Pain Management in a Model of Interstitial Cystitis/Bladder Pain Syndrome by a Vaccinal Strategy

Céline Augé; Lilian Basso; Catherine Blanpied; Nathalie Vergnolle; Xavier Gamé; Sophie Chabot; Philippe Lluel; Gilles Dietrich

doi:10.3389/fpain.2021.642706

Pain Management in a Model of Interstitial Cystitis/Bladder Pain Syndrome by a Vaccinal Strategy

Front Pain Res (Lausanne). 2021 Mar 8:2:642706. doi: 10.3389/fpain.2021.642706. eCollection 2021.

Authors

Céline Augé¹, Lilian Basso², Catherine Blanpied², Nathalie Vergnolle^{2

3}, Xavier Gamé^{4

5}, Sophie Chabot¹, Philippe Lluel¹, Gilles Dietrich²

Affiliations

¹ Urosphere, Department of Pain and Inflammation, Toulouse, France.
² IRSD, Université de Toulouse, INSERM, INRA, ENVT, UPS, Toulouse, France.
³ Department of Physiology and Pharmacology, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
⁴ Urology Department, Rangueil University Hospital, Toulouse, France.
⁵ INSERM, I2MC-U1048, CHU Rangueil, Toulouse, France.

Abstract

Current analgesic treatments for Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) are limited. Here, we propose a novel antinociceptive strategy exploiting the opioid-mediated analgesic properties of T lymphocytes to relieve from bladder pain. In a chronic model of IC/BPS in rats, we show that a secondary T cell response against intravesically administered ovalbumin prevents from visceral pain in OVA-primed animals. The analgesic effect is associated with the recruitment of T lymphocytes within the inflamed mucosa and is reversed by naloxone-methiodide, a peripheral opioid receptor antagonist. Similarly, intravesical instillation of BCG or tetanus toxoid antigens in vaccinated rats protects from pain in the same model. We show opioid-dependent analgesic properties of local vaccine antigen recall in a preclinical rat model of chronic cystitis. Since BCG bladder instillation is regularly used in humans (as anticancer therapy), our results open it as a new therapeutic positioning for a pain management indication for IC/BPS patients.

Keywords: T lymphocytes; bladder pain syndrome; cyclophosphamide; cystitis; opioid; vaccination.