Is anyone aware of a 'gold standard' treatment for painful bladder syndromes associated with inflammation? As far as I can find, there are numerous 'recommended' treatment strategies (RTX, Botox, NSAIDs, various instillation methods), but no single option suggested as the best.
I am working on behavioural characterisation of a pre-clinical model of bladder inflammation, and without a pharmacological standard to test with, I am left with characterising the behaviour and inflammatory response.
Does anyone else have similar experience working in an area with limited treatment options? Has it affected your ability to publish findings?
(personally, I feel that as long as a study is not claiming to investigate pharmacology, characterising a phenotype linked to clinical symptoms is still worthwhile, especially if translational links can be made)
Sadly enough there is NO gold standard for aseptical Bladder inflammation & pain, we call it interstitiel cystitis, no clinical trials of sufficient magnitude...
Yeah, that's what I'd found (this is my PhD topic).
Also the diagnosis itself is so tricky - interstitial cystitis/painful bladder syndrome... with and without neurogenic aspects!
How do you feel about pharmacological validation as one of the key components of a preclinical study for a disease with no recommended treatment?
(of course, all this said, there are very few true preclinical trials of things like paracetamol so sometimes a bit of back-engineering from what's seen in the clinic is required...)
interestingly in many IC patients there are a number of imflammatory markers high and the special ulcer, full of mast cells...I see quite a number of these patients and the first treatment is with the mast cell modulator and the natural analgesic palmitoylethanolamide; here the context:
http://www.neuropathie.nu/english-articles/interstitial-cystitis-the-role-of-the-mast-cell-and-treatment-with-palmitoylethanolamide-pea.html
I'm actually also looking at inflammatory markers within the bladder (as a proxy for the pain state as I don't feel reflex measures such as hind paw withdrawals are adequate) and preliminary studies have shown a massive upreg. so that's really interesting - thanks for the paper!
In considering gold standard, Different Food and Drugs Administration have several choice to be a norm in particular government. Any adaption clearly result into compassionate, investigative, and experimental trial. Risk can be manage, if historical medicine could be consulted such as herbal medicine toxic effect in humans. Since plants contain active treatment substance with toxic chemical like apple (cyanide). Limited treatment option could be expanded, if comparing pathological syndrome theoretical probe. Also, pain had electrical neural connection. It may be measure by electrical current contrast in normal signal and abnormal firing. As inflammatory markers.
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