PD05-06 INFECTION PHENOTYPE IN INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME: DOES BACTERIAL-INDUCED MUCOSAL CELLULAR IMMUNE IMBALANCE HYPERSENSITIVITY EXPLAIN RESPONSE TO MV140 RECURRENT UTI VACCINE?
Notice bibliographique
Résumé
You have accessJournal of UrologyCME1 Apr 2023PD05-06 INFECTION PHENOTYPE IN INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME: DOES BACTERIAL-INDUCED MUCOSAL CELLULAR IMMUNE IMBALANCE HYPERSENSITIVITY EXPLAIN RESPONSE TO MV140 RECURRENT UTI VACCINE? J. Curtis Nickel, Kerri-Lynn Kelly, Ashley Griffin, and R. Christopher Doiron J. Curtis NickelJ. Curtis Nickel More articles by this author , Kerri-Lynn KellyKerri-Lynn Kelly More articles by this author , Ashley GriffinAshley Griffin More articles by this author , and R. Christopher DoironR. Christopher Doiron More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003229.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A subset of interstitial cystitis/bladder pain syndrome (IC/BPS) patients experience recurrent UTI (rUTI) associated with symptom flares. rUTI subjects with associated IC/BPS were enrolled in the First North American Early Clinical experience trial evaluating a new sublingual UTI preventative vaccine, MV140. Recent research shows that women with rUTI develop an imbalance in the T Helper 1 and 2 (Th2 over expression) in the bladder mucosa. Our study will suggest that this infection subcategory of IC/BPS patients develop a T Helper 2 (Th2)-type hypersensitivity (or allergy) to bacteria present in their urinary microbiome that responds to mucosal immune modulation. METHODS: Female participants with ≥3 documented UTI/year underwent a 3 month vaccination treatment period with a 9 month efficacy period after completion of vaccine treatment (total 12 months). There was no exclusion criteria for subjects in relation to baseline urinary symptoms and/or discomfort/pain. Primary outcome was no UTI following vaccination. Secondary outcomes included change in UTI incidence, overall patient reported subjective global assessment (responder defined as moderately or markedly improved on 7-point SGA scale) and safety. RESULTS: Sixteen subjects with IC/BPS related symptoms and rUTI (mean age 46.6; range 23-74 years; mean number of UTI in previous year 6.1+/-4.2) were eligible to be included in the Health Canada approved MV140 vaccine study for prevention of rUTI. All subjects completed the 3 month vaccination period. One subject lost to followup after 6 month visit. Six subjects were UTI-free while all 16 subjects had a reduction in UTI compared to the year pre-vaccination. The total post-vaccination reduction in UTI compared to pre-vaccination was 80% (0.1 UTI/subject/month from 0.5 UTI/subject/month respectively) At 12 months, 13 subjects (81.3%) were SGA responders (moderately or markedly improved) and the responders reported a reduction in IC/BPS symptoms with 8 subjects reporting significant or almost complete resolution of their specific long-term bladder discomfort/pain and bothersome urinary frequency or urgency. Four subjects reported mild and self limited adverse events during vaccination period but none were related to MV140 vaccine. CONCLUSIONS: Sublingual MV140 vaccine in IC/BPS patients with rUTI not only report UTI-free or reduced UTI incidence status but also after approximately 9 months post vaccination, many have resolution of their-long term treatment refractory IC/BPS symptoms. This suggests some cases of IC/BPS may be etiologically based on a Th2 cell type hypersensitivity to bacteria within or entering the urinary microbiome that responds to a vaccine whose mechanism of action is to normalize or balance the bladder Th1/Th2 mucosal immune system. Source of Funding: Inmunotek provided MV140 vaccine © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e150 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information J. Curtis Nickel More articles by this author Kerri-Lynn Kelly More articles by this author Ashley Griffin More articles by this author R. Christopher Doiron More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».