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Urinary Biomarkers for Radiation Cystitis: Current Insights and Future Directions.

Rani Mahyoob1, Bernadette M M Zwaans1,2

  • 1Department of Urology, Corewell Health William Beaumont University Hospital, Royal Oak, MI 48073, USA.

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This review explores urinary biomarkers for diagnosing radiation cystitis (RC), a challenging complication of pelvic radiotherapy. Understanding these molecular signatures can lead to earlier detection and better patient outcomes.

Keywords:
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Area of Science:

  • Urology
  • Oncology
  • Biochemistry

Background:

  • Radiation cystitis (RC) is a progressive complication of pelvic radiotherapy.
  • Current diagnosis is challenging due to nonspecific symptoms and lack of validated molecular tools.
  • Urine is a valuable biofluid for understanding RC pathogenesis.

Purpose of the Study:

  • To review urinary biomarkers for acute, latent, and chronic phases of RC.
  • To integrate mechanistic insights into RC pathogenesis and urinary analyte release.
  • To highlight opportunities for urine-based diagnostics in RC.

Main Methods:

  • Comprehensive review of current literature on urinary biomarkers in RC.
  • Synthesis of molecular pathways and corresponding urinary signatures.
  • Integration of mechanistic insights including DNA damage, oxidative stress, and fibrosis.

Main Results:

  • Identified diverse urinary biomarkers across RC phases (cytokines, oxidative stress products, EVs, miRNAs, etc.).
  • Linked molecular mechanisms (ROS, hypoxia, TGF-β) to urinary analyte profiles.
  • Highlighted potential for urine-based measurements in early detection, risk stratification, and monitoring.

Conclusions:

  • Urinary biomarkers offer a promising avenue for early and accurate diagnosis of RC.
  • Understanding molecular mechanisms is key to developing effective urine-based diagnostic tools.
  • Precision diagnostics using urinary profiles can improve long-term outcomes for RC patients.