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Published on: January 5, 2017
Diagnostic value of urinary CXCL10 as a biomarker for predicting Hunner type interstitial cystitis
Aya Niimi1, Yasuhiko Igawa2, Naoki Aizawa2
1Department of Urology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Insights
Urinary CXCL10 and NGF show potential as biomarkers to differentiate Hunner type interstitial cystitis (HIC) from non-Hunner type (NHIC). Elevated levels of these chemokines and cytokines could aid in diagnosing HIC subtypes.
Area of Science:
- Urology
- Immunology
- Biochemistry
Background:
- Hunner type interstitial cystitis (HIC) is a subtype of interstitial cystitis (IC) that requires accurate differentiation from non-Hunner type (NHIC).
- Identifying reliable biomarkers for HIC is crucial for effective diagnosis and management.
- Chemokines and cytokines elevated in HIC bladder tissue are potential candidates for urinary detection.
Purpose of the Study:
- To evaluate the feasibility of using urinary chemokines and cytokines as markers to distinguish HIC from NHIC.
- To assess the correlation between urinary marker levels and symptom severity in IC patients.
Main Methods:
- Urine samples were collected from 41 HIC patients, 25 NHIC patients, and 31 healthy controls.
- ELISA kits were used to measure urinary levels of 10 cytokines and chemokines, normalized by creatinine (Cr).
- Receiver operating characteristic (ROC) analysis was performed to assess diagnostic efficiency, and correlations with symptom scores were examined.
Main Results:
- Urinary CXCL10 and NGF levels were significantly higher in HIC patients compared to NHIC patients.
- CXCL10 and NGF demonstrated moderate to good discriminatory ability between HIC and NHIC (AUC 0.78 and 0.68, respectively).
- A combination of CXCL10 and NGF showed improved differentiation (AUC 0.81), with CXCL10 exhibiting high specificity (93.7%) for HIC detection.
Conclusions:
- Elevated urinary CXCL10, with or without elevated NGF, may serve as a valuable supplementary biomarker for differentiating HIC from NHIC.
- The combination of CXCL10 and NGF offers a promising approach for improved diagnostic accuracy in IC subtypes.
- Urinary CXCL10 levels showed a significant correlation with symptom severity in IC patients.
Aim:
To investigate the feasibility of chemokines and cytokines potentially elevated in the bladder tissue of Hunner type interstitial cystitis (HIC) as urinary markers for distinguishing HIC from non-Hunner type interstitial cystitis (NHIC) METHODS: Urine specimens were collected from 41 HIC patients, 25 NHIC patients, and 31 healthy volunteers (control). The supernatants of urine specimens were subjected to ELISA kits for measurements of 10 cytokines and chemokines, whose gene expression was known to be elevated in HIC bladder tissue. Urinary levels normalized by urinary creatinine (Cr) concentration were compared among three groups. Efficiency in differentiating IC and IC subtypes was explored by ROC analysis. The correlation of marker levels with symptom severity, assessed by O'Leary-Sant's symptom index (OSSI) and problem index (OSPI), was examined.
Results:
The urinary levels of CXCL10 and NGF were significantly higher in HIC than NHIC. CXCL10 and NGF differentiated HIC against NHIC with AUC of 0.78 and 0.68, respectively. Combination of CXCL10 and NGF levels yielded an AUS of 0.81. The CXCL10 cut-off of 53.2 pg/mg Cr had sensitivity of 46.1%, specificity of 93.7%, positive predictive value of 97.7%, and negative predictive value of 60.0%. The urinary level of other cytokines showed no significant difference between HIC and NHIC. Significant correlation with symptoms was detected for CXCL10 alone.
Conclusion:
The results suggested that increased urinary level of CXCL10 combined with or without high NGF level could be a promising supplementary biomarker for differentiating HIC from NHIC with modest sensitivity and high specificity.
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