Interstitial cystitis (IC) is a chronic bladder pain syndrome that affects up to 10 million people in the United States. Symptoms can range from pressure and tenderness in the bladder area to debilitating bladder pain and urinary urgency. Little is understood about the biological processes that underlie IC, making treatment challenging.
In a study published in 2024, Lindsey McKernan, PhD, MPH, associate professor of Psychiatry and Behavioral Sciences, and colleagues demonstrated that telehealth cognitive behavioral therapy (CBT) may offer a promising treatment to reduce stress and improve patient outcomes in IC. In a new follow-up study published in Frontiers in Pain Research, McKernan and colleagues explored the role of inflammation in predicting and explaining CBT treatment response.
In a subset of female patients from their larger study examining the effects of CBT on IC symptoms, the researchers collected blood samples before, immediately after, and at a three-month follow-up to measure inflammatory markers. At each point, the participants underwent comprehensive symptom assessments.
The researchers found a significant association between levels of the inflammatory marker IL-1beta and pain. Notably, they did not observe significant changes in the six inflammatory markers they tested over time across treatment groups. However, CBT recipients with higher baseline levels of IL-1beta experienced greater overall improvement following cognitive behavioral therapy and improved urinary symptoms, suggesting that IL-1beta may be a useful biomarker for predicting CBT treatment response in IC patients.
The authors note that future research including larger sample sizes and analysis of more inflammatory markers will be useful for further investigating the biological mechanisms underpinning this complicated disease.
McKernan is the corresponding and first author of the Frontiers in Pain Research study. The senior author is Andrew Schrepf, PhD, at the University of Michigan. Other Vanderbilt University Medical Center collaborators include Leslie Crofford, MD, the Wilson Family Professor of Medicine in the Division of Rheumatology and Immunology, and Stephen Bruehl, professor of Anesthesiology. This study was supported by the National Institutes of Health (grants K23DK118118, L30DK118656, R01DK133415, UL1TR002243) and the Agency for Healthcare Research and Quality (5K12HS022990).
