This is an application from the Washington University Discovery Site to continue participation in the MAPP Research Network. The MAPP was launched in October 2008 to better understand urologic chronic pelvic pain syndromes (UCPPS), which include interstitial cystitis/ bladder pain syndrome (IC/BPS) in men and women, and chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS) in men. Through a wide range of scientific discovery projects in Phase 1 of the MAPP, we have better understanding of the phenotype subgroups, biomarkers, epidemiological factors of symptom exacerbation ("flare"), physiological correlates of UCPPS pain (e.g. quantitative sensory testing, anatomic and functional neuroimaging), and mechanistic underpinnings of pelvic pain, using preclinical models that recapitulated the key clinical symptoms of UCPPS. The Washington University Discovery Site has been particularly productive. We have nine publications so far, covering key areas such as UCPPS phenotypes, flares, infectious, and animal studies of bladder pain. We have met and exceeded our recruitment target by 25%. In fact, we have recruited more UCPPS and healthy controls than any other sites. We also have a 97% success rate in collecting biospecimens for the biomarker studies. For MAPP-II, we propose the following five specific aims:
Aim 1 : To conduct a Symptom Patterns Study across the MAPP Research Network. Preliminary data suggested that certain subgroups of UCPPS participants tend to improve their symptoms over the course of six months, whereas other subgroups tend to worsen. Here we propose a prospective observational study to identify phenotypic factors associated with worsening and/or improvement of urinary and non-urinary symptoms over a longer period of three years. The proposed study is important for many reasons. At the most basic level, it would be helpful to be able to accurately predict the clinical course of UCPPS symptoms for individual patients. This information is vital to guide management decisions. Having a better understanding of the UCPPS endo-phenotypes would be crucial to developing more effective and personalized treatments. In addition, we will propose the following expanded assessment to enhance the core Symptom Patterns Study:
Aim 2 : Expanded Assessment of Quantitative Sensory Testing, Pelvic Floor, and Somatic Burden.
Aim 3 : An expanded assessment of UCPPS symptom flares (exacerbation of UCPPS symptoms) Aim 4: Urinary Metabolomic Profiles of UCPPS Aim 5: Bi-directional Translational Study Using Preclinical Models

Public Health Relevance

This is an application from the Washington University Discovery Site to continue participation in the MAPP Research Network. This study will examine the biology and pathophysiology of symptoms associated with urologic chronic pelvic pain syndromes (which include interstitial cystitis and chronic prostatitis).

National Institute of Health (NIH)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZDK1)
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Mullins, Christopher V
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Washington University
Schools of Medicine
Saint Louis
United States
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Clemens, J Quentin; Mullins, Chris; Kusek, John W et al. (2014) The MAPP research network: a novel study of urologic chronic pelvic pain syndromes. BMC Urol 14:57
Sutcliffe, Siobhan; Colditz, Graham A; Goodman, Melody S et al. (2014) Urological chronic pelvic pain syndrome symptom flares: characterisation of the full range of flares at two sites in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. BJU Int 114:916-25
Landis, J Richard; Williams, David A; Lucia, M Scott et al. (2014) The MAPP research network: design, patient characterization and operations. BMC Urol 14:58
Kilpatrick, Lisa A; Kutch, Jason J; Tillisch, Kirsten et al. (2014) Alterations in resting state oscillations and connectivity in sensory and motor networks in women with interstitial cystitis/painful bladder syndrome. J Urol 192:947-55
Stemler, Kristina M; Crock, Lara W; Lai, H Henry et al. (2013) Protamine sulfate induced bladder injury protects from distention induced bladder pain. J Urol 189:343-51
Lai, H Henry; North, Carol S; Andriole, Gerald L et al. (2012) Polysymptomatic, polysyndromic presentation of patients with urological chronic pelvic pain syndrome. J Urol 187:2106-12
Crock, Lara W; Stemler, Kristina M; Song, David G et al. (2012) Metabotropic glutamate receptor 5 (mGluR5) regulates bladder nociception. Mol Pain 8:20
Lv, Haitao; Hung, Chia S; Chaturvedi, Kaveri S et al. (2011) Development of an integrated metabolomic profiling approach for infectious diseases research. Analyst 136:4752-63
Lv, Haitao; Henderson, Jeffrey P (2011) Yersinia high pathogenicity island genes modify the Escherichia coli primary metabolome independently of siderophore production. J Proteome Res 10:5547-54
Lai, H Henry; Qiu, Chang-Shen; Crock, Lara W et al. (2011) Activation of spinal extracellular signal-regulated kinases (ERK) 1/2 is associated with the development of visceral hyperalgesia of the bladder. Pain 152:2117-24