Abstract
Purpose:
In our study, three different intravesical treatment agents were compared by the effectiveness; chondroitin sulphate, hyaluronic acid and hyaluronic acid-chondroitin sulphate combination in a rat interstitial cystitis model.
Methods:
Thirty-five female rats were divided into five groups by and control (group I), isotonic (group II), chondroitin sulphate (group III), hyaluronic acid (group IV), hyaluronic acid-chondroitin sulphate combination (group V). Chemical cystitis was induced in all groups by intravesical instillation of hydrogen peroxide (H2O2) via transurethral route except sham control group. 1 ml of 5% H202 was instilled intravesically for 15 min to create chemical cystitis. The treatment protocol was administered every other day for a total of three sessions in all the groups two days after the formation of chemical cystitis except the group I. All the animals in the group II, III, IV and V were treated with 1 ml 0.9% NaCl, 1 ml 0.2% sodium chondroitin sulfate, 1 ml low molecular weight hyaluronic acid, 1 ml 2% sodium chondroitin sulfate + 1.6% sodium hyaluronic acid, respectively. On the seventh day, the animals were sacrificed and the bladders were removed for histopathological and immunohistochemical assessment.
Results:
Based on histopathological examinations, there was a significant difference between the groups in terms of vascular congestion (p=0.006). The grade of submucosal edema in the group II and group IV were found significantly higher than group I (p=0,006; p=0.006). In the group I, the grade of granulation tissue was lower than the other four groups, but no significant difference was found between these four groups (p=0.016). The intensity of neutrophil cell infiltration in group II and group IV were higher than group I (p=0,006; p=0,006; respectively). According to the analysis of leukocyte and mast cell count; significant differences were detected between the groups (p<0.001; p<0.001). Immunohistochemical evaluation revealed that the abnormal immunoreactivity of ZO-1 and UP-III in the group II were higher than group I, group III and group V (p=0.002, p=0.010). The level of IL-8 expression was lower in group V than I group II (p=0.001).
Conclusion:
We have showed that single treatment of chondroitin sulphate and combination treatment of hyaluronic acid-chondroitin sulphate agents provided treatment efficacy by suppressing inflammatory process and achieving improvement in the urothelium.
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