In the spectrum of BPS, IC is still a pathophysiologic enigma and its treatment empirical.
Simplistically, it is considered to be result of a multifactorial cascade of events
that culminate into an imbalance of the damage-repair process of the urothelium, leading
to deficiency of the GAG layer and the resulting symptoms. Various oral and intravesical
GAG analogs have been in clinical use, most notably pentosan polysulphate (oral),
hyaluronic acid (intravesical), and heparin (intravesical). Of these, only pentosan
polysulphate has been subject to comprehensive scrutiny through randomized placebo-controlled
trials, the results of which have been published in peer-reviewed reports. Its efficacy
has been reported to be moderate at best.
1
In this regard, the authors must be complimented for conducting a very well-designed,
double-blind, placebo-controlled trial on another GAG analog chondroitin sulphate
and reaffirming the inefficacy of this medication. Therefore, despite the pathologic
proof of GAG deficiency, none of the available GAG analogs have proved to have robust
activity in controlling the symptoms.To read this article in full you will need to make a payment
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References
- Safety and efficacy of the use of intravesical and oral pentosan polysulfate sodium for interstitial cystitis: a randomized double-blind clinical trial.J Urol. 2008; 179: 177-185
- Sensitivity and specificity of antiproliferative factor, heparin-binding epidermal growth factor-like growth factor, and epidermal growth factor as urine markers for interstitial cystitis.Urology. 2001; 57: 9-14
- Normalization of proliferation and tight junction formation in bladder epithelial cells from patients with interstitial cystitis/painful bladder syndrome by D-proline and D-pipecolic acid derivatives of antiproliferative factor.Chem Biol Drug Des. 2011; 77: 421-430
- Decreased nanobacteria levels and symptoms of nanobacteria-associated interstitial cystitis/painful bladder syndrome after tetracycline treatment.Int Urogynecol J. 2010; 21: 103-109
- Proteomic techniques identify urine proteins that differentiate patients with interstitial cystitis from asymptomatic control subjects.Am J Obstet Gynecol. 2008; 198: 553.e1-553.e6
Article info
Publication history
Published online: April 18, 2012
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
