Pelvic pain syndromes cause severe pelvic pain and morbidity and impact families and the economy. Patients with urologic chronic pelvic pain syndromes (UCPPS) often suffer co-morbid conditions, such as irritable bowel syndrome (IBS). Effective treatment of chronic pelvic pain is complicated by imprecise clinical diagnoses and incomplete mechanistic understanding of these diseases, individually or as systemic conditions. Thus, our central hypothesis for this MAPP proposal is that improved diagnoses of well-defined patient groups and understanding of pelvic pain mechanisms will lead to improved therapies. The MAPP initiative will examine UCPPS within the context of co-morbidities at the levels of patient phenotype, epidemiology, and basic science. In other chronic conditions, chronic pain can be induced by a peripheral insult. Neural mechanisms can result in sustained pain even after the initiating insult is resolved, but it is unknown whether UCPPS causes similar changes. We will apply state-of-the-art pain methodologies to characterization of pelvic pain conditions. Because UCPPS and IBS share many similarities, including overlapping pain localization and voiding dysfunction, we will focus on UCPPS and IBS and will regard these conditions collectively as syndromes of chronic pelvic pain (SCPP). We will study mechanisms of SCPP in three innovative and synergistic projects. In Project I, we identify novel brain biomarkers of SCPP by characterizing brain morphometry/activity and cognitive function. In Project II, we will exploit the NIH Roadmap initiative PROMIS to determine the prevalence of SCPP in a large cohort. Finally, in Project III, we dissect pelvic organ crosstalk and spinal cord integration mechanisms that mediate co-morbidities and sustained pain in SCPP murine models. By focusing on the bladder, prostate, and bowel, our studies will benefit equally digestive disease and kidney/urologic disease, the dual missions of NIDDK, and provide the critical foundation for targeted therapies for SCPP. KEY ABBREVIATIONS SCPP = Syndromes of Chronic Pelvic Pain UCPPS = Urological Chronic Pelvic Pain Syndromes IBS = Irritable Bowel Syndrome CP = Chronic Prostatitis

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01DK082342-05
Application #
8334679
Study Section
Special Emphasis Panel (ZDK1-GRB-G (M1))
Program Officer
Mullins, Christopher V
Project Start
2008-09-15
Project End
2014-06-30
Budget Start
2012-07-01
Budget End
2014-06-30
Support Year
5
Fiscal Year
2012
Total Cost
$962,204
Indirect Cost
$701,149
Name
Northwestern University at Chicago
Department
Urology
Type
Schools of Medicine
DUNS #
005436803
City
Chicago
State
IL
Country
United States
Zip Code
60611
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
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
Clemens, J Quentin; Clauw, Daniel J; Kreder, Karl et al. (2015) Comparison of baseline urological symptoms in men and women in the MAPP research cohort. J Urol 193:1554-8
Kutch, Jason J; Yani, Moheb S; Asavasopon, Skulpan et al. (2015) Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP: Research Network Neuroimaging Study. Neuroimage Clin 8:493-502
Farmer, Melissa A; Huang, Lejian; Martucci, Katherine et al. (2015) Brain White Matter Abnormalities in Female Interstitial Cystitis/Bladder Pain Syndrome: A MAPP Network Neuroimaging Study. J Urol 194:118-26
Kairys, Anson E; Schmidt-Wilcke, Tobias; Puiu, Tudor et al. (2015) Increased brain gray matter in the primary somatosensory cortex is associated with increased pain and mood disturbance in patients with interstitial cystitis/painful bladder syndrome. J Urol 193:131-7
Schrepf, Andrew; Bradley, Catherine S; O'Donnell, Michael et al. (2015) Toll-like receptor 4 and comorbid pain in Interstitial Cystitis/Bladder Pain Syndrome: a multidisciplinary approach to the study of chronic pelvic pain research network study. Brain Behav Immun 49:66-74

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