Summary
Bladder vessel walls of 20 patients with interstitial cystitis were studied by the electron microscope.
14 (70%) had severe endothelial injury. 10 (50%) showed injured smooth muscle cells. Odd basement membrane proliferations and disruptions were seen. Clusters of microfibrils about 10 nm in diameter and numerous partially membrane-bound vesicles of 100–600 nm with granular or tiny vesicular content (“granulovesicular bodies”) were also seen. Intercellular junctions of endothelial cells were open and there was emigration of polymorphonuclear leucocytes and platelets.
The findings show pronounced vascular injury to have taken place, with neoformation of elastic tissue. It is suggested that the injury is immunologically mediated and that particularly those clusters of connective tissue microfibrils not yet covered by an amorphous elastin component may be involved in the pathogenesis of this disease.
Similar content being viewed by others
References
Allison AC (1973) Heberden Oration, 1972. Mechanisms of tolerance and autoimmunity. Ann Rheum Dis 32: 282–293
Boye E, Morse M, Huttner I. Erlanger BF, McKinnon KJ, Classen J (1979) Immune-complex mediated interstitial cystitis as a major manifestation of systemic lupus erythematosus. Clin Immunol Immunopathol 13:67–76
Collan Y, Alfthan O, Kivilaakso E, Oravisto KJ (1976) Electron microscopic and histological findings on urinary bladder epithelium in interstitial cystitis. Eur Urol 2:242–247
De la Serna AR, Alarcon-Segovia D (1981) Chronic intestitial cystits as an initial major manifestation of systemic lupus erythematosus. J Rheumatol 8:803–810
Glynn LE (1975) Experimental models and etiology of inflammatory rheumatic diseases. Scand J Rheumatol 5:55–62
Greenlee TK, Ross R, Hartman JL (1966) The fine structure of elastic fibers. J Cell Biol 30:59–71
Haust MD (1979) Proliferation and degeneration of elastic tissue in aortic explants from normo-, and hypercholesterolemic rabbits. Exp Mol Pathol 31:169–181
Linder E, Hormia M, Lehto V-P, Törnroth T (1981) Identification of cytoskeletal intermediate filaments of vascular endothelial cells as targets for autoantibodies in patient sera. Clin Immunol Immunopathol 21:217–227
Linder E, Lehto V-P (1978) Antibodies against microfibrils of developing connective tissue in patients with inflammatory conditions. Scand J Immunol 7:239–244
Linder E, Lehto V-P, Stenman S, Lindqvist K, Bjorvatn B, Bergquist R (1979) Circulating antibodies to connective tissue microfibrils and dermal immunoglobulin deposits in lepropsy. Clin Immunol Immunopathol 13:1–8
Mattila J (1982) Vascular immunopathology in interstitial cystitis. Clin Immunol Immunopathol 23:648–655
Oravisto KJ (1980) Interstitial cystitis as an autoimmune disease. Rev Eur Urol 6:10–13
Oravisto KJ, Alfthan OS (1976) Treatment of intestinal cystitis with immunosuppression and chloroquine derivates. Eur Urol 2:82–84
Rhodin JA (1968) Ultrastructure of mammalian venous capillaries, venules and small collecting veins. J Ultrastruct Res 25:452–500
Skoluda D, Wegner K, Lemmel EM (1974) Kritische Bemerkungen zur Immunpathogenese der interstitiellen Cystitis. Urologe A 13:15–23
Trillo AA (1981) Formation of “ghost” bodies and calcification in experimental atherosclerosis in nonhuman primates. Virchows Arch [Cell Pathol] 38:127–134
Trillo A, Haust MD (1972) Granulovesicular bodies and vascular elastic fibers under normal and experimental conditions (Abstr.). Lab Invest 26:493
Trillo A, Haust MD (1975) The granulovesicular bodies of the arterial wall. Lab Invest 32:105–110
Weisman MH, McDanald EC, Wilson CB (1981) Studies of the pathogenesis of interstitial cystitis, obstructive uropathy and intestinal malabsorption in a patient with systemic lupus erythematosus. Am J Med 70:875–881
Wracko R (1974) Basal lamina layering in Diabetes mellitus. Evidence for accelerated rate of cell death and cell degeneration. Diabetes 23:94–104
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mattila, J., Pitkänen, R., Vaalasti, T. et al. Fine-structural evidence for vascular injury in patients with interstitial cystitis. Vichows Archiv A Pathol Anat 398, 347–355 (1983). https://doi.org/10.1007/BF00583590
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00583590