Treating BCG-Induced Cystitis with Combined Chondroitin and Hyaluronic Acid Instillations in Bladder Cancer
Pichler, Renate (Medical University of Innsbruck)
Stäblein, Johannes (Medical University of Innsbruck)
Mari, Andrea (Università degli Studi di Firenze)
Afferi, Luca (Luzerner Kantonsspital (Suïssa))
D'Andrea, David (Medical University of Vienna)
Marcq, Gautier (Claude Huriez Hospital)
Del Giudice, Francesco (Policlinico Umberto I Hospital. 'Sapienza' University of Rome)
Soria, Francesco (University of Studies of Torino)
Caño-Velasco, Jorge (Hospital General Universitario Gregorio Marañón)
Subiela, José Daniel (Hospital Universitario Ramón y Cajal (Madrid))
Gallioli, Andrea (Institut de Recerca Sant Pau)
Tully, Karl Heinrich (Ruhr-University Bochum)
Mori, Keiichiro (The Jikei University School of Medicine)
Herms, Achim (Medical University of Innsbruck)
Pradere, Benjamin (La Croix du Sud Hospital (Toulouse, França))
Moschini, Marco (Vita-Salute San Raffaele University)
Mertens, Laura S. (Antoni van Leeuwenhoek Hospital)
Thurnher, Martin (Medical University of Innsbruck)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	In non-muscle invasive bladder cancer, Bacillus Calmette-Guérin (BCG) responders benefit from strong Th1-type inflammatory and T cell responses mediating tumor rejection. However, the corresponding lack of anti-inflammatory Th2-type immunity impairs tissue repair in the bladder wall and facilitates the development of cystitis, causing urinary pain, urgency, incontinence, and frequency. Mechanistically, the leakage of the glycosaminoglycan (GAG) layer enables an influx of potassium ions, bacteria, and urine solutes towards the underlying bladder tissue, promoting chronic inflammation. Treatments directed towards re-establishing this mucopolysaccharide-based protective barrier are urgently needed. We discuss the pathomechanisms, as well as the therapeutic rationale of how chondroitin and hyaluronic acid instillations can reduce or prevent BCG-induced irritative bladder symptoms. Moreover, we present a case series of five patients with refractory BCG-induced cystitis successfully treated with combined chondroitin and hyaluronic acid instillations.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	BCG ; Bladder cancer ; Chondroitin ; Cystitis ; Hyaluronic acid ; Intravesical instillations
Published in:	Journal of clinical medicine, Vol. 13 Núm. 7 (april 2024) , p. 2031, ISSN 2077-0383

DOI: 10.3390/jcm13072031
PMID: 38610796

7 p, 6.5 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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