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Do infectious agents cause interstitial cystitis?
1Department of Microbiology-Immunology, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Abstract:
The possibility that infectious agents play a role in the etiology of interstitial cystitis (IC) has been investigated for a number of years. Early studies were directed toward attempts to cultivate bacteria and fungi on routine culture media and microscopic examinations of urine or bladder tissue specimens for the presence of microorganisms. In more recent years, this approach has been expanded to include sophisticated culture techniques to search for the presence of fastidious and unusual organisms that would not be detected by routine culture methods. Similarly, the presence of viruses has been sought by incubating specimens from interstitial cystitis patients in mammalian cell cultures to detect cytopathic effects. None of these approaches has provided convincing evidence that micro-organisms or viruses are associated with IC. The latest attempts to search for the presence of bacteria have made use of the polymerase chain reaction (PCR) to amplify bacterial 16S rRNA genes that would be present if bacteria were present in bladder tissue or urine of IC patients. This approach allows bacteria to be detected and even identified without culture. However, the results from the great majority of bladder biopsy samples analyzed by these molecular techniques have been negative. PCR strategies have also been used to search for the presence of certain viruses in IC specimens, again without success. At this time, the results from laboratory culture, light and electron microscopy, and various molecular strategies to detect micro-organisms and viruses in IC specimens all argue against an infectious etiology for IC.
Insights
Extensive research into interstitial cystitis (IC) has investigated infectious agents. Current evidence from various detection methods, including PCR, does not support a microbial or viral cause for IC.
Area of Science:
- Urology
- Microbiology
- Pathogen Research
Background:
- Interstitial cystitis (IC) is a chronic bladder condition with an unknown cause.
- The potential role of infectious agents in IC etiology has been a long-standing research question.
Purpose of the Study:
- To comprehensively review and evaluate the evidence for an infectious etiology of interstitial cystitis (IC).
- To assess the findings from traditional and advanced microbiological and molecular techniques in relation to IC.
Main Methods:
- Review of studies employing routine and sophisticated bacterial/fungal cultures.
- Analysis of viral detection methods, including cell culture for cytopathic effects.
- Examination of results from molecular techniques like polymerase chain reaction (PCR) for bacterial 16S rRNA genes.
- Inclusion of microscopy (light and electron) findings.
Main Results:
- Traditional culture methods and microscopy have failed to consistently identify microorganisms in IC patients.
- Advanced culture techniques and cell culture assays for viruses have not yielded positive results.
- Molecular methods, including PCR targeting bacterial 16S rRNA genes and viral detection, have predominantly produced negative findings in bladder tissue and urine samples from IC patients.
Conclusions:
- The collective evidence from microbiological, virological, and molecular investigations does not support an infectious origin for interstitial cystitis.
- Current data argues against microorganisms or viruses being a primary cause of IC.