New Research Begins for Painful Bladder Disease

UR Team Hopes to Revolutionize Therapy for Interstitial Cystitis

October 22, 2001

With a new $1 million grant in hand, the University of Rochester Medical Center will be the first to develop a study of mice specifically to seek the causes and potential treatments for interstitial cystitis. The debilitating bladder condition, known as IC, makes a patient urinate frequently and is associated with severe pelvic and lower abdominal pain.

IC afflicts mostly women. It's estimated that as many as 1 million Americans may experience pain and urgency consistent with interstitial cystitis, but an infection, bladder stone or cancer cannot explain their symptoms. Physicians do not know why some people develop IC, and the diagnosis is often made only by excluding other conditions. Symptoms vary from a relatively mild need to frequently urinate at night, to such severe pain that patients experience sleep deprivation and are even suicidal in extreme cases.

A leading medical theory is that IC is caused when normal chemicals in the urine penetrate the normally impervious lining of the bladder and irritate cells deep inside the bladder wall. But researchers do not have a thorough understanding of how this leaky bladder defect occurs.

The UR Medical Center's team believes the best hope of testing the bladder permeability theory is to study mice that are genetically engineered to have a similar condition. The researchers will then use a new method, developed here, to measure leakage of a fluorescent dye through the bladder wall of mice, said Edward Schwarz, Ph.D., the project's principal investigator and an expert in animal modeling of human diseases.

Ronald Wood, Ph.D., a URMC research professor in Obstetrics and Gynecology and co-investigator for the study, developed the way to analyze the urination function of mice. The research is funded by the National Institutes of Health.

"With our new methods, we can proceed to make the first mouse models of this disease," Schwarz said. "The long-term goal is to develop an effective therapy that will treat the irritable voiding without altering a person's lifestyle."

Right now, the most aggressive single drug available for IC is Elmiron, which acts like an adhesive to patch the bladder's lining. "But the treatment is only effective 30 to 40 percent of the time," said Edward Messing, M.D., chairman of Urology at Strong Memorial Hospital of the UR Medical Center. Messing, another co-investigator on the research, greatly heightened awareness of IC in 1978 by describing ways to diagnose the disease.

"Unfortunately, while this syndrome is now relatively easy to diagnose, it can be devastating for patients, both because of the severity of symptoms and our inability to treat it consistently," Messing said. "By substantiating or refuting the barrier defect hypothesis in rodents, we can develop objective ways to diagnose, classify and follow patients. Moreover, it will permit us to develop and test new therapeutic strategies, as well as to monitor patient responses to these treatments. This has the very real potential of revolutionizing therapy for IC."

During the past two decades, little progress has been reported on IC. But URMC scientists think the mouse model will permit them to take full advantage of the modern genetic revolution - all of the mouse genes are known - to tackle the underlying cause of this chronic inflammatory condition.

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