2024-03-06 21:01:51
Lead author Dr. Soman Abraham, professor of pathology, molecular genetics and microbiology, integrative immunobiology and cell biology at Duke, recalls that “urinary tract infections account for nearly 25% of infections in women “. Pain is common, long after a UTI has passed, and is a confusing problem, making many patients doubt even the effectiveness of treatment.
“Many of these infections are recurrent, with patients frequently complaining of frequent chronic pelvic pain, even after antibiotic treatment. Our study, for the first time, describes an underlying cause and identifies a new treatment strategy.” This symptom indeed finds its explanation here.
An overgrowth of nerve cells in the bladder
The study: Researchers collected bladder biopsies from patients with recurrent UTIs who experienced pain despite the absence of bacteria in the urine and biopsies from people without UTIs. This analysis identifies:
- evidence that sensory nerves are highly activated in patients with urinary tract infection, explaining the persistent sensation of pain and urinary frequency.
- The researchers then decipher the biological events underlying this hyperactivation of the mucosal nerves during each infection in mice:
- during each episode of urinary infection, the epithelial cells loaded with bacteria are eliminated and significant destruction of the neighboring nervous tissue occurs;
- a rapid repair program for the damaged bladder is triggered, involving massive regrowth of destroyed nerve cells;
- this immune response, including repair activity, is directed by mast cells, which are immune cells that fight infections and allergens. These mast cells release nerve growth factors, which cause excessive proliferation and increase nerve sensitivity.
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The result is pain and urgency.
What treatment is possible? The researchers managed to treat these symptoms in the study mice with molecules that suppress the production of nerve growth factor generated by mast cells.
Understanding the interactions between mast cells and nerves was an essential key to effective treatments for people suffering from repeated urinary tract infections. The study thus reveals an explanation for this post-urinary infection pain as well as a treatment to eliminate it.
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