Diagnostic Challenges in IC (and Male CPPS) - Full Text View

Purpose

The etiology and pathogenesis of interstitial cystitis (IC) and its related condition in men, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has remained elusive. This has hampered development of mechanistic treatment strategies for these common, chronic and distressing medical conditions. We believe that IC and perhaps CP/CPPS are a spectrum of complex but inter-related genetic and acquired diseases resulting from the interaction of several genes regulating immune/inflammatory and neurogenic parameters and environmental factors/circumstances or exposure, culminating in the combination of pain, frequency, urgency and sexual specific symptoms. New research has delineated the dynamic and powerful association of the immune and neurogenic system in pain activation. An immune-modulated neurogenic model of IC illuminating the action of immune derived substances and pain related substances might be important in discovering the determinants of pain, voiding dysfunction and gender specific sexual problems. This inter-related dynamic model of IC disease pathogenesis could be explored for potential avenues leading to novel diagnostic and treatment strategies. We plan to identify and evaluate the sensitivity and specificity of several novel nerve and inflammation related markers in the diagnosis and follow up of IC (and CP/CPPS). By correlating the levels of urine immune and pain related substances to disease mechanisms, severity and progression, we may be able to create a human disease specific model for diagnosis and treatment.

Condition	Intervention
Chronic Prostatitis With Chronic Pelvic Pain Syndrome Chronic Bacterial Prostatitis Asymptomatic Inflammatory Prostatitis Painful Bladder Syndrome Cystitis, Interstitial	Genetic: Genomic and proteomic biomarker discovery

Study Type:	Observational
Study Design:	Observational Model: Cohort Time Perspective: Prospective
Official Title:	Diagnostic Challenges in IC (and Male CPPS)

Resource links provided by NLM:

MedlinePlus related topics: Interstitial Cystitis Pelvic Pain

U.S. FDA Resources

Further study details as provided by Beth Israel Deaconess Medical Center:

Biospecimen Retention: Samples With DNA

saliva, whole blood, serum, white cells, urine, prostatic fluid, prostate/bladder tissue

Estimated Enrollment:	1000
Study Start Date:	September 2003
Estimated Study Completion Date:	September 2023
Estimated Primary Completion Date:	September 2013 (Final data collection date for primary outcome measure)

Groups/Cohorts	Assigned Interventions
A Chronic prostatitis/chronic pelvic pain syndrome patients	Genetic: Genomic and proteomic biomarker discovery Discovery of novel biomarkers for CP/CPPS and PBS/IC using genomic and proteomic methods
B Painful bladder syndrome/interstitial cystitis patients	Genetic: Genomic and proteomic biomarker discovery Discovery of novel biomarkers for CP/CPPS and PBS/IC using genomic and proteomic methods
C Asymptomatic controls	Genetic: Genomic and proteomic biomarker discovery Discovery of novel biomarkers for CP/CPPS and PBS/IC using genomic and proteomic methods

Eligibility

Ages Eligible for Study:	18 Years to 80 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes
Sampling Method:	Probability Sample

Study Population

Tertiary university medical centers and primary care clinic

Criteria

Inclusion Criteria:

Participant has signed and dated the appropriate Informed Consent document.
Participant must have had symptoms of discomfort or pain in the pelvic region for at least a three (3) month period within the last six (6) months.

Exclusion Criteria:

Major structural/anatomical urinary tract abnormalities
Underlying inborn conditions

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00672087

Contacts

Contact: Jordan D Dimitrakoff, MD, PhD	6176672051	jdimitra@bidmc.harvard.edu
Contact: Jordan Dimitrakoff	6176672051	jdimitrakov@gmail.com

Locations

United States, Massachusetts
Beth Israel Deaconess Medical Center	Recruiting
Boston, Massachusetts, United States, 02215
Contact: Jordan D Dimitrakoff, MD, PhD 617-667-2051 jdimitra@bidmc.harvard.edu

Sponsors and Collaborators

Beth Israel Deaconess Medical Center

Investigators

Study Chair:

Jordan D Dimitrakoff, MD, PhD

Harvard Medical School, Boston, MA

More Information

Publications:

Dimitrakov J, Joffe HV, Soldin SJ, Bolus R, Buffington CA, Nickel JC. Adrenocortical hormone abnormalities in men with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2008 Feb;71(2):261-6.

Dimitrakov J, Kroenke K, Steers WD, Berde C, Zurakowski D, Freeman MR, Jackson JL. Pharmacologic management of painful bladder syndrome/interstitial cystitis: a systematic review. Arch Intern Med. 2007 Oct 8;167(18):1922-9. Review. Erratum in: Arch Intern Med. 2007 Dec 10-22;167(22):2452.

Dimitrakov JD, Kaplan SA, Kroenke K, Jackson JL, Freeman MR. Management of chronic prostatitis/chronic pelvic pain syndrome: an evidence-based approach. Urology. 2006 May;67(5):881-8. Review. No abstract available.

Allsop SA, Erstad DJ, Brook K, Bhai SF, Cohen JM, Dimitrakoff JD. The DABBEC Phenotyping System: towards a mechanistic understanding of CP/CPPS. Nat Rev Urol. 2011 Feb;8(2):107-13. Epub 2011 Jan 18.

Strauss AC, Dimitrakov JD. New treatments for chronic prostatitis/chronic pelvic pain syndrome. Nat Rev Urol. 2010 Mar;7(3):127-35. Epub 2010 Feb 9. Review.

Responsible Party:	Jordan Dimitrakoff, MD, PhD, Director of Urogynecology and Chronic Pelvic Pain Lab, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
ClinicalTrials.gov Identifier:	NCT00672087 History of Changes
Other Study ID Numbers:	DK65990, NIH DK065990
Study First Received:	May 2, 2008
Last Updated:	June 22, 2011
Health Authority:	United States: Federal Government

Keywords provided by Beth Israel Deaconess Medical Center:

Chronic Prostatitis with Chronic Pelvic Pain Syndrome
Chronic Bacterial Prostatitis
Asymptomatic Inflammatory Prostatitis
Painful Bladder Syndrome
Cystitis, Interstitial

Additional relevant MeSH terms:

Cystitis
Pain
Pelvic Pain
Prostatitis
Chronic Disease
Cystitis, Interstitial
Somatoform Disorders
Urinary Bladder Diseases
Urologic Diseases

Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Prostatic Diseases
Genital Diseases, Male
Disease Attributes
Pathologic Processes
Mental Disorders

ClinicalTrials.gov processed this record on June 17, 2013