Reviewing Interstitial CystitisModels and Treatments: A Focus on the Urothelium

Author

Orthopaedic Trauma Institute, San Francisco General Hospital, University of California, San Francisco, USA

10.5812/rijm.64551

Abstract

Abstract Context: Interstitial cystitis is amultifactorial chronic and debilitating disease which is commonly associated with pain localized in the bladder region, increased urinary frequency, urgency and nocturia. Due to the high prevalence of pain in the population affectedmore recently the condition is often referred to as interstitial cystitis / bladder pain syndrome (IC/BPS). Evidence Acquisition: Although IC presentswithmany different symptoms, researchers have formulated three different theories, which are notmutually exclusive, to explain IC pathology: the first is related to the alteration of the proteoglycan and protein junc- tion composition, structure and presence in the urothelium. The second is an immune induced IC resulting from an increased number of activated mast cells in the bladder internal layers, such as detrusor muscle (DM), and mucosa/submucosa. The third type, which is closely related to the second one, is due to a sensory nerve sensitization as an effect of neurotrophic factorsmolecule release. Results: Previous classification has beenmirrored in the development of various in vitro and in vivo diseasemodels created tomimic IC, aswell as in the available therapies used to treat the condition to date. Conclusions: This reviewwill summarize themost recent advances in the field, related to the different causative factors contributing to the development of the condition, the in vivomodels used as well as the evidence they provide in advancing our knowledge and their limitations. The focus will be on works report- ing on IC in the domain related to alterations in proteoglycans and cellular junction, specifically their composition, structure and appearance in the urothelium, and also discuss present and future therapies. Conclusions: This reviewwill summarize themost recent advances in the field, related to the different causative factors contribut- ing to the development of the condition, the in vivomodels used as well as the evidence they provide in advancing our knowledge and their limitations. The focus will be on works reporting on IC in the domain related to alterations in proteoglycans and cellular junction, specifically their composition, structure and appearance in the urothelium, and also discuss present and future therapies.

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