INCREASED NERVE GROWTH-FACTOR LEVELS IN THE URINARY-BLADDER OF WOMEN WITH IDIOPATHIC SENSORY URGENCY AND INTERSTITIAL CYSTITIS

Objectives To determine whether nerve growth factor (NGF) is elevated in painful conditions of the urinary bladder (idiopathic sensory urgen cy, interstitial cystitis and painful chronic cystitis). Patients and methods Sixteen women patients were recruited from the Urodynamic Clin ic at The Elizabeth Garrett Anderson Hospital, London. Four each had i diopathic sensory urgency (mean age 34 years, range 24-51), chronic cy stitis (mean age 51 years, range 40-79) and interstitial cystitis (mea n age 41 years, range 29-53). Four women who had genuine stress incont inence on cystometry but with no irritative symptoms were used as cont rols (mean age 45 years, range 35-54). The levels of NGF were determin ed in bladder biopsies from all women and biopsy sections were immunos tained to detect NGF. Results The levels of NGF were higher in samples from all three painful bladder conditions than in samples from contro ls. Immunostaining showed increased NGF expression in the urothelium, most marked in patients with idiopathic sensory urgency. Conclusions T he increased level of NGF may explain several clinical and pathologica l features in these conditions, including sensitization of nociceptor fibres and increased numbers of mast cells. We propose that anti-NGF t reatment may be a rational and effective treatment in intractable blad der pain.