I have evolved from a long standing interest in urinary tract infections to interstitial cystitis (IC), which from all available evidence is NOT an infectious disease. This is a disease comprising bladder pain, urinary urgency, urinary frequency, and nocturia, 90% of patients are women, and the etiology is unknown.
Funded by the National Institutes of Health, my colleagues and I have four objectives in our investigations of interstitial cystitis:
1) To determine risk factors for IC in a nation-wide case control study seeking exposures antecedent to onset of symptoms.
2) To seek the alleles of susceptibility to IC in a, separate, nation-wide study of families with 2 or more IC patients.
3) To carefully study the onset of IC to reveal hints as to its etiology.
4) To carefully investigate the symptoms of IC to develop a better case definition for this symptom-based disease.
In the process of investigating these aspects of IC, we are attempting to understand its relationship with several non-bladder diseases which appear to be epidemiologically associated with IC: systemic lupus erythematosis, panic attacks, fibromyalgia, irritable bowel syndrome, and inflammatory bowel disease.
Clinical Speciality:I continue to be excited about the variety of infectious diseases patients encountered at University Hospital and attend, on an inpatient basis, two to three months a year.
Trifillis, A.L., Cui, X., Jacobs, S., Warren, J.W. Culture of bladder epithelium from cystoscopic biopsies of patients with interstitial cystitis. J. Urol. 1995; 153:243-248.
Keay, S., Schwalbe, R.S., Trifillis, A.L., Lovchik, J.C., Jacobs, S., Warren, J.W. A prospective study of microorganisms in urine and bladder biopsies from interstitial cystitis patients and controls. Urology 1995; 45:223-229.
Johnson, D.E., Lockatell, C.V., Russell, R.G., Hebel, J.R., Island, M.D., Stapleton, A., Stamm, W.E., Warren, J.W. Comparison of Escherichia coli strains recovered from human cystitis and pyelonephritis infections in transurethrally challenged mice. Infect. Immun. 1998; 66:3059-3065.
Warren, J.W., Abrutyn, E., Hebel, J.R., Johnson, J.R., Schaeffer, A.J., Stamm, W.E. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Clin. Infect. Dis. 1999; 29:745-758.
Warren, J.W., Horne, L.M., Hebel, J.R., Marvel, R.P., Keay, S.K., Chai, T.C. Pilot study of sequential oral antibiotics in the treatment of interstitial cystitis. J. Urol. 2000; 163:1685-1688.
Warren, J.W., Keay, S.K., Meyers, D., Xu, J. Concordance of interstitial cystitis in monozygotic and dizygotic twin pairs. Urology 2001; 57:22-25.
Warren, J.W., Jackson T.L., Langenberg, P., Meyers, D.J., and Xu, J. Prevalence of interstitial cystitis in first-degree relatives of patients with interstitial cystitis. J Urol 2004; 63 (1): 17-21.
Warren, J.W., Diggs, C., Brown, V., Meyer, W.A., Markowitz, S., and Greenberg, P. Dysuria on onset of interstitial cystitis/painful bladder syndrome in women. Urology. (accepted for publication).
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