NIH tackles urologic chronic pelvic pain disorders

Sep 7 2008

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH), announces awards to eight academic research centers to conduct collaborative studies of urologic chronic pelvic pain disorders by looking for clues outside the bladder and prostate. The total research investment for the five-year project is estimated to be up to $37.5 million.

"The launch of this novel research effort is an excellent example of NIH's commitment to encouraging translational research," said NIH Director Elias A. Zerhouni, M.D. "It also illustrates NIH's leadership in furthering innovative approaches to discovering effective new therapies to help our patients."

The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network includes six Discovery Sites that will conduct the studies and two Core Sites that will coordinate data collection, analyze tissue samples, and provide technical support. The Discovery Sites are at: Northwestern University, Chicago; the University of California, Los Angeles; the University of Iowa, Iowa City; the University of Michigan, Ann Arbor; the University of Washington, Seattle; and Washington University, St. Louis. Core Sites are at the University of Colorado, Denver and the University of Pennsylvania, Philadelphia.

The MAPP initiative is unusual in requiring investigators to conduct highly collaborative research of the most common urologic chronic pelvic pain syndromes from a broadened systemic perspective. This is a major shift from earlier organ-specific research on the two most prominent urologic chronic pelvic pain disorders, interstitial cystitis/painful bladder syndrome, and chronic prostatitis/chronic pelvic pain syndrome.

"The MAPP Network's expanded scientific approach will address many persistent questions about urologic chronic pelvic pain," said NIDDK Director Griffin P. Rodgers, M.D. "Knowing whether there are risk factors common to all the disorders and whether clinical profiles can be identified for each will provide invaluable, fundamental information for developing treatment strategies."

The innovative shift in research focus represented by the MAPP initiative is supported by recent epidemiological studies showing that interstitial cystitis/painful bladder syndrome and chronic prostatitis/chronic pelvic pain syndrome are frequently associated with other chronic pain disorders such as fibromyalgia (chronic pain of unknown origin), chronic fatigue syndrome, and irritable bowel syndrome. These latest findings suggest the possibility of common underlying disease processes in these chronic disorders.

"The bladder was assumed to be the origin of the interstitial cystitis/painful bladder syndrome symptoms and the prostate was assumed to be the source of chronic prostatitis/chronic pelvic pain syndrome symptoms," explained Leroy M. Nyberg Jr., M.D., Ph.D., the NIDDK urologist heading the program. "However, in spite of intense study funded by NIDDK, no organ-specific cause has been identified for either disorder."

The MAPP research effort is expected to lead to critical new insights into the underlying causes of urologic chronic pelvic pain. Widening the scope of research will be bolstered by the perspectives of project leaders not normally involved in urologic pelvic pain studies, but who have expertise in relevant scientific disciplines. This will expand the context in which research into interstitial cystitis/painful bladder syndrome and chronic prostatitis/chronic pelvic pain syndrome occurs and will encourage a more comprehensive approach to understanding chronic pelvic pain.

Scientists at Discovery Sites will conduct individual and collaborative multi-site research projects, supported by each Core Site. An important first step in these studies will be the careful and extensive phenotyping (clinical characterization) of the men and women participating in the studies.

The Data Coordination Core (University of Pennsylvania) will provide overall administration and coordination of multi-site research studies and perform data analyses.

The Tissue Analysis and Technology Core (University of Colorado) will bank, analyze, and distribute biopsy, serum and urine samples. Tissue analyses will help in the search for biomarkers, important in screening for diseases and for monitoring treatment outcomes. The Colorado Core Site also will perform genomic and proteomic tissue expression analyses which may lead to new treatment approaches and help predict which patients may respond to these treatments.

In addition to initial collaborative projects by the Network, MAPP investigators will be invited to propose ancillary research projects to further the goals of the collaborative study group. Proposals will be reviewed for scientific merit and feasibility by an external Scientific Advisory Committee.

For more information on the MAPP Research Network, visit http://www2.niddk.nih.gov/Research/ScientificAreas/Urology/MAPP.

NIDDK conducts and supports research in diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic, and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe, and disabling conditions affecting Americans.