Advanced

Current pharmacologic approaches in painful bladder research : An update

Andersson, Karl Erik LU and Birder, Lori (2017) In International Neurourology Journal 21(4). p.235-242
Abstract

The symptoms of interstitial cystitis (IC)/bladder pain syndrome (BPS) may have multiple causes and involve many contributing factors. Traditional treatments (intravesical instillations) have had a primary focus on the bladder as origin of symptoms without adequately considering the potential influence of other local (pelvic) or systemic factors. Systemic pharmacological treatments have had modest success. A contributing factor to the low efficacy is the lack of phenotyping the patients. Individualized treatment based on is desirable, but further phenotype categorization is needed. There seems to be general agreement that IC is a unique disease and that BPS is a syndrome with multiple pathophysiologies, but this has so far not been not... (More)

The symptoms of interstitial cystitis (IC)/bladder pain syndrome (BPS) may have multiple causes and involve many contributing factors. Traditional treatments (intravesical instillations) have had a primary focus on the bladder as origin of symptoms without adequately considering the potential influence of other local (pelvic) or systemic factors. Systemic pharmacological treatments have had modest success. A contributing factor to the low efficacy is the lack of phenotyping the patients. Individualized treatment based on is desirable, but further phenotype categorization is needed. There seems to be general agreement that IC is a unique disease and that BPS is a syndrome with multiple pathophysiologies, but this has so far not been not been well reflected in preclinical research with the aim of finding new pharmacological treatments. Current research approaches, including anti-nerve growth factor treatment, anti-tumor necrosis factor-a treatment, activation of SHIP1 (AQX-1125), and P2X3 receptor antagonists, and a1-adrenoceptor antagonists are potential systemic treatments, implying that not only the bladder is exposed to the administered drug, which may be beneficial if the IC/BPS is a bladder manifestation of a systemic disease, or negative (adverse effects) if it is a local bladder condition. Local treatment approaches such as the antagonism of Toll-like receptors (which still is only experimental) and intravesical liposomes (with positive proof-of-concept), may have the advantages of a low number of systemic adverse effects, but cannot be expected to have effects on symptoms generated outside the bladder. Assessment of which of the treatment approaches discussed in this review that can be developed into useful therapies requires further studies.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Liposomes, Nerve growth factor, P2X3 receptor, SHIP1, Toll-like receptors, Tumor necrosis factor-alpha
in
International Neurourology Journal
volume
21
issue
4
pages
8 pages
external identifiers
  • scopus:85038949169
ISSN
2093-4777
DOI
10.5213/inj.1735022.511
language
English
LU publication?
yes
id
f1ee5228-ef5e-49bb-af11-2ac6e3131e71
date added to LUP
2018-01-22 17:28:29
date last changed
2018-07-15 04:47:09
@article{f1ee5228-ef5e-49bb-af11-2ac6e3131e71,
  abstract     = {<p>The symptoms of interstitial cystitis (IC)/bladder pain syndrome (BPS) may have multiple causes and involve many contributing factors. Traditional treatments (intravesical instillations) have had a primary focus on the bladder as origin of symptoms without adequately considering the potential influence of other local (pelvic) or systemic factors. Systemic pharmacological treatments have had modest success. A contributing factor to the low efficacy is the lack of phenotyping the patients. Individualized treatment based on is desirable, but further phenotype categorization is needed. There seems to be general agreement that IC is a unique disease and that BPS is a syndrome with multiple pathophysiologies, but this has so far not been not been well reflected in preclinical research with the aim of finding new pharmacological treatments. Current research approaches, including anti-nerve growth factor treatment, anti-tumor necrosis factor-a treatment, activation of SHIP1 (AQX-1125), and P2X3 receptor antagonists, and a1-adrenoceptor antagonists are potential systemic treatments, implying that not only the bladder is exposed to the administered drug, which may be beneficial if the IC/BPS is a bladder manifestation of a systemic disease, or negative (adverse effects) if it is a local bladder condition. Local treatment approaches such as the antagonism of Toll-like receptors (which still is only experimental) and intravesical liposomes (with positive proof-of-concept), may have the advantages of a low number of systemic adverse effects, but cannot be expected to have effects on symptoms generated outside the bladder. Assessment of which of the treatment approaches discussed in this review that can be developed into useful therapies requires further studies.</p>},
  author       = {Andersson, Karl Erik and Birder, Lori},
  issn         = {2093-4777},
  keyword      = {Liposomes,Nerve growth factor,P2X3 receptor,SHIP1,Toll-like receptors,Tumor necrosis factor-alpha},
  language     = {eng},
  number       = {4},
  pages        = {235--242},
  series       = {International Neurourology Journal},
  title        = {Current pharmacologic approaches in painful bladder research : An update},
  url          = {http://dx.doi.org/10.5213/inj.1735022.511},
  volume       = {21},
  year         = {2017},
}