Presentation Authors: Craig Comiter*, Nichole Younglin, Aman Mahal, Amy Dobberfuhl, Stanford, CA
Introduction: To understand the therapeutic potential of pioglitazone, a peroxisome proliferator-activated receptor gamma (PPAR-Î³) agonist with a propensity to cause bladder mucosal proliferation, on interstitial cystitis (IC) in a rat model.
Methods: Using a previously described animal model for IC, Sprague-Dawley rats were treated with biweekly cyclophosphamide injections (35 mg/kg) to induce cystitis. Animals were divided into 4 groups (n=6 for each group): IC plus daily sham saline gavage (IC+Pio-), IC plus daily pioglitazone gavage (15 mg/kg) (IC+Pio+), normal rats with daily pioglitazone (IC-Pio+), and normal rats with neither IC nor pioglitazone (IC-Pio- or Control). At the end of four weeks, urinary frequency and bladder capacity were measured. Histologic examination of urothelial integrity was also performed.
Results: Average voids per hour were significantly lower in IC+Pio+ (4.0 Â±1.9) vs. IC+Pio- (10.0 Â± 2.4) rats (p < 0.01) and were similar to IC-Pio+ (6.0 Â±1.4) and IC-Pio- (6.0 Â± 1.5) controls. Cystometric capacity was significantly higher in IC+Pio+ (0.945 Â± 0.122 mL) vs. IC+Pio- rats (0.588 Â±0.165 mL, p=0.01) and was comparable to IC-Pio- capacity (0.817 Â± 0.196 mL) and IC-Pio+ capacity (0.941 Â± 0.188 mL). Urothelial structural integrity was improved in IC+Pio+ rats versus IC+Pio- rats upon histologic observation.
Conclusions: Pioglitazone, a PPAR-Î³ agonist, improved bladder function in cyclophosphamide-induced cystitis by both observed urinary frequency and measured cystometric capacity. Urothelial structural integrity was also improved. Pioglitazone, due to a propensity to cause bladder mucosal proliferation, may prove useful for treating IC, and deserves further investigation.
Source of Funding: Stanford SPARK grant