Comparison of Intravesical Hyaluronic Acid, Chondroitin Sulfate, and Combination of Hyaluronic Acid-Chondroitin Sulfate Therapies in Animal Model of Interstitial Cystitis
	    		
		   		
		   			
		   		
	    	
    	- Author:
	        		
		        		
		        		
			        		Yavuz Onur DANACIOGLU
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Bulent EROL
			        		
			        		;
		        		
		        		
		        		
			        		Seyma OZKANLI
			        		
			        		;
		        		
		        		
		        		
			        		Asif YILDIRIM
			        		
			        		;
		        		
		        		
		        		
			        		Ramazan Gokhan ATIS
			        		
			        		;
		        		
		        		
		        		
			        		Mesrur Selcuk SILAY
			        		
			        		;
		        		
		        		
		        		
			        		Turhan CASKURLU
			        		
			        		
		        		
		        		
		        		
			        		
			        		Author Information
			        		
 - Publication Type:Original Article
 - From:International Neurourology Journal 2021;25(1):42-50
 - CountryRepublic of Korea
 - Language:English
 - 
		        	Abstract:
			       	
			       		
				        
				        	Purpose:Three intravesical treatment agents were compared in an interstitial cystitis rat model: chondroitin sulfate, hyaluronic acid, and combined hyaluronic acid-chondroitin sulfate. 
				        	
Methods:Thirty-five female rats were divided into 5 groups: control (group I), isotonic (group II), chondroitin sulfate (group III), hyaluronic acid (group IV), and hyaluronic acid-chondroitin sulfate (group V). Chemical cystitis was induced in all experimental groups by intravesical instillation of 1 mL of hydrogen peroxide (H2O2) for 15 minutes via the transurethral route. The treatment was administered every other day for 3 sessions 2 days after inducing chemical cystitis. Groups II, III, IV, and V received 1 mL of 0.9% NaCl, 1 mL of 0.2% sodium chondroitin sulfate, 1 mL of low-molecular-weight hyaluronic acid, and 1 mL of 2% sodium chondroitin sulfate+1.6% sodium hyaluronic acid, respectively. On day 7, the animals were sacrificed and the bladders were removed for histopathological and immunohistochemical assessments.
Results:Significant between-group differences were found in vascular congestion (P=0.006). The grade of submucosal edema in groups II and IV was significantly higher than in group I (P=0.006, P=0.006, respectively). In group I, the grade of granulation tissue was lower than the other 4 groups, but no significant difference was found between the remaining groups (P=0.016). Neutrophil cell infiltration was more intense in groups II and IV than in group I (P=0.006, P=0.006, respectively). Significant differences in the leukocyte and mast cell count were detected between groups II and IV (P<0.001, P<0.001, respectively). Abnormal zonula occludens-1 and uroplakin-III immunoreactivity in group II was higher than in groups I, III, or V (P=0.002, P=0.010, respectively). Interleukin-8 expression was lower in group V than in group II (P=0.001).
Conclusion:A single treatment of chondroitin sulfate and combined hyaluronic acid-chondroitin sulfate treatment demonstrated efficacy by suppressing inflammation and achieving improvements in the urothelium. 
            