Epstein-Barr Virus Presence As A Potential Etiology of Persistent Bladder Inflammation in Human Interstitial Cystitis/Bladder Pain Syndrome

Interstitial cystitis/bladder pain syndrome is characterized by bladder inflammation without a bacterial infection. Although viral infection is a potential etiologic cause, few studies are reported.

Bladder specimens were obtained from patients with interstitial cystitis/bladder pain syndrome and patients with stress urinary incontinence (control). Bladder specimens were tested for Epstein-Barr-encoded RNAs by in situ hybridization, Epstein-Barr DNA by quantitative real-time polymerase chain reaction (qPCR), serology, and immunohistochemical staining.

Sixteen patients with interstitial cystitis/bladder pain syndrome and Hunner lesions (HIC), 23 without lesions (NHIC), and 10 controls were enrolled. The Epstein-Barr-encoded RNA by in situ hybridization positive rate in HIC and NHIC bladder specimens was 50% and 8.6%, respectively, while none was found in control specimens. Epstein-Barr DNA by qPCR was detected in 68.8% of HIC and 16.7% of NHIC bladder specimens (medium viral load: 1836 copies/mL, range: 216-75144 copies/mL). Only one control specimen was Epstein-Barr positive in qPCR. All sera from interstitial cystitis/bladder pain syndrome patients showed past Epstein-Barr viral infection. Epstein-Barr infection was present in 87.5% of bladder specimens from HIC patients and in 17.4% of specimens from NHIC patients (total interstitial cystitis/bladder pain syndrome: 46.2%). Immunohistochemical staining of CD3 and CD20 revealed that Epstein-Barr infection was mainly restricted to T lymphocytes of interstitial cystitis/bladder pain syndrome bladders.

Bladder EBV infection in T cells may be linked to the pathogenesis of persistent inflammation in patients with interstitial cystitis/bladder pain syndrome.

The Journal of urology. 2018 Apr 10 [Epub ahead of print]

Jia-Fong Jhang, Yung-Hsiang Hsu, Chih-Wen Peng, Yuan-Hong Jiang, Han-Chen Ho, Hann-Chorng Kuo

Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan., Department of Pathology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan., Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan; Department of Life Sciences, Tzu Chi University., Department of Anatomy, Tzu Chi University, Hualien, Taiwan., Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan. Electronic address: .

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