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Hence, this study aims to propose a possible immune mechanism of irreversible bladder damage caused by KC. A total of 53 KC patients and 21 healthy volunteers as controls have been retrospectively assessed. The levels of serum immunoglobulin E (IgE), IL-6, and IFN-<jats:italic>\u03b3<\/jats:italic> of KC patients were significantly higher than those of controls, whereas the TGF-<jats:italic>\u03b2<\/jats:italic> levels of KC patients substantially reduced but the IL-2 and IL-4 levels of KC patients were comparable to those of controls. Moreover, the KC patients had significantly higher counts of <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">H<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>1, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">H<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>2, and <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">H<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>17 cells than those of controls. The immune response of KC users may begin with the IL-6 production and differentiation of <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">H<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>17 and may be followed by alternating between high expressions of <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">H<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>1 and <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">H<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>2. The IL-6 may further suppress the <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">R<\/mml:mi><mml:mi mathvariant=\"normal\">E<\/mml:mi><mml:mi mathvariant=\"normal\">G<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math> cells which can aggravate chronic inflammation in KC patients and the imbalance in <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">H<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>17 and <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">R<\/mml:mi><mml:mi mathvariant=\"normal\">E<\/mml:mi><mml:mi mathvariant=\"normal\">G<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math> cells may involve the pathogenesis of KC. Further investigation is needed to define the role of IL-6 in <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">H<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>1\/<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">H<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>2\/<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=\"normal\">T<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">H<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>17-regulated signaling pathway in ketamine-induced cystitis.<\/jats:p>","DOI":"10.1155\/2017\/2329868","type":"journal-article","created":{"date-parts":[[2017,10,24]],"date-time":"2017-10-24T23:30:29Z","timestamp":1508887829000},"page":"1-9","source":"Crossref","is-referenced-by-count":16,"title":["The Immunomodulatory Imbalance in Patients with Ketamine Cystitis"],"prefix":"10.1155","volume":"2017","author":[{"given":"Gang-Yi","family":"Fan","sequence":"first","affiliation":[{"name":"Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juin-Hong","family":"Cherng","sequence":"additional","affiliation":[{"name":"Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6203-057X","authenticated-orcid":true,"given":"Shu-Jen","family":"Chang","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, School of 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