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Bladder hypersensitivity of interstitial cystitis complicated by allergic diseases
individual lifestyle factors (ie, convenient access to a bathroom). We hypothesize that the difference in pain is largely an artifact caused by the omission of the word “pressure” from the symptom question. Many IC patients respond to the word “pressure” while denying any pain or burning.
ICBR-61 Bladder Hypersensitivity of Interstitial Cystitis Complicated by Allergic Diseases T. Yamada, T. Murayama, H. Mita, and K. Akiyama Department of Urology (TY, TM) and Clinical Research Center for Allergology (HM, KA), National Sagamihara Hospital, Sagamihara, Japan
ICBR-60 Effects of CP55,940 and Methanadamide on Detrusor Activity R. J. Theobald, Jr. Kirksville College of Osteopathic Medicine, Kirksville, Missouri, USA Previous studies have demonstrated an effect of several cannabinoid agents on detrusor activity, including micturition volume threshold (MVT). These studies suggest that the effects are mediated via CB1 cannabinoid receptors that have multiple mechanisms of action associated with the responses, including effects on calcium channels and effects on adenylate cyclase activity. The current study was designed to determine the effects of 2 distinct cannabinoid agonists on various detrusor activities. Naive cats, weighing 2 to 5 kg were instrumented, under anesthesia, via a midline incision, to monitor MVT, onset and frequency of spontaneous premicturition contractions, and magnitude of detrusor contractions. Normal saline was infused into the bladder via a 3-way stopcock, using a Harvard Infusion-Withdrawal pump, at a rate of 0.018 mL/mg/min, allowing continuous monitoring of intravesical pressure. Data were displayed on a Grass Model 7D polygraph, and collected and analyzed on a desktop computer using a DATAQ, Inc. data capture device, Model DI-700. After a control MVT was obtained, either CP55,940 or methanandamide was administered at doses ranging from 1 to 40 g/kg intra-arterially Following the cannabinoid administration, another MVT was obtained. During data collection, all detrusor activity was monitored and recorded for analysis after the experiment. The results indicate that both agents effectively decreased certain detrusor functions. CP55,940 decreased MVT at all— doses tested, while the effects of methanandamide on MVT were mixed. Similarly, CP55,940 decreased the time to onset of spontaneous premicturition contractions during filling, while only the lowest dose of methanandamide produced a similar effect. Neither CP55,940 nor methanandamide altered the frequency of the spontaneous detrusor contractions, nor did either agent have an effect on the magnitude of MVT contractions. With the knowledge that cannabinoid agonists are negatively coupled to calcium channels, and their inhibition of adenylate cyclase, the mixed picture of effects is understandable. Decreased time to onset of spontaneous contractions during filling could be due to inhibition of adenylate cyclase, which may be involved in relaxation of detrusor smooth muscle during collection of urine. Removal of this inhibitory influence on the detrusor most likely allows the spontaneous activity to become apparent more quickly. The alteration of calcium fluxes may decrease neurotransmitter release required for detrusor contractions, and that decrease could be manifested as an increase in the volume requirement to produce a micturition contraction reduction contractility during filling-enhanced inhibition produced by the exogenously administered agents. More experiments must be performed to confirm or deny these preliminary results. UROLOGY 57 (Supplement 6A), June 2001
Many patients with interstitial cystitis (IC) have allergic diseases. In this study, an allergic evaluation was conducted on patients with IC complicated by bronchial asthma. Clinical histories were obtained and biopsy specimens of the vesical walls were examined histologically. Cutaneous tests and immunoglobulin E (IgE) radioallergosorbent tests (RASTs) were performed. Further, intravesical provocation tests were carried out using IgE RAST-positive antigens, and histamine release assays were conducted on the vesical biopsy specimens using anti IgE antibodies. A group (5 of 6) of patients alternately exhibited symptoms of allergic diseases and bladder symptoms. The mast cell counts in the vesical biopsy specimens of these 5 patients were increased. Furthermore, the result of the intravesical provocation test performed using the IgE RAST-positive antigen was positive in the case of 4 patients. The mean vesical biopsy specimen percent histamine release was 17.7 for the IC patients with bronchial asthma, significantly higher than that of 8.9 for the IC patients without bronchial asthma, and 4.5 for the control group. The prognosis of the IC patients with allergic complications was relatively good. The patients with bronchial asthma exhibited hypersensitivity both generally and locally in the bladder. The alternation phenomenon was observed between the hypersensitive organs. Patients with hypersensitivity predisposition of organs are closely related via parasympathetic innervation.
ICBR-62 Are Glomerulations Present in Patients of Other Diseases? N. Mishra Jivraj Mehta Hospital, Ahmedabad, India It is believed that glomerulations are not the hallmark of interstitial cystitis, but if they are found in a patient of frequency, urgency, and dysuria syndrome they are significant. This prospective study was done to find out if glomerulations are present on cystoscopy in patients with other diseases. This study was conducted from December 1997 to August 2000. A total of 47 patients were included in the study: 26 patients had diseases of the bladder, urethra, and prostate; 7 patients had renal and ureteral diseases; and 14 had diseases of other organs. There were 22 men and 25 women ranging from 19 to 75 years. None of the patients had been recently catheterized or irradiated. None of them had urinary tract infection. Cystoscopy was done in all the patients using a 21-Fr scope. Bladder was distended to full capacity under gravity with reservoir height being 80 cm, drained and distended again. The second distention was maintained for 2 to 3 minutes and bladder drained again. Cold cup biopsy was taken. 125
ICBR-61 Bladder Hypersensitivity of Interstitial Cystitis Complicated by Allergic Diseases T. Yamada, T. Murayama, H. Mita, and K. Akiyama Department of Urology (TY, TM) and Clinical Research Center for Allergology (HM, KA), National Sagamihara Hospital, Sagamihara, Japan
ICBR-60 Effects of CP55,940 and Methanadamide on Detrusor Activity R. J. Theobald, Jr. Kirksville College of Osteopathic Medicine, Kirksville, Missouri, USA Previous studies have demonstrated an effect of several cannabinoid agents on detrusor activity, including micturition volume threshold (MVT). These studies suggest that the effects are mediated via CB1 cannabinoid receptors that have multiple mechanisms of action associated with the responses, including effects on calcium channels and effects on adenylate cyclase activity. The current study was designed to determine the effects of 2 distinct cannabinoid agonists on various detrusor activities. Naive cats, weighing 2 to 5 kg were instrumented, under anesthesia, via a midline incision, to monitor MVT, onset and frequency of spontaneous premicturition contractions, and magnitude of detrusor contractions. Normal saline was infused into the bladder via a 3-way stopcock, using a Harvard Infusion-Withdrawal pump, at a rate of 0.018 mL/mg/min, allowing continuous monitoring of intravesical pressure. Data were displayed on a Grass Model 7D polygraph, and collected and analyzed on a desktop computer using a DATAQ, Inc. data capture device, Model DI-700. After a control MVT was obtained, either CP55,940 or methanandamide was administered at doses ranging from 1 to 40 g/kg intra-arterially Following the cannabinoid administration, another MVT was obtained. During data collection, all detrusor activity was monitored and recorded for analysis after the experiment. The results indicate that both agents effectively decreased certain detrusor functions. CP55,940 decreased MVT at all— doses tested, while the effects of methanandamide on MVT were mixed. Similarly, CP55,940 decreased the time to onset of spontaneous premicturition contractions during filling, while only the lowest dose of methanandamide produced a similar effect. Neither CP55,940 nor methanandamide altered the frequency of the spontaneous detrusor contractions, nor did either agent have an effect on the magnitude of MVT contractions. With the knowledge that cannabinoid agonists are negatively coupled to calcium channels, and their inhibition of adenylate cyclase, the mixed picture of effects is understandable. Decreased time to onset of spontaneous contractions during filling could be due to inhibition of adenylate cyclase, which may be involved in relaxation of detrusor smooth muscle during collection of urine. Removal of this inhibitory influence on the detrusor most likely allows the spontaneous activity to become apparent more quickly. The alteration of calcium fluxes may decrease neurotransmitter release required for detrusor contractions, and that decrease could be manifested as an increase in the volume requirement to produce a micturition contraction reduction contractility during filling-enhanced inhibition produced by the exogenously administered agents. More experiments must be performed to confirm or deny these preliminary results. UROLOGY 57 (Supplement 6A), June 2001
Many patients with interstitial cystitis (IC) have allergic diseases. In this study, an allergic evaluation was conducted on patients with IC complicated by bronchial asthma. Clinical histories were obtained and biopsy specimens of the vesical walls were examined histologically. Cutaneous tests and immunoglobulin E (IgE) radioallergosorbent tests (RASTs) were performed. Further, intravesical provocation tests were carried out using IgE RAST-positive antigens, and histamine release assays were conducted on the vesical biopsy specimens using anti IgE antibodies. A group (5 of 6) of patients alternately exhibited symptoms of allergic diseases and bladder symptoms. The mast cell counts in the vesical biopsy specimens of these 5 patients were increased. Furthermore, the result of the intravesical provocation test performed using the IgE RAST-positive antigen was positive in the case of 4 patients. The mean vesical biopsy specimen percent histamine release was 17.7 for the IC patients with bronchial asthma, significantly higher than that of 8.9 for the IC patients without bronchial asthma, and 4.5 for the control group. The prognosis of the IC patients with allergic complications was relatively good. The patients with bronchial asthma exhibited hypersensitivity both generally and locally in the bladder. The alternation phenomenon was observed between the hypersensitive organs. Patients with hypersensitivity predisposition of organs are closely related via parasympathetic innervation.
ICBR-62 Are Glomerulations Present in Patients of Other Diseases? N. Mishra Jivraj Mehta Hospital, Ahmedabad, India It is believed that glomerulations are not the hallmark of interstitial cystitis, but if they are found in a patient of frequency, urgency, and dysuria syndrome they are significant. This prospective study was done to find out if glomerulations are present on cystoscopy in patients with other diseases. This study was conducted from December 1997 to August 2000. A total of 47 patients were included in the study: 26 patients had diseases of the bladder, urethra, and prostate; 7 patients had renal and ureteral diseases; and 14 had diseases of other organs. There were 22 men and 25 women ranging from 19 to 75 years. None of the patients had been recently catheterized or irradiated. None of them had urinary tract infection. Cystoscopy was done in all the patients using a 21-Fr scope. Bladder was distended to full capacity under gravity with reservoir height being 80 cm, drained and distended again. The second distention was maintained for 2 to 3 minutes and bladder drained again. Cold cup biopsy was taken. 125