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Distribution of mast cell subtypes in interstitial cystitis: implications for novel diagnostic and therapeutic strategies?
  1. Shabana T Malik1,
  2. Brian R Birch2,
  3. David Voegeli1,
  4. Mandy Fader1,
  5. Vipul Foria3,
  6. Alan J Cooper4,
  7. Andrew F Walls2,
  8. Bashir A Lwaleed1
  1. 1Faculty of Health Sciences, University of Southampton, Southampton, UK
  2. 2Faculty of Medicine, University of Southampton, Southampton, UK
  3. 3Department of Histopathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  4. 4Faculty of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
  1. Correspondence to Associate Professor  Bashir A Lwaleed, Faculty of Health Sciences, University of Southampton,Southampton SO16 6YD, UK; bashir{at}soton.ac.uk

Abstract

Aims To identify the presence and geographical distribution of mast cell (MC) subtypes: MCT (tryptase positive–chymase negative) and MCTC (tryptase positive–chymase positive) in bladder tissue.

Methods Bladder tissue was obtained from patients with painful bladder syndrome/interstitial cystitis (n=14) and normal histology from University Hospital Southampton tissue bank. Sequential tissue slices were immunohistochemically stained for MC subtypes using anti-MC tryptase (for MCT and MCTC) and anti-MC chymase (for MCTC). Stained sections were photographed, and positively stained MCs were quantified using ImageJ. Data were analysed using descriptive statistics and individual paired t-tests.

Results There was a significant difference in the density of MCs between each layer of the disease bladder, with the greatest accumulation within the detrusor (p<0.001). There was a significant increase in MCTC subtype in the lamina (p=0.009) in painful bladder syndrome/interstitial cystitis.

Conclusions Our results suggest that mastocytosis is present within all layers of disease bladder, especially the muscle layer. The varying increase in MC subtypes in the lamina and mucosa may explain the variability in painful bladder syndrome/interstitial cystitis symptoms. A high influx of MCTC in the mucosa of individuals who also had ulceration noted within their diagnostic notes may be of the Hunner’s ulcer subclassification. These findings suggest a relationship between the pathogenesis of MC subtypes and the clinical presentation of painful bladder syndrome/interstitial cystitis. A cohort study would further elucidate the diagnostic and/or therapeutic potential of MCs in patients with painful bladder syndrome/interstitial cystitis.

  • mast cell
  • painful bladder
  • cystitis
  • inflammation

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Footnotes

  • Handling editor Cheok Soon Lee.

  • Contributors STM: made a substantial contribution to the design, organisation and conduct of the study (including data acquisition). BRB: made a substantial contribution to the conception and critiquing the output for important intellectual content. DV, MF, VF, AJC and AFW: made substantial contribution to data analysis, manuscript preparation revision and critiquing the output for important intellectual content. BAL: made a substantial contribution to the conception, design, organisation and conduct of the study, including manuscript preparation and revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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