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October 22, 2001 New Research Begins for Painful Bladder Disease
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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