Recommendations on the use of intravesical hyaluronic acid instillations in bladder pain syndrome

Patuel, B. Madurga; González-López, Raquel; Folkersma, L. Resel; Fernández, Gonzales; Zurbano, José María Adot; Bonillo, Miguel Ángel; Chicharro, Raúl Vozmediano; Líbano, C. Zubiaur

doi:10.1016/j.acuroe.2022.02.007

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…HA is a component of numerous fluids and biological tissues, where it is involved in either structural or biological processes such as pathogen/viral defense, coagulation, inflammation, wound healing, cell proliferation, cell adhesion, cell migration, morphogenesis, tissue integrity, tissue flexibility, and lubrication [12,[44][45][46]. HA, as described before, is an important component of the GAG layer that increases in the urine of patients with BPS, thus demonstrating a disruption of the GAG barrier at the bladder level [47]. When this barrier decreases or becomes absent, it allows for the diffusion of urinary potassium ions into the bladder wall, resulting in the stimulation of C-type nerve fibers, as already described.…”

Section: Hyaluronic Acidmentioning

confidence: 79%

The Model of Interstitial Cystitis for Evaluating New Molecular Strategies of Interstitial Regeneration in Humans

Mormone,

Cisternino,

Capone

et al. 2024

IJMS

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Given the recent evidence in the clinical application of regenerative medicine, mostly on integumentary systems, we focused our interests on recent bladder regeneration approaches based on mesenchymal stem cells (MSCs), platelet-rich plasma (PRP), and hyaluronic acid (HA) in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) in humans. IC/BPS is a heterogeneous chronic disease with not-well-understood etiology, characterized by suprapubic pain related to bladder filling and urothelium dysfunction, in which the impairment of immunological processes seems to play an important role. The histopathological features of IC include ulceration of the mucosa, edema, denuded urothelium, and increased detection of mast cells and other inflammatory cells. A deeper understanding of the molecular mechanism underlying this disease is essential for the selection of the right therapeutic approach. In fact, although various therapeutic strategies exist, no efficient therapy for IC/BPS has been discovered yet. This review gives an overview of the clinical and pathological features of IC/BPS, with a particular focus on the molecular pathways involved and a special interest in the ongoing few investigational therapies in IC/BPS, which use new regenerative medicine approaches, and their synergetic combination. Good knowledge of the molecular aspects related to stem cell-, PRP-, and biomaterial-based treatments, as well as the understanding of the molecular mechanism of this pathology, will allow for the selection of the right and best use of regenerative approaches of structures involving connective tissue and epithelia, as well as in other diseases.

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Section: Hyaluronic Acidmentioning

confidence: 79%

The Model of Interstitial Cystitis for Evaluating New Molecular Strategies of Interstitial Regeneration in Humans

Mormone,

Cisternino,

Capone

et al. 2024

IJMS

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“…HA does not have its own mechanical properties, such as gelation and toughness, thus making its adherence to the bladder mucosa susceptible to loss by flushing under the effects of bladder urine dilution or urination. This not only results in the waste of expensive drugs but also increases the risk of urinary tract infection, urethral injury, patient discomfort, and financial burden, all of which offset the therapeutic effect to some extent 9–11 …”

Section: Introductionmentioning

confidence: 99%

“…This not only results in the waste of expensive drugs but also increases the risk of urinary tract infection, urethral injury, patient discomfort, and financial burden, all of which offset the therapeutic effect to some extent. [9][10][11] Hydrogels have been widely used in the medical field due to their good drug release properties. [12][13][14] Temperature-sensitive hydrogels can undergo a sol-gel phase transition due to volume changes in response to temperature changes, which is of great value for the controlled release of cytokines and drugs from biomaterials.…”

mentioning

confidence: 99%

Preparation and characterization of a novel composite acellular matrix/hyaluronic acid thermosensitive hydrogel for interstitial cystitis/bladder pain syndrome

Guo,

Liu,

Zhang

et al. 2023

J Biomedical Materials Res

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Bladder mucosa damage that causes harm to the interstitium is a recognized pathogenesis of interstitial cystitis/bladder pain syndrome (IC/BPS). The intravesical instillation of drugs is an important second‐line therapy, but it is often necessary to use drugs repeatedly in the clinic because of their short residence time in the bladder cavity, which alters the therapeutic effect. To overcome this drawback, this study developed a novel composite acellular matrix/hyaluronic acid (HA) thermosensitive hydrogel (HA‐Gel) using rabbit small intestinal submucosa extracellular matrix (ECM) as the thermosensitive material and HA as the drug component and examined its composition, microstructure, thermodynamic properties, temperature sensitivity, rheological properties, biocompatibility, drug release, hydrogel residue, and bacteriostatic properties. The study showed HA‐Gel was liquid at temperatures of 15–37.5°C and solid at 37.5–50°C, its swelling rate decreased with increasing temperature, and its lower critical solution temperature occurred at approximately 37.5°C. This property made the hydrogel liquid at room temperature convenient for intravesical perfusion and turned into a solid about 1 min after entering the body and rising to body temperature to increase its residence time. Subsequent experiments also proved that the gel residue time of HA‐Gel in vivo and the drug release time of HA in vivo could reach more than 5 days, which was significantly higher than that of HA alone, and it had good biocompatibility and antibacterial properties. Therefore, this hydrogel possesses the proper characteristics to possibly make it an ideal dosage form for IC/BPS intravesical instillation therapy.

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Efficacy of intravesical cocktail therapy with or without dimethyl sulphoxide in interstitial cystitis

Söğütdelen

Citamak

2022

Cent european J Urol

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Recommendations on the use of intravesical hyaluronic acid instillations in bladder pain syndrome

Cited by 3 publications

References 29 publications

The Model of Interstitial Cystitis for Evaluating New Molecular Strategies of Interstitial Regeneration in Humans

The Model of Interstitial Cystitis for Evaluating New Molecular Strategies of Interstitial Regeneration in Humans

Preparation and characterization of a novel composite acellular matrix/hyaluronic acid thermosensitive hydrogel for interstitial cystitis/bladder pain syndrome

Efficacy of intravesical cocktail therapy with or without dimethyl sulphoxide in interstitial cystitis

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