Elevated Urine Levels of Macrophage Migration Inhibitory Factor in Inflammatory Bladder Conditions: a Potential Biomarker for a Subgroup of Interstitial Cystitis/Bladder Pain Syndrome Patients

(1) Objectives: To investigate whether urinary levels of macrophage migration inhibitory factor (MIF) are elevated in Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) patients with Hunner lesions and also whether urine MIF is elevated in other forms of inflammatory cystitis. (2) Methods: Urine samples were assayed for MIF by ELISA. Urine samples from three female groups were examined: IC/BPS patients without (N=55) and with Hunner lesions (N=43); Non-IC/BPS patients (N=100; control group; no history of IC/BPS; cancer or recent bacterial cystitis). Urine samples from three male groups were examined: patients with bacterial cystitis (N=50), radiation cystitis (N=18) and non-cystitis patients (N = 119; control group; negative for bacterial cystitis). (3) Results: Urine MIF (Mean MIF pg/ml ± SEM) was increased in female IC/BPS patients with Hunner lesions (2159 ± 435.3) compared to IC/BPS patients without Hunner lesions (460 ± 114.5) or non- IC/BPS patients (414 ± 47.6). Receiver-operating curve analyses showed that urine MIF levels discriminated between the two IC groups (AUC = 72%; CI: 61-82%). Male patients with bacterial and radiation cystitis had elevated urine MIF levels (2839 ± 757.1 and 4404 ± 1548.1; respectively) compared to non-cystitis patients (681 ± 75.2). (4) Conclusions: Urine MIF is elevated in IC/BPS patients with Hunner lesions and also in patients with other bladder inflammatory and painful conditions. MIF also may serve as a noninvasive biomarker to select IC/BPS patients more accurately for endoscopic evaluation and possible anti-inflammatory treatment.

Urology. 2018 Mar 23 [Epub ahead of print]

Pedro L Vera, David M Preston, Robert M Moldwin, Deborah R Erickson, Behzad Mowlazadeh, Fei Ma, Dimitrios E Kouzoukas, Katherine L Meyer-Siegler, Magnus Fall

Lexington VA Medical Center, Lexington, Kentucky, United States; Department of Physiology, University of Kentucky, Lexington, Kentucky, United States; Department of Surgery, University of Kentucky, Lexington, Kentucky, United States. Electronic address: ., Lexington VA Medical Center, Lexington, Kentucky, United States; Department of Urology, University of Kentucky, Lexington, Kentucky, United States., The Arthur Smith Institute for Urology, Zucker School of Medicine at Hofstra-Northwell, Lake Success, New York, United States., Department of Urology, University of Kentucky, Lexington, Kentucky, United States., The Bay Pines VA Healthcare System, Bay Pines, Florida., Lexington VA Medical Center, Lexington, Kentucky, United States; Department of Physiology, University of Kentucky, Lexington, Kentucky, United States., Lexington VA Medical Center, Lexington, Kentucky, United States; Saha Cardiovascular Research Center, University of Kentucky, Lexington, Kentucky, United States., Department of Natural Sciences, St. Petersburg College, St Petersburg, Florida, United States; The Bay Pines VA Healthcare System, Bay Pines, Florida., Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.

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