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Query: UNIPROT:P15088 (mast cell)
 14,925 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eight women with severe intractable interstitial cystitis were treated with supratrigonal cystectomy and Mainz ileocecocystoplasty. The preoperative evaluation consisted of symptom analysis, cystometry, cystoscopy and bladder pathological findings. Seven patients had increased mast cell density. Median followup was 10 months. The symptoms resolved in 2 patients but recurred in 6 shortly after the operation. Voiding could not be established in 4 patients. Self-catheterization was difficult and painful. Ultimately, cystectomy and urinary diversion were performed in 5 patients and is scheduled in 1. The 2 cured patients had a small contracted bladder preoperatively while they were under anesthesia, while all 6 failed cases had a large bladder capacity. Postoperative biopsies from the trigone showed no difference in the amount of fibrosis, the degree of degenerative changes in the muscle and mast cell density between the 2 cured patients and the 6 who failed to improve. The mast cell density and the histological status of the trigone cannot be used as predictors of the outcome of supratrigonal cystectomy. The role of the mast cells in interstitial cystitis is reviewed. Combination of supratrigonal cystectomy and a Mainz augmentation cystoplasty cannot be recommended in patients with intractable interstitial cystitis and a large bladder capacity.
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PMID:Failure of combined supratrigonal cystectomy and Mainz ileocecocystoplasty in intractable interstitial cystitis: is histology and mast cell count a reliable predictor for the outcome of surgery? 237 89

Painful bladder disease, sensory bladder disease, chronic abacterial cystitis and interstitial cystitis are ill-defined conditions of unknown etiology and pathogenesis, and, therefore, they are without any rational therapy. Pathogenetic theories concerning defects in the epithelium and/or mucous surface coat (including glycosaminoglycans) of the bladder, and theories concerning immunological disturbances predominate. Sodium pentosanpolysulfate (Elmiron) acts by substituting a defective glycosaminoglycan layer and inhibits complement reactions in inflammatory processes. We compared sodium pentosanpolysulfate versus placebo in a prospective double-blind, clinically controlled multicenter trial of 115 patients with painful bladder disease. Two protocols were used. Protocol A included 43 patients with clinically and pathologically anatomically verified interstitial cystitis (28 or more mast cells per mm.2), and protocol B included 72 patients with a painful bladder and unspecific histological findings. The patients were randomized to receive either sodium pentosanpolysulfate (200 mg. twice daily) or placebo capsules for 4 months. Before and after the trial the patients were evaluated with symptom grading, urodynamics and cystoscopy with distension and deep bladder biopsies. The results showed no difference between the pre-trial and post-trial values in the sodium pentosanpolysulfate and placebo groups in both protocols in regard to symptoms, urodynamic parameters, cystoscopic appearance and mast cell counts. A significant increase in the cystoscopically determined bladder capacity in the sodium pentosanpolysulfate group in protocol A was found. We conclude that no statistically or clinically significant effect of sodium pentosanpolysulfate was found compared to placebo in patients with painful bladder disease.
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PMID:A prospective double-blind clinically controlled multicenter trial of sodium pentosanpolysulfate in the treatment of interstitial cystitis and related painful bladder disease. 244 15

Painful bladder disease is an ill-defined disease presenting with chronic cystitis symptoms, despite sterile urine. This report includes only patients with painful bladder diseases of unknown etiology and pathogenesis. We have chosen to classify these patients pathoanatomically as follows: interstitial cystitis, detrusor myopathy, chronic unspecific cystitis and eosinophilic cystitis. The pathoanatomical appearance of the four groups of patients are described in details and certain clinical differences appear between the groups. The etiology and pathogenesis to the inflammatory reactions and muscle changes found in the detrusor biopsies are unknown, but many theories exist. It is suggested that something in the urine gains access to the bladder wall and initiates the pathoanatomical changes through a defective urothelium and glycosaminoglycans layer. In the interstitial cystitis patients, the inflammatory process and mast cell degranulation might be monitored by the urinary excretion of 1,4-methyl-imidazole-acetic acid and eosinophil cationic protein. It is concluded that no specific therapy for the disease exists, since etiology and pathogenesis are still unknown and therefore future research in this field is very important.
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PMID:Pathology and pathophysiology of painful bladder diseases. 262 83

Interstitial cystitis (IC) is a chronic inflammatory disorder of the urinary bladder of unknown aetiology and pathogenesis. The classic form (Hunner's ulcer) is characterized by high mast cell numbers in the detrusor muscle and an expansion of mucosal mast cells in the lamina propria and also in the epithelium. Such cells can be recovered in bladder washings and in the urine in single cell suspensions. We have counted the mast cells and measured the histamine in bladder washings from 16 patients with classic IC and from a control group of 15 patients with so-called early, non-ulcerative IC. The bladder washings from all patients with classic IC contained well preserved mast cells (median 2.16, range 0.5-8.6 x 10(3) cells/I) and histamine (median 14.3, range 6-66 ng/l), while only occasional mast cells and traces of histamine were found in washings from patients with non-ulcerative IC. The histamine content was strongly correlated to the number of mast cells (r = 0.87). The mean histamine content per mast cell was estimated at 7.6 +/- 0.65 (SEM) pg/cell. The high histamine content per mast cell in relation to previously published data (2.8-4.6 pg/cell) can be attributed to the mild and rapid handling of the specimens.
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PMID:Histamine and mucosal mast cells in interstitial cystitis. 275 May 82

A prospective study was designed to examine the relationship of mast cells, and eosinophilic leukocyte density and mediator levels to clinical and histological parameters of interstitial cystitis. Interstitial cystitis and control patients underwent bladder biopsy with histological examination, and quantification of intact and degranulated mast cell and eosinophilic leukocyte density. In addition, bladder tissue histamine content, urinary prostaglandin E2 excretion rates, and serum and urinary major basic protein levels were determined. A strong relationship among detrusor mast cell density, especially degranulated, and degree of epithelial loss, submucosal inflammation, epithelial ulceration, urinary pyuria and response to treatment was noted. Bladder tissue histamine content and urinary prostaglandin E2 excretion were increased in the interstitial cystitis patients. Eosinophil density in bladder biopsies was low uniformly, and interstitial cystitis and control patients showed no statistical difference. In addition, serum and urinary major basic protein levels were below the accepted normal lower limits for this protein. Therefore, our study demonstrates a relationship between the mast cell and the inflammatory process of interstitial cystitis. No similar relationship was noted for the eosinophil.
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PMID:Mast cell involvement in interstitial cystitis. 347 49

The patient was a 46-year-old man. His chief complaints were urinary frequency and pain on urination. They first appeared one year earlier. The patient had had a history of bronchial asthma and urticaria. Vesical capacity decreased and vesico-cutaneous developed. The urine sediment contained eosinophils and vesico ureteral reflux was observed. The bladder tissues contained a moderate amount of eosinophils, lymphocytes and plasma cells. The total IgE was 360 IU/ml. The IgE RAST score and immediate reaction to the skin tests were all negative. The Arthus and delayed-type reaction skin tests were positive to various Eumycetees and foods. Provocation tests by eating foods such as eggs, meats, and shellfish reproduced the above-mentioned bladder disorders. The patient was therefore put on a diet that restricted the amount of animal protein consumed except for white meat fishes, and a mast cell membrane stabilizer was administered. The interstitial cystitis improved but the asthma aggravated. The cystitis was found to develop alternately with asthma.
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PMID:[A case of interstitial cystitis that developed alternately with bronchial asthma]. 357 70

The diagnostic criteria for interstitial cystitis considered as a subgroup of painful bladder disease (that is sensory bladder disease and chronic abacterial cystitis) are not well established. Some urologists rely on symptoms, while others rely on cystoscopic appearance or pathological findings. Among 115 patients with painful bladder disease we compared symptoms, and cystoscopic and urodynamic findings in those with and without detrusor mastocytosis (28 or more mast cells per mm.2) and attempted to elucidate possible differences between the groups. We chose the pathological anatomical criterion of detrusor mastocytosis to be diagnostic for interstitial cystitis. A total of 43 patients had detrusor mastocytosis and other pathological anatomical signs of interstitial cystitis, and 72 had no mastocytosis but the pathological diagnoses of chronic unspecific cystitis, fibrosis of the bladder, detrusor myopathy, intestinal metaplasia and normal findings. When the 2 groups of patients were compared we found no differences in regard to symptoms (pain, dysuria, frequency, nocturia and urgency), frequency of allergy and hysterectomy, duration of symptoms, petechial bleeding during cystoscopy with bladder distension and cystometric findings. The patients with mastocytosis differed from those without mastocytosis in that they were older, and had a higher frequency of hematuria, a higher frequency of a red, scarred and richly vascularized bladder at cystoscopy before distension, and a smaller cystoscopic bladder capacity. We conclude that by dividing patients with painful bladder into 2 groups according to the mast cell counts in the detrusor, certain differences in the clinical findings in the groups can be ruled out. However, in individual patients one cannot note with certainty to which pathological anatomical group the patient belongs, since great overlapping between the groups exists. Whether only patients with detrusor mastocytosis have interstitial cystitis depends on definitions and still remains an open question.
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PMID:Painful bladder disease: clinical and pathoanatomical differences in 115 patients. 362 48

The distribution and abundance of mast cells, as well as their fixation, staining and ultrastructural properties, were studied in the urinary bladders of 16 patients with interstitial cystitis (IC) and in 14 normal subjects. Tissues were fixed in both standard formaldehyde solution and a special fixative, IFAA, optimized for the preservation of mucosal mast cells. An expansion of two distinct mast cell populations was observed in IC. One of these, comprising formaldehyde-sensitive cells, was found only in the mucosa underlying lesions of IC. They were most numerous in the lamina propria but were also frequent in the epithelial layer as well as in the bladder washings, indicating a migratory capacity for these cells. The other mast cell population was visualized equally well irrespective of fixation and staining procedure. In control subjects, such cells were found both in the lamina propria and detrusor muscle, but not in the epithelium nor in bladder washings. In lesions of IC they were increased in the detrusor muscle only. Both types of mast cell contained granules with the highly characteristic lamellar arrays and scrolls, distinguishing human mast cell granules from those of blood basophils. The proliferation and intraepithelial distribution of mucosal mast cells are unusual findings, but prominent features of helminth responses and human mucosal allergic reactions. These findings thus suggest that the mucosal mast cell-IgE system may be involved in the pathogenesis and/or aetiology of IC.
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PMID:Proliferation and transepithelial migration of mucosal mast cells in interstitial cystitis. 373 46

A series of 28 patients with interstitial cystitis and 14 healthy volunteers were studied. We found marked histopathological differences between classic (ulcerative) interstitial cystitis and early (nonulcerative) interstitial cystitis. The bladder mucosa of patients with classic disease exhibited focal ulceration, edema and perineural-perivascular infiltrates. There was a marked increase in 2 distinct mast cell populations. Mast cells increased in the detrusor muscle and mucosa. Mucosal mast cells, unlike those in the muscular coat, are susceptible to aldehyde fixation, and require special fixation and staining techniques for proper demonstration. These cells were numerous in the epithelium and were recovered in bladder washings, consistent with the finding that they have a migratory capacity. In nonulcerative interstitial cystitis all signs of mast cell activation were absent, and the histopathological changes were few and fairly uncharacteristic. We also observed some marked clinical differences between ulcerative and nonulcerative interstitial cystitis. These 2 conditions appear to represent separate entities and should be evaluated separately in clinical studies.
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PMID:Chronic interstitial cystitis: a heterogeneous syndrome. 379 63

The quantitative mast cell count in the detrusor muscle, the histamine content and the degree of collagen staining material in the bladder wall have been evaluated in order to elucidate their value in distinguishing between patients with interstitial cystitis and other types of chronic cystitis. The number of mast cells in the detrusor muscle was statistically significantly increased in patients with interstitial cystitis compared with the control group (P less than 0.0001). With a proposed level of greater than 20 mast cells/sq mm of muscle tissue the diagnostic specificity was 88% and the diagnostic sensitivity 95%. The histamine content in the bladder wall was significantly increased in patients with interstitial cystitis (P less than 0.05) but not useful as a diagnostic test. The amount of collagen staining material was significantly increased in the intra- and inter-fascicular muscle tissue of the bladder in patients with interstitial cystitis (P less than 0.0005, P less than 0.001) and might be used as a support for the histological diagnosis, even in patients with uncontracted bladders.
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PMID:Histamine content and mast cell count of detrusor muscle in patients with interstitial cystitis and other types of chronic cystitis. 662 95


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