminished expression of CK14, CK20, cell proliferation protein tumor protein 63, sonic hedgehog, and fibroblast growth factor receptors 3 and 4, and increased expression of CK5 and BCL2‐associated X protein were observed in biopsy specimens from patients with Hunner’s lesion compared with those from patients without Hunner’s lesion and controls. In the patients with grade 3 glomerulation hemorrhage, lower expression levels of urothelial CK20, tumor protein 63 and fibroblast growth factor receptor 4, and lower expression of CK5 and BCL2‐associated X protein were detected compared with other types of NHIC. Conclusion A diminished expression of proliferation proteins tumor protein 63 and the mature urothelium marker CK20, and increased expression of the immature marker CK5 in specimens from both Hunner’s lesion and grade 3 glomerulation hemorrhage patients can be observed. The urothelium of patients with interstitial cystitis/bladder pain syndrome might be in a state of persistent or chronic injury that could relate to the limited expression of cell proliferation proteins.