Mast Cell Activation in Sterile Bladder and Prostate Inflammation

Abstract

Sterile inflammation of the bladder has often been associated with interstitial cystitis (IC), a urologic condition of unknown etiology, predominantly affecting young and middle-aged females, for which no effective therapy is known. Recent reports have indicated that IC is associated with an increased number of bladder mast cells. Here we report the case of a middle-aged man with chronic sterile hematuria, dysuria and lower abdominal pain associated with a high number of bladder and prostate mast cells. Following therapeutic transurethral resection of the trigone area, bladder neck and prostate, samples of bladder and prostate were examined with light and electron microscopy and contained many mast cells (about 150 cells/mm²) which were not degranulated. Nevertheless, mast cells contained many altered granules and urinary levels of histamine were elevated, implying secretion without exocytosis. These findings are discussed in the context of the pathophysiology of IC and possible therapeutic interventions.

Stress and Chronic Pelvic Pain

“…208 Expressed prostatic secretions from men with CP/CPPS had increased mast cell tryptase and NGF levels, 211 and a later study confirmed that tryptase and carboxypeptidase A (CPA3), a marker of mast cell activation, were also increased in the urine of CP/CPPS patients. 212 The extent of mast cell degranulation or activation has varied between studies as both altered granular structure 213 and a decrease in the number of intact mast cells 214 have been observed in biopsies from CP/CPPS patients, implying that mast cell activation without complete degranulation, as well as a higher rate of complete mast cell degranulation, respectively, could occur in CP/CPPS. The potential role for mast cells in the onset and maintenance of CP/CPPS has been a major focus of animal research on this syndrome thus far.…”

Similarities between interstitial cystitis and male chronic pelvic pain syndrome

“…Although little work has been conducted to determine the role of the mast cell in MCPPS IIIA, case reports such as that submitted by Theoharides et al [48] suggest that mastocytosis and elevated urinary histamine levels might be observed in some patients with prostatitis. This correlates well with an estrogen-induced model of prostatitis where increased numbers of degranulated mast cells were noted [49].…”

Dermatitis Characterized by Mastocytosis at Immunization Sites in Mast-Cell-Deficient <i>W/W^v</i> Mice

“…Dye bind ing of the glycosaminoglycans is well preserved in the latter fixative [19], IFAA fixation reportedly increases the yield of stainable mast cells by approximately 25% in human bladder tissue [19,20). Samples (5-um thick) were stained with 0.25% toluidinc blue, pH 2.5, for 45 min to allow the identification of aldehyde-susceptible mast cells which differentiate mucosal mast cells (MMC, staining blue) from connective tissue mast cells (CTMC, staining metachromatically vio let).…”

“…Thin sections (50-70 nnt) were cut on an LKB 8801 ultramicrotome and stained with uranyl acetate and lead citrate (Fisher Scientific, Pittsburgh. Pa., USA): they were then examined with a JEOL-100 electron microscope [20,21 ].…”