Uronate Peaks and Urinary Hyaluronic Acid Levels Correlate With Interstitial Cystitis Severity

Vinata B. Lokeshwar, Marie G. Selzer, Darius J. Unwala, Veronica Estrella, Maria Fernanda Lorenzo Gomez, Roozbeh Golshani, Robert R. Kester, David J. Klumpp, Angelo E. Gousse

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: Levels of uronate, a basic component of urothelial glycosaminoglycans, are increased in urine specimens of patients with interstitial cystitis with severe symptoms. In this study we examined the urinary glycosaminoglycan profile and correlated the profile and urinary hyaluronic acid (a glycosaminoglycan) levels with symptom severity. Materials and Methods: Urine specimens and completed O'Leary-Sant interstitial cystitis symptom and problem indexes questionnaires were obtained from 29 patients with interstitial cystitis, 14 normal individuals, and 14 patients with other benign pelvic and bladder conditions. Patients with interstitial cystitis were divided into group 1-1 or both indexes less than 50% maximum score, and group 2-both indexes 50% of maximum score or greater. All patients met the National Institutes of Diabetes and Digestive and Kidney Diseases criteria except regarding glomerulation. In a followup study 30 urine specimens were collected from 8 patients with interstitial cystitis and from 4 normal individuals during 12 months. The urinary glycosaminoglycan profile was determined by gel filtration chromatography. Glycosaminoglycan peaks were analyzed by polyacrylamide gel electrophoresis. Urinary hyaluronic acid levels were determined by the hyaluronic acid test. Results: Group 2 urine specimens contained 3 uronate peaks, whereas urine specimens from normal individuals and patients in group 1 contained 1 or 2 peaks. Peak 1 consisted of macromolecular glycosaminoglycans whereas peaks 2 and 3 contained oligosaccharides. Urinary hyaluronic acid levels were 3 to 4-fold increased in group 2. Glycosaminoglycan profile and hyaluronic acid levels detected interstitial cystitis severity with 83% sensitivity, and 89.7% and 74.4% specificity, respectively. Interstitial cystitis urothelial cells/tissues also over expressed hyaluronic acid synthase 1 (which synthesizes hyaluronic acid) compared to normal urothelial cells/tissues. In the followup study urinary uronate levels, glycosaminoglycan profile and hyaluronic acid levels detected patients with severe symptoms with 73% sensitivity and 87% to 94% specificity. In both studies uronate, glycosaminoglycan profile and hyaluronic acid levels significantly correlated with interstitial cystitis severity (p <0.001). Conclusions: Urinary glycosaminoglycan profile, uronate content and hyaluronic acid levels are potentially useful markers for monitoring interstitial cystitis severity, and are likely to be involved in interstitial cystitis pathophysiology.

Original languageEnglish
Pages (from-to)1001-1007
Number of pages7
JournalJournal of Urology
Volume176
Issue number3
DOIs
StatePublished - Sep 1 2006
Externally publishedYes

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Interstitial Cystitis
Hyaluronic Acid
Glycosaminoglycans
Urine
National Institute of Diabetes and Digestive and Kidney Diseases (U.S.)
Oligosaccharides
Gel Chromatography
Polyacrylamide Gel Electrophoresis
Urinary Bladder

Keywords

  • biological markers
  • cystitis
  • glycosaminoglycans
  • health status indicators
  • hyaluronic acid
  • interstitial

ASJC Scopus subject areas

  • Urology

Cite this

Lokeshwar, V. B., Selzer, M. G., Unwala, D. J., Estrella, V., Gomez, M. F. L., Golshani, R., ... Gousse, A. E. (2006). Uronate Peaks and Urinary Hyaluronic Acid Levels Correlate With Interstitial Cystitis Severity. Journal of Urology, 176(3), 1001-1007. https://doi.org/10.1016/j.juro.2006.04.012

Uronate Peaks and Urinary Hyaluronic Acid Levels Correlate With Interstitial Cystitis Severity. / Lokeshwar, Vinata B.; Selzer, Marie G.; Unwala, Darius J.; Estrella, Veronica; Gomez, Maria Fernanda Lorenzo; Golshani, Roozbeh; Kester, Robert R.; Klumpp, David J.; Gousse, Angelo E.

In: Journal of Urology, Vol. 176, No. 3, 01.09.2006, p. 1001-1007.

Research output: Contribution to journalArticle

Lokeshwar, VB, Selzer, MG, Unwala, DJ, Estrella, V, Gomez, MFL, Golshani, R, Kester, RR, Klumpp, DJ & Gousse, AE 2006, 'Uronate Peaks and Urinary Hyaluronic Acid Levels Correlate With Interstitial Cystitis Severity', Journal of Urology, vol. 176, no. 3, pp. 1001-1007. https://doi.org/10.1016/j.juro.2006.04.012
Lokeshwar VB, Selzer MG, Unwala DJ, Estrella V, Gomez MFL, Golshani R et al. Uronate Peaks and Urinary Hyaluronic Acid Levels Correlate With Interstitial Cystitis Severity. Journal of Urology. 2006 Sep 1;176(3):1001-1007. https://doi.org/10.1016/j.juro.2006.04.012
Lokeshwar, Vinata B. ; Selzer, Marie G. ; Unwala, Darius J. ; Estrella, Veronica ; Gomez, Maria Fernanda Lorenzo ; Golshani, Roozbeh ; Kester, Robert R. ; Klumpp, David J. ; Gousse, Angelo E. / Uronate Peaks and Urinary Hyaluronic Acid Levels Correlate With Interstitial Cystitis Severity. In: Journal of Urology. 2006 ; Vol. 176, No. 3. pp. 1001-1007.
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abstract = "Purpose: Levels of uronate, a basic component of urothelial glycosaminoglycans, are increased in urine specimens of patients with interstitial cystitis with severe symptoms. In this study we examined the urinary glycosaminoglycan profile and correlated the profile and urinary hyaluronic acid (a glycosaminoglycan) levels with symptom severity. Materials and Methods: Urine specimens and completed O'Leary-Sant interstitial cystitis symptom and problem indexes questionnaires were obtained from 29 patients with interstitial cystitis, 14 normal individuals, and 14 patients with other benign pelvic and bladder conditions. Patients with interstitial cystitis were divided into group 1-1 or both indexes less than 50{\%} maximum score, and group 2-both indexes 50{\%} of maximum score or greater. All patients met the National Institutes of Diabetes and Digestive and Kidney Diseases criteria except regarding glomerulation. In a followup study 30 urine specimens were collected from 8 patients with interstitial cystitis and from 4 normal individuals during 12 months. The urinary glycosaminoglycan profile was determined by gel filtration chromatography. Glycosaminoglycan peaks were analyzed by polyacrylamide gel electrophoresis. Urinary hyaluronic acid levels were determined by the hyaluronic acid test. Results: Group 2 urine specimens contained 3 uronate peaks, whereas urine specimens from normal individuals and patients in group 1 contained 1 or 2 peaks. Peak 1 consisted of macromolecular glycosaminoglycans whereas peaks 2 and 3 contained oligosaccharides. Urinary hyaluronic acid levels were 3 to 4-fold increased in group 2. Glycosaminoglycan profile and hyaluronic acid levels detected interstitial cystitis severity with 83{\%} sensitivity, and 89.7{\%} and 74.4{\%} specificity, respectively. Interstitial cystitis urothelial cells/tissues also over expressed hyaluronic acid synthase 1 (which synthesizes hyaluronic acid) compared to normal urothelial cells/tissues. In the followup study urinary uronate levels, glycosaminoglycan profile and hyaluronic acid levels detected patients with severe symptoms with 73{\%} sensitivity and 87{\%} to 94{\%} specificity. In both studies uronate, glycosaminoglycan profile and hyaluronic acid levels significantly correlated with interstitial cystitis severity (p <0.001). Conclusions: Urinary glycosaminoglycan profile, uronate content and hyaluronic acid levels are potentially useful markers for monitoring interstitial cystitis severity, and are likely to be involved in interstitial cystitis pathophysiology.",
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AU - Selzer, Marie G.

AU - Unwala, Darius J.

AU - Estrella, Veronica

AU - Gomez, Maria Fernanda Lorenzo

AU - Golshani, Roozbeh

AU - Kester, Robert R.

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AU - Gousse, Angelo E.

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N2 - Purpose: Levels of uronate, a basic component of urothelial glycosaminoglycans, are increased in urine specimens of patients with interstitial cystitis with severe symptoms. In this study we examined the urinary glycosaminoglycan profile and correlated the profile and urinary hyaluronic acid (a glycosaminoglycan) levels with symptom severity. Materials and Methods: Urine specimens and completed O'Leary-Sant interstitial cystitis symptom and problem indexes questionnaires were obtained from 29 patients with interstitial cystitis, 14 normal individuals, and 14 patients with other benign pelvic and bladder conditions. Patients with interstitial cystitis were divided into group 1-1 or both indexes less than 50% maximum score, and group 2-both indexes 50% of maximum score or greater. All patients met the National Institutes of Diabetes and Digestive and Kidney Diseases criteria except regarding glomerulation. In a followup study 30 urine specimens were collected from 8 patients with interstitial cystitis and from 4 normal individuals during 12 months. The urinary glycosaminoglycan profile was determined by gel filtration chromatography. Glycosaminoglycan peaks were analyzed by polyacrylamide gel electrophoresis. Urinary hyaluronic acid levels were determined by the hyaluronic acid test. Results: Group 2 urine specimens contained 3 uronate peaks, whereas urine specimens from normal individuals and patients in group 1 contained 1 or 2 peaks. Peak 1 consisted of macromolecular glycosaminoglycans whereas peaks 2 and 3 contained oligosaccharides. Urinary hyaluronic acid levels were 3 to 4-fold increased in group 2. Glycosaminoglycan profile and hyaluronic acid levels detected interstitial cystitis severity with 83% sensitivity, and 89.7% and 74.4% specificity, respectively. Interstitial cystitis urothelial cells/tissues also over expressed hyaluronic acid synthase 1 (which synthesizes hyaluronic acid) compared to normal urothelial cells/tissues. In the followup study urinary uronate levels, glycosaminoglycan profile and hyaluronic acid levels detected patients with severe symptoms with 73% sensitivity and 87% to 94% specificity. In both studies uronate, glycosaminoglycan profile and hyaluronic acid levels significantly correlated with interstitial cystitis severity (p <0.001). Conclusions: Urinary glycosaminoglycan profile, uronate content and hyaluronic acid levels are potentially useful markers for monitoring interstitial cystitis severity, and are likely to be involved in interstitial cystitis pathophysiology.

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