Interstitial Cystitis/Bladder Pain Syndrome Linked to EBV

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Nearly 50% of patients with Interstitial Cystitis/Bladder Pain Syndrome have evidence of Epstein-Barr virus infection, investigators reported.
Nearly 50% of patients with Interstitial Cystitis/Bladder Pain Syndrome have evidence of Epstein-Barr virus infection, investigators reported.

Bladder infection with Epstein-Barr virus (EBV) may have a causative role in interstitial cystitis/bladder pain syndrome (IC/BPS), investigators reported.

Jia-Fong Jhang, MD, of Buddhist Tzu Chi General Hospital and Tzu Chi University, and colleagues tested for EBV encoded RNA and EBV DNA using bladder specimens from 16 patients with IC/BPS and Hunner lesions (HIC), 23 without HIC, and 10 controls (patients with stress urinary incontinence). The positive rate of EBV encoded RNA, measured using in situ hybridization, was higher among bladder specimens from patients with HIC than in those without HIC (50% vs 8.6%), Dr Jhang and colleagues reported in The Journal of Urology. They found no EBV encoded RNA in control specimens.

Using quantitative real-time polymerase chain reaction, the investigators detected EBV DNA  68.8% of bladder specimens with HIC compared with 16.7% of bladder specimens from patients without HIC and only 1 control specimen.

Serum EBV antibody analysis revealed past infection all patients with HIC, the investigators reported. EBV infection was present in 87.5% vs 17.4% of bladder specimens from patients with vs without HIC.

Results of the various assays collectively showed that 46% of patients with HIC showed evidence of EBV infection.

Immunohistochemical staining of CD3 and CD20 showed that EBV infection as mainly restricted to T lymphocytes in bladders showing IC/BPS, the investigators reported.

The authors noted that IC/BPS is characterized by bladder inflammation without bacterial infection. Studies have provided immunochemical and histopathologic evidence demonstrating that inflammation has a role in the pathogenesis of IC/BPS, they stated. Viral infection is a possible cause, but few studies looking at a relationship between viral infection and IC/BPS have been reported, according to the investigators.

Reference

Jhang JF, Hsu YH, Peng CW, et al. Epstein-Barr virus as a potential etiology of persistent bladder inflammation in human interstitial cystitic/bladder pain syndrome. J Urol. 2018;200:590-596.

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