Journal article
Toll-like Receptor 4 and comorbid pain in Interstitial Cystitis/Bladder Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain research network study
Brain Behavior and Immunity, Vol.49, pp.66-74
10/2015
DOI: 10.1016/j.bbi.2015.03.003
PMCID: PMC4567436
PMID: 25771510
Abstract
•We measured inflammatory responses in PBMCs to TLR stimulation in IC/BPS patients.•Greater responses to TLR-4 stimulation were associated with widespread pain.•Greater responses to TLR-4 stimulation were associated with comorbid conditions.•TLR-4 mediated inflammation may be a therapeutic target in unexplained chronic pain. Background: Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a condition characterized by pelvic pain and urinary symptoms. Some IC/BPS patients have pain confined to the pelvic region, while others suffer widespread pain. Inflammatory processes have previously been linked to pelvic pain in IC/BPS, but their association with widespread pain in IC/BPS has not been characterized. Methods: Sixty-six women meeting criteria for IC/BPS completed self-report measures of pain as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP), collected 3days of saliva for cortisol assays, and provided blood samples. Peripheral blood mononuclear cells (PBMCs) were stimulated with Toll-like Receptor (TLR) 2 and 4 agonists and cytokines were measured in supernatant; IL-6 was also measured in plasma. Associations between inflammatory variables and the likelihood of endorsing extra-pelvic pain, or the presence of a comorbid syndrome, were tested by logistic regression and General Linear Models, respectively. A subset of patients (n=32) completed Quantitative Sensory Testing. Results: A one standard deviation increase in TLR-4 inflammatory response was associated with a 1.59 greater likelihood of endorsing extra-pelvic pain (p=.019). Participants with comorbid syndromes also had higher inflammatory responses to TLR-4 stimulation in PBMCs (p=.016). Lower pressure pain thresholds were marginally associated with higher TLR-4 inflammatory responses (p=.062), and significantly associated with higher IL-6 in plasma (p=.031). Conclusions: TLR-4 inflammatory responses in PBMCs are a marker of widespread pain in IC/BPS, and should be explored in other conditions characterized by medically unexplained pain.
Details
- Title: Subtitle
- Toll-like Receptor 4 and comorbid pain in Interstitial Cystitis/Bladder Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain research network study
- Creators
- Andrew Schrepf - Department of Psychology, University of Iowa, United StatesCatherine S Bradley - Department of Urology, University of Iowa, United StatesMichael O’Donnell - Department of Urology, University of Iowa, United StatesYi Luo - Department of Urology, University of Iowa, United StatesSteven E Harte - Departments of Anesthesiology and Internal Medicine–Rheumatology, University of Michigan, United StatesKarl Kreder - Department of Urology, University of Iowa, United StatesSusan Lutgendorf - Department of Psychology, University of Iowa, United StatesThe Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network
- Resource Type
- Journal article
- Publication Details
- Brain Behavior and Immunity, Vol.49, pp.66-74
- DOI
- 10.1016/j.bbi.2015.03.003
- PMID
- 25771510
- PMCID
- PMC4567436
- NLM abbreviation
- Brain Behav Immun
- ISSN
- 0889-1591
- eISSN
- 1090-2139
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100000062, name: National Institute of Diabetes Digestive and Kidney Diseases, award: UO1DK082344; name: Institute for Clinical and Translational Science, award: 2 UL1 TR000442-06
- Language
- English
- Date published
- 10/2015
- Academic Unit
- Epidemiology; Psychological and Brain Sciences; Iowa Neuroscience Institute; Obstetrics and Gynecology; Urology
- Record Identifier
- 9983930511002771
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