Impact of intravesical hyaluronic acid treatment on bladder inflammation in interstitial cystitis rat model

Abstract

Objective:To evaluate the effect of intravesical hyaluronic acid (HA) treatment on inflammatory cells and the severity of inflammation in an interstitial cystitis rat model created with hydrogen chloride (HCL) via immunohistochemical studies and myeloperoxidase activity for the first time in the literature.Materials and Methods:A total of 30 adult female white Rattus Norvegicus rats were divided into 3 groups as the HCL group, hyaluronic acid treatment (HCL-HA) group and control group. Chemical cystitis was created by administering HCL(400 microL,10 mM) except control group. A single dose of intravesical HA(0.5 mL,0.8 mg/mL) was administered to the treatment group. The bladder tissues of all subjects were immunohistochemically stained. The cell surface markers were used to evaluate inflammatory cell infiltration. Mast cell activation and IL-6 was evaluated to assess the inflammation and severity of inflammation, respectively. Myeloperoxidase activity was measured as it shows neutrophil density. Statistical significance was accepted as P<0.05.Results:It was observed that there was rich monocyte, T lymphocyte, B lymphocyte, and Natural Killer cells infiltration and high IL-6 levels in the bladder tissue after the intravesical hydrogen chloride instillation, especially in the stroma layer(p<0.005). In the HCL-HA group, severity of inflammation had statistically significantly regressed to the levels of the control group(p<0.005). An increase was observed in the bladder myeloperoxidase activity of the HCL group compared to the other two groups(p<0.05).Conclusions:Single dose intravesical hyluronic acid instillation reduces inflammatory cell infiltration and the severity of bladder inflammation in the rat model of bladder pain syndrome/interstitial cystitis.

Hyaluronic Acid: A Key Ingredient in the Therapy of Inflammation

“…It was also found that the integrity of the bladder mucosa is preserved. A decrease was found in mast cell counts and IL-6 levels [167]. Similarly, Yildiz et al, evaluated the effect of intravesical HA on cystitis induced by Escherichia coli (E. coli) in rats.…”

Effect of Glycosaminoglycan Replacement on Markers of Interstitial Cystitis In Vitro

“…In this study both exogenous HA, CS, and combination were anti-inflammatory. A similar trend was observed in the IL-6 levels in a mouse model treated with single dose HA after induction chemical cystitis (Sahiner et al, 2018). A major confounding factor is the exact molecular weight of the formulations employed as many of the physiological effects of exogenous HA are dependent on molecular weight (Hascall et al, 2004;Medina et al, 2006).…”

“…Intermediate molecular weight HA has been shown to increase the expression of ICAM-1 via the transcription factors NF-κB and AP-1 in kidney tubular cells (Oertli et al, 1998). A reduction in ICAM-1 is one of the potential routes through which HA alters IL-6 expression which correlates well with symptom severity in chemical induced cystitis models (Sahiner et al, 2018). Thus, the differential effects of the GAG formulation may reflect differences in molecular weight species in the various formulation.…”

Evaluation of the impact of platelet rich plasma and hyaluronic acid on ketamine-induced cystitis in albino rats : A histological and immunohistochemical study.

“…Moreover, there was a significant (P<0.01) decrease in the collagen fibers deposition. Proliferating cell nuclear antigen immunopositive nuclei and Desmin immunoreaction were significantly (P<0.01) increased, while, NF-κ B immunoreaction was significantly decreased compared to group I. Intravesical administration of PRP was chosen in our study because it can provide more intensive use of the PRP in the bladder and reduce its systemic adverse effects [20] .…”

“…It is clinically safe, well-tolerated and possess important tissue healing properties [16,17] . Hyaluronic acid (HA) is an alternative therapeutic line for treatment of different types of cystitis as KIC, IC, radiation induced or recurrent bacterial cystitis and also in many degenerative conditions such as osteoarthritis [18,19,20,21] .…”