Urologic Diseases Research Updates
Fall 2008

NIDDK Advances Collaborative Studies of Urologic Chronic Pelvic Pain Disorders

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH), has launched a research initiative to conduct collaborative studies of urologic chronic pelvic pain disorders by looking for clues outside the bladder and prostate.

Six discovery sites will conduct the studies through the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. Two core sites will coordinate data collection, analyze tissue samples, and provide technical support. The total research investment for the 5-year project is estimated to be up to $37.5 million.

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
• Washington University, St. Louis

Core sites are at the University of Colorado, Denver, and the University of Pennsylvania, Philadelphia.

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

The MAPP initiative is unusual in requiring investigators to conduct highly collaborative research of the most common urologic chronic pelvic pain syndromes from a wider systemic perspective. The initiative represents a major shift from earlier organ-specific research on the two most prominent urologic chronic pelvic pain disorders: interstitial cystitis/painful bladder syndrome (IC/PBS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

“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., M.A.C.P. “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 IC/PBS and CP/CPPS are frequently associated with other chronic pain disorders such as fibromyalgia, 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 the NIDDK, no organ-specific cause has been identified for either disorder.”

New Insights

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 approach will expand the context in which research into IC/PBS and CP/CPPS occurs and will encourage a more comprehensive understanding of chronic pelvic pain.

Scientists at discovery sites will conduct individual and collaborative multisite research projects, supported by each core site. An important first step in these studies will be the careful and extensive phenotyping, or clinical characterization, of the men and women participating in the studies.

The data coordination core at the University of Pennsylvania will provide overall administration and coordination of multisite research studies and perform data analyses.

The Tissue Analysis and Technology Core at the 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 core site in Colorado also will perform genomic and proteomic tissue expression analyses, which may lead to new treatment approaches and help predict which patients might 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. An external Scientific Advisory Committee will review proposals for scientific merit and feasibility.

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

NIH Publication No. 09–5743
December 2008

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