INFLAMMATORY CELL-TYPES AND CLINICAL-FEATURES OF INTERSTITIAL CYSTITIS

Purpose: We tested whether the types of inflammatory cells seen on bla dder biopsies were associated with other clinical features and urinary markers of interstitial cystitis. Materials and Methods: Bladder biop sies from 30 interstitial cystitis patients were evaluated by immunohi stochemical staining for T cells, B cells, macrophages and human leuko cyte antigen-DR positive cells. These findings were tested for associa tions with clinical features and urinary markers of interstitial cysti tis using alpha = 0.01 because multiple tests were performed. Results: Overall severity of inflammation was significantly associated with ag e at symptom onset, symptom relief after bladder distention and urinar y interleukin-6 levels. Patients with severe inflammation had trends t oward smaller bladder capacity under anesthesia, increased bladder vas cularity and mucosal cracks, lower urinary MUC-1 glycoprotein levels a nd absence of bloating as a symptom. B cell staining was significantly associated with severe inflammation, symptom relief after distention and absence of bloating as a symptom. T cell staining was significantl y associated with severe inflammation and age at symptom onset. Human leukocyte antigen-DR staining had trends with symptoms, including pres ence of bloating, constant urge to void and absence of burning. Macrop hage staining did not associate with any features tested at the alpha = 0.05 level. Conclusions: Interstitial cystitis patients with severe inflammation have different age, treatment response and urinary marker levels than those with mild inflammation. These findings suggest that the 2 patient groups have different underlying pathophysiologies. The significant associations for T and B cell staining were similar to th ose for overall inflammation.