Urine cytokine profile in assessing the efficacy of Vesusten and intravesical hyaluronic acid instillations in patients with chronic recurrent cystitis

Galkina N.G., Levashova O.A., Volkova T.I., Galkin A.V., Kogan M.I.

1) Department of Surgery, Penza State University, Penza, Russia; 2) Urology Clinic LLC, Penza, Russia; 3) Department of Medical Microbiology and Laboratory Medicine, Laboratory of Molecular and Personalized Medicine Penza Institute for Further Training of Physicians – Branch of Russian Medical Academy of Continuing Professional Education, Penza, Russia; 4) City Polyclinic, Penza, Russia; 5) N.N. Burdenko Penza Regional Clinical Hospital, Penza, Russia; 6) Penza Institute for Advanced Medical Studies – Branch of the Russian Medical Academy of Continuous Professional Education, Penza, Russia; 7) Rostov State Medical University, Rostov-on-Don, Russia

Introduction. Chronic recurrent cystitis (CRC) in women is characterized by frequent exacerbations and the difficulty of achieving stable remission. Local inflammation and impaired urothelial barrier function play a key role in its pathogenesis. The search for objective markers of therapy effectiveness, such as urinary cytokines, is an urgent task. Objective. To analyze the clinical efficacy and urinary cytokine profile in the treatment of CRC in women with the polypeptide drug Vesusten and intravesical hyaluronic acid instillations. Materials and Methods. This prospective, open-label, comparative study included 45 patients with CRC, divided into two groups: Group I (n=25) received Vesusten 5 mg IM, 10 injections; Group II (n=20) received intravesical instillations of sodium hyaluronate 40 mg, 4 procedures. Clinical efficacy was assessed using VAS, PPIUS, TUFS scales, and urinary frequency. Urinary cytokine levels (MCP-1, calprotectin, RANTES, MIF, TNF-α, IL-6) were measured by ELISA before and after treatment. Results. Both groups achieved significant improvement in all clinical parameters (p<0.05). Group I showed a more pronounced reduction in TUFS score (3.9-fold). Cytokine analysis revealed a significant decrease in MCP-1, calprotectin, and IL-6 in both groups. The key difference was the dynamics of RANTES: Group I showed a trend towards an increase (+8.6%, p=0.412), while Group II showed a significant decrease (p=0.02). The median relapse-free period in Group I was 42.5 weeks, significantly higher than in Group II (38.0 weeks; p<0.05). Conclusions. The conducted study demonstrated the effectiveness of Vesusten and intravesical hyaluronic acid instillations in achieving prolonged remission in patients with chronic recurrent cystitis (CRC). Vesusten provides a longer relapse-free period (42.5 vs 38.0 weeks, p<0.05).

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About the Authors

Corresponding author: N.G. Galkina – Ph.D. in Medical Sciences, Associate Professor at the Department of Surgery, Penza State University; Urologist, Urology Clinic LLC, Penza, Russia; e-mail: natalya-galkina@mail.ru

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