title: Changes in nerve growth factor level and symptom severity following antibiotic treatment for refractory overactive bladder.
abstract: OBJECTIVE
  Overactive bladder (OAB) has a multifactorial aetiology, and for some women symptoms may be associated with chronic urothelial inflammation secondary to bacterial colonisation. One marker of such inflammation may be urinary nerve growth factor (NGF). We hypothesised that for women with OAB and urothelial inflammation, urinary NGF would be reduced following antibiotic therapy.
  
  
  METHODS
  Women with overactive bladder and urodynamic diagnosis of detrusor overactivity who were refractory to anticholinergics, and had histological evidence of urothelial inflammation were treated with a 6-week course of rotating antibiotics. Urinary NGF was measured by ELISA before and after treatment. Three-day bladder diaries, the Patients' Perception of Intensity of Urgency Scale, the King's Health Questionnaire and the Patients' Perception of Bladder Condition questionnaire were used to assess subjective and objective outcomes of therapy.
  
  
  RESULTS
  Thirty-nine women with refractory DO were recruited. The NGF levels decreased significantly after antibiotic therapy (Wilcoxon signed rank test; p = 0.015). There were significant improvements in daytime frequency, nocturia and urgency (p < 0.05), and 74 % of women reported improvement in perception of their bladder condition.
  
  
  CONCLUSIONS
  Urinary NGF is responsive to antibiotic therapy. Women with refractory overactive bladder and elevated NGF may benefit from antibiotic treatment.
authors: St. Mary's Hospital, Imperial College Healthcare NHS Trust, Paddington, London, UK. vijayamathi@aol.com
authors: G
authors: G
authors: Vijaya
authors: R
authors: R
authors: Cartwright
authors: A
authors: A
authors: Derpapas
authors: P
authors: P
authors: Gallo
authors: R
authors: R
authors: Fernando
authors: V
authors: V
authors: Khullar
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000652:urine; D002506:Cephalexin / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D015331:Cohort Studies; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D020932:Nerve Growth Factor / Q000652:urine*; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000652:urine
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002939:Ciprofloxacin; D020932:Nerve Growth Factor; D004318:Doxycycline; D002506:Cephalexin
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