Elevated Urine Levels of Macrophage Migration Inhibitory Factor in Inflammatory Bladder Conditions: A Potential Biomarker for a Subgroup of Interstitial Cystitis/Bladder Pain Syndrome Patients

• Published in: Urology (Ridgewood, N.J.) N.J.), 2018-06, Vol.116, p.55-62
• Main Authors: Vera, Pedro L., Preston, David M., Moldwin, Robert M., Erickson, Deborah R., Mowlazadeh, Behzad, Ma, Fei, Kouzoukas, Dimitrios E., Meyer-Siegler, Katherine L., Fall, Magnus
• Format: Article
• Language: English
• Subjects: Area Under Curve; Biomarkers - urine; Cystitis, Interstitial - blood; Cystitis, Interstitial - etiology; Cystitis, Interstitial - urine; diagnosis; Enzyme-Linked Immunosorbent Assay; expression; Female; Humans; Inflammation; Intramolecular Oxidoreductases - urine; Macrophage Migration-Inhibitory Factors - urine; Male; mif; Pain - etiology; prevalence; Radiation Injuries - urine; ROC Curve; syndrome/interstitial cystitis; Ulcer - complications; Ulcer - urine; ulcers; Urinary Bladder Diseases - urine; Urinary Tract Infections - urine; Urologi och njurmedicin; Urology & Nephrology; Urology and Nephrology
• ISSN: 0090-4295; 1527-9995; 1527-9995
• DOI: 10.1016/j.urology.2018.02.039

To investigate whether urinary levels of macrophage migration inhibitory factor (MIF) are elevated in interstitial cystitis/bladder pain syndrome (IC/BPS) patients with Hunner lesions and also whether urine MIF is elevated in other forms of inflammatory cystitis. Urine samples were assayed for MIF by enzyme-linked immunosorbent assay. Urine samples from 3 female groups were examined: IC/BPS patients without (N = 55) and with Hunner lesions (N = 43), and non-IC/BPS patients (N = 100; control group; no history of IC/BPS; cancer or recent bacterial cystitis). Urine samples from 3 male groups were examined: patients with bacterial cystitis (N = 50), radiation cystitis (N = 18) and noncystitis patients (N = 119; control group; negative for bacterial cystitis). Urine MIF (mean MIF pg/mL ±  standard error of the mean) was increased in female IC/BPS patients with Hunner lesions (2159 ± 435.3) compared with IC/BPS patients without Hunner lesions (460 ± 114.5) or non-IC/BPS patients (414 ± 47.6). Receiver operating curve analyses showed that urine MIF levels discriminated between the 2 IC groups (area under the curve = 72%; confidence interval 61%-82%). Male patients with bacterial and radiation cystitis had elevated urine MIF levels (2839 ± 757.1 and 4404 ± 1548.1, respectively) compared with noncystitis patients (681 ± 75.2). Urine MIF is elevated in IC/BPS patients with Hunner lesions and also in patients with other bladder inflammatory and painful conditions. MIF may also serve as a noninvasive biomarker to select IC/BPS patients more accurately for endoscopic evaluation and possible anti-inflammatory treatment.