Gene-based biomarkers could cut invasive bladder biopsies

Interstitial cystitis, an uncomfortable and sometimes embarrassing condition, is hard to study because the only way to see what is going on is through bladder biopsies, which are invasive and painful. Having a biomarker could unlock the route to better treatments and diagnostics, and the University of Kentucky has found a possible contender.

Interstitial cystitis, also known as bladder pain syndrome, happens when the lining of the bladder gets inflamed, and leads to pain during urination and sex, and an increased need to urinate--perhaps even 60 times a day. On top of this, some patients get ulcers in the bladder, called Hunner lesions. Cells from the lining of the bladder are shed into the urine on a daily basis, and the researchers looked at these as a potential source of biomarkers.

The team looked at the gene expression in cells in urine samples from people with interstitial cystitis (with or without ulcers), and from healthy people. The cells from people with cystitis and Hunner lesions had increased expressions of some genes, compared with the people without the lesions and those with no bladder symptoms. The genes seen working harder in the cells were ones connected with inflammation, which is perhaps unsurprising--what is perhaps surprising is that the same was not seen in the people with cystitis but without the ulcers. This could perhaps suggest that the two are actually different diseases.

Bladder biopsies are painful and inconvenient, need anesthesia and can injure an already damaged bladder, so these results could lead to a noninvasive biomarker for patients with Hunner lesions. "A crucial next step will be to determine the stability of this set of biomarkers across larger samples of the population, and to also see if similar procedures could be used for early diagnosis and intervention in the disease process," says Eric Blalock, associate professor in the Department of Molecular and Biomedical Pharmacology at the U.K. College of Medicine.

- read the press release
- see the abstract in the Journal of Urology