Immunologic and histologic evaluation of the urinary bladder wall after group A streptococcal infection

A progressive chronic inflammation characterized by acute intermittent exacerbations was produced by injection of small numbers of Group A, type 12, S. pyogenes into the bladder wall of rabbits. A quantitative cell count on serially sacrificed rabbits was made. The cellular response was found to be greatly altered and dependent upon the tissue layer of the bladder wall injected. With chronicity of the lesions, tissue injury and alterations were prominent. Concomitantly, tissue DNA fluorescence using acridine orange was found to be reduced. Tissue DNA antibodies were demonstrated in all rabbits injected with streptococci. These antibodies were also demonstrated in a human patient with the clinical diagnosis of interstitial cystititis. Streptococcal antigens were found to be present in the bladder tissue long after viability had ceased using immunofluorescence. A relation between cystitis, interstitial cystitis, and streptococcal and poststreptococcal inflammation is suggested.