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Cystitis

Doctors still don't know what causes interstitial cystitis, so medical detectives continue to search for clues. A few years ago, researchers from the University of Maryland School of Medicine discovered in a lab study that urine from women with interstitial cystitis tends to prevent normal cells from the lining of the bladder (epithelial cells) from multiplying. This does not happen in healthy women or even in those with bladder infections. Because damage to the lining of the bladder is one of the important findings in interstitial cystitis, the researchers wanted to find out more.

In a recent study, the same researchers tested urine taken during catheterization from 20 women with interstitial cystitis, and one woman without bladder disease as a control. This time, they took urine from the bladder and from the renal pelvis, which is where urine drains from the kidney to the ureter before going to the bladder. They wanted to know if the urine that kept epithelial cells from reproducing came from the bladder end of the system or from closer to the kidney.

In 19 out of 20 samples, bladder urine kept epithelial cells from multiplying. Only one sample of urine from the renal pelvis did this, so the researchers concluded that the "factor" that causes this anti-proliferative activity is either made in the bladder or activated there. For example, this substance could be all over the urinary system but just have higher concentrations in the bladder, it could be produced in the bladder somehow, or it could be produced elsewhere and become active when it gets to the bladder.

The researchers are hoping that whatever it is in the urine of women with interstitial cystitis that prevents normal epithelial cells from reproducing in the laboratory, it will help to explain what causes the disorder in the first place. If this factor keeps epithelial cells from repairing the bladder, perhaps it's responsible for the bladder damage that's seen in patients with interstitial cystitis -there will be no way to find out until the research is extended to animals. But so far at least, these medical detectives have provided evidence to support the idea that this process discovered in the lab is somehow linked to this painful, but perplexing condition.