Urinary Markers

Clearly, a convenient, objective, and noninvasive diagnostic test of adequate sensitivity and specificity for IC is needed. Researchers have continued to seek objective tests that could be used in diagnosis. Many urinary substances have been described as increased or decreased in IC compared with controls. These substances, including histamine, interleukins, GAGs, hyaluronic acid, epithelial growth factors, nerve growth factor, and others, were selected based on theorized etiologies for IC. One of the major problems of using many of these substances as diagnostic markers is that, although the levels may be statistically significantly higher or lower in IC, most of the individual values significantly overlap among control and IC subjects. Extensive reviews of urine markers have been published.37 Glycoprotein-51 and APF did not show overlap between controls and IC patients who met NIDDK criteria.38,39 The level of APF is detected with indirect assay based on inhibition of H-thymidine incorporation. The sensitivity and specificity of APF were 94% and 95%, respectively.40 Antiproliferative factor is more likely to be a diagnostic marker for IC.

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