TY - JOUR
T1 - Biomarkers implicated in lower urinary tract symptoms
T2 - Systematic review and pathway analyses
AU - Siddiqui, Nazema Y.
AU - Helfand, Brian T.
AU - Andreev, Victor P.
AU - Kowalski, Joseph T.
AU - Bradley, Megan S.
AU - Lai, H. Henry
AU - Berger, Mitchell B.
AU - Mueller, Margaret G.
AU - Bickhaus, Jennifer A.
AU - Packiam, Vignesh T.
AU - Fenner, Dee
AU - Gillispie, Brenda W.
AU - Kirkali, Ziya
N1 - Publisher Copyright:
© 2019 by American UROLOGICAL ASSOCIATION EDUCATION AND RESEARCH, INC.
PY - 2019
Y1 - 2019
N2 - Purpose: Lower urinary tract symptoms are prevalent and burdensome, yet methods to enhance diagnosis and appropriately guide therapies are lacking. We systematically reviewed the literature for human studies of biomarkers associated with lower urinary tract symptoms. Materials and Methods: PubMed®, EMBASE® and Web of Science® were searched from inception to February 13, 2018. Articles were included if they were in English, performed in benign urological populations without neurological disorders or interstitial cystitis/bladder pain syndrome, and assessed a biomarker's association with or ability to predict specific lower urinary tract symptoms or urological conditions. Bioinformatic pathway analyses were conducted to determine whether individual biomarkers associated with symptoms are present in unifying pathways. Results: Of 6,150 citations identified 125 met the inclusion criteria. Most studies (93.6%) assessed biomarkers at 1 time point and were crosssectional in nature. Few studies adjusted for potentially confounding clinical variables or assessed biomarkers in an individual over time. No individual biomarkers are currently validated as diagnostic tools for lower urinary tract symptoms. Compared to controls, pathway analyses identified multiple immune response pathways that were enriched in overactive bladder syndrome and cell migration/cytoskeleton remodeling pathways that were enriched in female stress incontinence. Conclusions: Major deficiencies in the existing biomarker literature include poor reproducibility of laboratory data, unclear classification of patients with lower urinary tract symptoms and lack of adjustment for clinical covariates. Despite these limitations we identified multiple putative pathways in which panels of biological markers need further research.
AB - Purpose: Lower urinary tract symptoms are prevalent and burdensome, yet methods to enhance diagnosis and appropriately guide therapies are lacking. We systematically reviewed the literature for human studies of biomarkers associated with lower urinary tract symptoms. Materials and Methods: PubMed®, EMBASE® and Web of Science® were searched from inception to February 13, 2018. Articles were included if they were in English, performed in benign urological populations without neurological disorders or interstitial cystitis/bladder pain syndrome, and assessed a biomarker's association with or ability to predict specific lower urinary tract symptoms or urological conditions. Bioinformatic pathway analyses were conducted to determine whether individual biomarkers associated with symptoms are present in unifying pathways. Results: Of 6,150 citations identified 125 met the inclusion criteria. Most studies (93.6%) assessed biomarkers at 1 time point and were crosssectional in nature. Few studies adjusted for potentially confounding clinical variables or assessed biomarkers in an individual over time. No individual biomarkers are currently validated as diagnostic tools for lower urinary tract symptoms. Compared to controls, pathway analyses identified multiple immune response pathways that were enriched in overactive bladder syndrome and cell migration/cytoskeleton remodeling pathways that were enriched in female stress incontinence. Conclusions: Major deficiencies in the existing biomarker literature include poor reproducibility of laboratory data, unclear classification of patients with lower urinary tract symptoms and lack of adjustment for clinical covariates. Despite these limitations we identified multiple putative pathways in which panels of biological markers need further research.
KW - Biomarkers
KW - Lower urinary tract symptoms
KW - Nocturia
KW - Overactive
KW - Stress
KW - Urinary bladder
KW - Urinary incontinence
UR - http://www.scopus.com/inward/record.url?scp=85065607085&partnerID=8YFLogxK
U2 - 10.1097/JU.0000000000000257
DO - 10.1097/JU.0000000000000257
M3 - Review article
C2 - 30925127
AN - SCOPUS:85065607085
VL - 202
SP - 880
EP - 889
JO - The Journal of Urology
JF - The Journal of Urology
SN - 0022-5347
IS - 5
ER -