Abstract
Trial registration. ClinicalTrials.gov identifier: NCT01098279 "Chronic Pelvic Pain Study of Individuals with Diagnoses or Symptoms of Interstitial Cystitis and/or Chronic Prostatitis (MAPP-EP)".
Urologic chronic pelvic pain syndrome (UCPPS) may be defined to include interstitial cystitis/bladder pain syndrome (IC/BPS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The hallmark symptom of UCPPS is chronic pain in the pelvis, urogenital floor, or external genitalia often accompanied by lower urinary tract symptoms. Despite numerous past basic and clinical research studies there is no broadly identifiable organ-specific pathology or understanding of etiology or risk factors for UCPPS, and diagnosis relies primarily on patient reported symptoms. In addition, there are no generally effective therapies. Recent findings have, however, revealed associations between UCPPS and "centralized" chronic pain disorders, suggesting UCPPS may represent a local manifestation of more widespread pathology in some patients. Here, we describe a new and novel effort initiated by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the U.S. National Institutes of Health (NIH) to address the many long standing questions regarding UCPPS, the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. The MAPP Network approaches UCPPS in a systemic manner, in which the interplay between the genitourinary system and other physiological systems is emphasized. The network's study design expands beyond previous research, which has primarily focused on urologic organs and tissues, to utilize integrated approaches to define patient phenotypes, identify clinically-relevant subgroups, and better understand treated natural history and pathophysiology. Thus, the MAPP Network provides an unprecedented, multi-layered characterization of UCPPS. Knowledge gained is expected to provide important insights into underlying pathophysiology, a foundation for better segmenting patients for future clinical trials, and ultimately translation into improved clinical management. In addition, the MAPP Network's integrated multi-disciplinary research approach may serve as a model for studies of urologic and non-urologic disorders that have proven refractory to past basic and clinical study.
Original language | English (US) |
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Article number | 57 |
Journal | BMC Urology |
Volume | 14 |
Issue number | 1 |
DOIs | |
State | Published - Aug 1 2014 |
Funding
JQ Clemens, C Mullins, JW Kusek, Z Kirkali, EA Mayer, LV Rodriguez, AJ Schaeffer, D Buchwald, and JR Landis declare no competing interests. DJ Klumpp declares ownership and equity interests in ProbioTx Inc, and Gold Coast Therapeutics Inc. KJ Kreder is a Consultant for Medtronic, Astellas, Symptelligence, and Tengion. GL Andriole is a Consultant for Augmenix, Bayer, Genomic Health, GlaxoSmithKline and Myriad Genetics and has received research grants from Johnson & Johnson, Medivation and Wilex. MS Lucia declares ownership of 3D Biopsy and has consulted for Myriad Genetics and Bayer Healthcare. DJ Clauw has received grants from Pfizer, Cerephex, Lilly, Merck, Nuvo and Furest, and Consulting Fees and Honoraria from Pfizer, Cerephex, Lilly, Merck, Nuvo, Furest, Tonix, Purdue, Therauance, and Johnson & Johnson. Numerous studies have been conducted over the past two decades to define the pathophysiology and natural history of UCPPS and to examine the efficacy of therapies. Many of those studies were supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the U.S. National Institutes of Health (NIH). The first NIDDK-sponsored pelvic pain clinical research network, the Interstitial Cystitis Database study (ICDB) was initiated in 1991 [3]. This five-year prospective cohort The MAPP Research Network acknowledges support through NIH grants: U01 DK82315, U01 DK82316, U01 DK82325, U01 DK82333, U01 DK82342, U01 DK82344, U01 DK82345, and U01 DK82370. The NIDDK and MAPP Network investigators wish to thank the Interstitial Cystitis Association (ICA) and the Prostatitis Foundation (PF) for their assistance in study participant recruitment and other network efforts. We thank the participants and staff from the following sites that participated in the study: Northwestern University; University of California, Los Angeles; University of Iowa; Washington University, St. Louis; University of Washington, Seattle; University of Michigan; University of Pennsylvania (Data Coordinating Core); University of Colorado Denver (Tissue Analysis & Technology Core); Stanford University; NIDDK. This article outlines independent research commissioned by the National Institute for Health (NIH). The views expressed in this article are those of the author(s) and are not necessarily those of the NIH, the NIDDK, or the Department of Health and Human Services (DHHS).
Keywords
- Chronic prostatitis
- Interstitial cystitis
- Multi-disciplinary
- Translational research
- Urological chronic pelvic pain syndromes
ASJC Scopus subject areas
- Reproductive Medicine
- Urology