Int Neurourol J.  2016 Nov;20(Suppl 2):S95-S104. 10.5213/inj.1632712.356.

Pathomechanism of Interstitial Cystitis/Bladder Pain Syndrome and Mapping the Heterogeneity of Disease

• Jhang JF
• Kuo HC

• KMID: 2362502
• DOI: http://doi.org/10.5213/inj.1632712.356

Abstract

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a heterogeneous syndrome which is usually characterized by urinary frequency, nocturia, and bladder pain. Several pathomechanisms have been proposed, including uroepithelial dysfunction, mast cell activation, neurogenic inflammation, autoimmunity, and occult urinary tract infections. It is possible that an inflammatory process alters regulation of urothelial homeostasis and results in dysfunction of the bladder epithelium. Different phenotypes of IC/BPS have been explored including Hunner and non-Hunner type IC, hypersensitive bladder, and bladder pain both with and without functional somatic syndrome. Different gene expressions have also been found in different IC phenotypes. Abnormal expressions of uroplakin, chondroitin sulfate and adhesive protein E-cadherin, tight junction protein zonula occludens-1 in IC/BPS bladder suggest abnormal epithelial differentiation in this bladder disease. Analysis of inflammatory proteins, or cytokines in the urine or serum provides another diagnostic foundation forIC/BPS subtypes. The involvement of IC/BPS in systemic functional somatic syndrome and other pelvic organ diseases might also subdivide subtypes of IC/BPS. Chronic inflammation, increased urothelial apoptosis, and abnormal urothelial function are closely associated in IC bladders. This article reviews recent research on the pathomechanisms of IC, which might help us in mapping the heterogeneity of the disease.

Keyword

Lower Urinary Tract Symptoms; Cystitis; Bladder Pain; Biomarkers; Urotheliuim

MeSH Terms

Adhesives
Apoptosis
Autoimmunity
Biomarkers
Cadherins
Chondroitin Sulfates
Cystitis
Cytokines
Epithelium
Gene Expression
Homeostasis
Inflammation
Lower Urinary Tract Symptoms
Mast Cells
Neurogenic Inflammation
Nocturia
Phenotype
Population Characteristics*
Tight Junctions
Urinary Bladder
Urinary Bladder Diseases
Urinary Tract Infections
Uroplakins
Adhesives
Biomarkers
Cadherins
Chondroitin Sulfates
Cytokines
Uroplakins