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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Alger, Jeffry R; Ellingson, Benjamin M; Ashe-McNalley, Cody et al. (2016) Multisite, multimodal neuroimaging of chronic urological pelvic pain: Methodology of the MAPP Research Network. Neuroimage Clin 12:65-77
Nickel, J Curtis; Stephens, Alisa; Landis, J Richard et al. (2016) Assessment of the Lower Urinary Tract Microbiota during Symptom Flare in Women with Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Study. J Urol 195:356-62
Deutsch, Georg; Deshpande, Hrishikesh; Frölich, Michael A et al. (2016) Bladder Distension Increases Blood Flow in Pain Related Brain Structures in Subjects with Interstitial Cystitis. J Urol 196:902-10
Stephens-Shields, Alisa J; Clemens, J Quentin; Jemielita, Thomas et al. (2016) Symptom Variability and Early Symptom Regression in the MAPP Study: A Prospective Study of Urological Chronic Pelvic Pain Syndrome. J Urol 196:1450-1455
Huang, Lejian; Kutch, Jason J; Ellingson, Benjamin M et al. (2016) Brain white matter changes associated with urological chronic pelvic pain syndrome: multisite neuroimaging from a MAPP case-control study. Pain 157:2782-2791
Griffith, James W; Stephens-Shields, Alisa J; Hou, Xiaoling et al. (2016) Pain and Urinary Symptoms Should Not be Combined into a Single Score: Psychometric Findings from the MAPP Research Network. J Urol 195:949-54
Naliboff, Bruce D; Stephens, Alisa J; Afari, Niloo et al. (2015) Widespread Psychosocial Difficulties in Men and Women With Urologic Chronic Pelvic Pain Syndromes: Case-control Findings From the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network. Urology 85:1319-27
Sutcliffe, Siobhan; Colditz, Graham A; Pakpahan, Ratna et al. (2015) Changes in symptoms during urologic chronic pelvic pain syndrome symptom flares: findings from one site of the MAPP Research Network. Neurourol Urodyn 34:188-95
Sutcliffe, Siobhan; Bradley, Catherine S; Clemens, James Quentin et al. (2015) Urological chronic pelvic pain syndrome flares and their impact: qualitative analysis in the MAPP network. Int Urogynecol J 26:1047-60
Martucci, Katherine T; Shirer, William R; Bagarinao, Epifanio et al. (2015) The posterior medial cortex in urologic chronic pelvic pain syndrome: detachment from default mode network-a resting-state study from the MAPP Research Network. Pain 156:1755-64

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