The etiology and pathogenesis of interstitial cystitis (IC) and its related condition in men, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has remained elusive. This has hampered development of mechanistic treatment strategies for these common, chronic and distressing medical conditions. We believe that IC and perhaps CP/CPPS are a spectrum of complex but inter-related genetic and acquired diseases resulting from the interaction of several genes regulating immune/inflammatory and neurogenic parameters and environmental factors/circumstances or exposure, culminating in the combination of pain, frequency, urgency and sexual specific symptoms. New research has delineated the dynamic and powerful association of the immune and neurogenic system in pain activation. An immune-modulated neurogenic model of IC illuminating the action of immune derived substances and pain related substances might be important in discovering the determinants of pain, voiding dysfunction and gender specific sexual problems. This inter-related dynamic model of IC disease pathogenesis could be explored for potential avenues leading to novel diagnostic and treatment strategies. We plan to identify and evaluate the sensitivity and specificity of several novel nerve and inflammation related markers in the diagnosis and follow up of IC (and CP/CPPS). By correlating the levels of urine immune and pain related substances to disease mechanisms, severity and progression, we may be able to create a human disease specific model for diagnosis and treatment.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
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Special Emphasis Panel (ZRG1-UROL (51))
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Mullins, Christopher V
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Children's Hospital Boston
United States
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Strauss, Adam C; Dimitrakov, Jordan D (2010) New treatments for chronic prostatitis/chronic pelvic pain syndrome. Nat Rev Urol 7:127-35
Rubio-Diaz, Daniel E; Pozza, Megan E; Dimitrakov, Jordan et al. (2009) A candidate serum biomarker for bladder pain syndrome/interstitial cystitis. Analyst 134:1133-7
Dimitrakov, Jordan; Guthrie, David (2009) Genetics and phenotyping of urological chronic pelvic pain syndrome. J Urol 181:1550-7
Dimitrakov, Jordan D (2008) Re: Nadler RB, McNaughton Collins M, Propert KJ, et al: Prostate-specific antigen test in diagnostic evaluation of chronic prostatitis/chronic pelvic pain syndrome (Urology 67: 337-342, 2006). Urology 71:353
Dimitrakov, Jordan; Joffe, Hylton V; Soldin, Steven J et al. (2008) Adrenocortical hormone abnormalities in men with chronic prostatitis/chronic pelvic pain syndrome. Urology 71:261-6
Dimitrakov, Jordan (2008) A road map to biomarker discovery and validation in urological chronic pelvic pain syndrome. J Urol 179:1660-1
Dimitrakov, Jordan; Kroenke, Kurt; Steers, William D et al. (2007) Pharmacologic management of painful bladder syndrome/interstitial cystitis: a systematic review. Arch Intern Med 167:1922-9
Kim, Jayoung; Keay, Susan K; Dimitrakov, Jordan D et al. (2007) p53 mediates interstitial cystitis antiproliferative factor (APF)-induced growth inhibition of human urothelial cells. FEBS Lett 581:3795-9
Dimitrakov, Jordan D (2006) Saw palmetto for benign prostatic hyperplasia. N Engl J Med 354:1950-1; author reply 1950-1
Farokhzad, Omid C; Dimitrakov, Jordan D; Karp, Jeffrey M et al. (2006) Drug delivery systems in urology--getting ""smarter"". Urology 68:463-9

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