title: Increased vascular endothelial growth factor expression in patients with bladder pain syndrome/interstitial cystitis: its association with pain severity and glomerulations.
abstract: OBJECTIVE
  To determine the angiogenic profiles in the bladder of patients with bladder pain syndrome (BPS)/interstitial cystitis (IC), and to evaluate the relationship between these profiles and associated clinical features including pelvic pain and glomerulations.
  
  
  METHODS
  Angiogenesis and angiogenic components are important in chronic inflammatory disease. High levels of vascular endothelial growth factor (VEGF) have been shown to induce immature angiogenesis, where microvessels have insufficient coverage of pericytes, resulting in haemorrhagic vessels. Biopsy specimens from 30 patients with BPS/IC and glomerulations, and 10 control patients, were examined immunohistochemically for VEGF expression, microvessel density (MVD) and immature microvessels. Pericyte coverage of microvessels in the specimens was used as an indicator of mature microvessels, and pericytes were identified by double-immunohistochemistry for CD34 and alpha-smooth muscle actin. The microvessel pericyte coverage index (MPI) was calculated as the ratio of mature vessels to total vessels. We also assessed the relationship between these angiogenic profiles and associated clinical features including pain and glomerulations.
  
  
  RESULTS
  VEGF expression in the lamina propria was significantly higher in BPS/IC than in control samples (50% vs 10%, P < 0.05). Among patients with BPS/IC, VEGF expression was significantly higher in those with severe pain than in those with mild pain (78% vs 38%, P < 0.05). The MPI was significantly lower in BPS/IC than in control samples (23% vs 35%, P < 0.05), whereas MVD did not differ significantly between BPS/IC and control samples.
  
  
  CONCLUSIONS
  There is increased VEGF and immature vascularization in patients with BPS/IC, and VEGF expression is associated with the degree of pain described by patients. Taken together, VEGF might contribute to pain and promote the formation of immature vessels in BPS/IC, and the increased immature vascularization might have a role in glomerulations in patients with BPS/IC.
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kiuchi
authors.forename: Akira
authors.initials: A
authors.lastname: Tsujimura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Takao
authors.forename: Keisuke
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Jiro
authors.initials: J
authors.lastname: Nakayama
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyagawa
authors.forename: Norio
authors.initials: N
authors.lastname: Nonomura
authors.forename: Masami
authors.initials: M
authors.lastname: Takeyama
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okuyama
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D018856:Cystitis, Interstitial / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000473:pathology*; D017699:Pelvic Pain / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013577:Syndrome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D042461:Vascular Endothelial Growth Factor A