Journal article
Interstitial cystitis/bladder pain syndrome: The evolving landscape, animal models and future perspectives
International journal of urology, Vol.27(6), pp.491-503
06/2020
DOI: 10.1111/iju.14229
PMCID: PMC7768977
PMID: 32246572
Abstract
Interstitial cystitis/bladder pain syndrome is a debilitating condition of unknown etiology characterized by persistent pelvic pain with lower urinary tract symptoms and comprises a wide variety of potentially clinically useful phenotypes with different possible etiologies. Current clinicopathological and genomic evidence suggests that interstitial cystitis/bladder pain syndrome should be categorized by the presence or absence of Hunner lesions, rather than by clinical phenotyping based on symptomatology. The Hunner lesion subtype is a distinct inflammatory disease with proven bladder etiology characterized by epithelial denudation and enhanced immune responses frequently accompanied by clonal expansion of infiltrating B cells, with potential engagement of infection. Meanwhile, the non-Hunner lesion subtype is a non-inflammatory disorder with little evidence of bladder etiology. It is potentially associated with urothelial malfunction and neurophysiological dysfunction, and frequently presents with somatic and/or psychological symptoms, that commonly result in central nervous sensitization. Animal models of autoimmune cystitis and neurogenic sensitization might serve as disease models for the Hunner lesion and non-Hunner lesion subtypes, respectively. Here, we revisit the taxonomy of interstitial cystitis/bladder pain syndrome according to current research, and discuss its potential pathophysiology and representative animal models. Categorization of interstitial cystitis/bladder pain syndrome based on cystoscopy is mandatory to design optimized treatment and research strategies for each subtype. A tailored approach that specifically targets the characteristic inflammation and epithelial denudation for the Hunner lesion subtype, or the urothelial malfunction, sensitized/altered nervous system and psychosocial problems for the non-Hunner lesion subtype, is essential for better clinical management and research progress in this complex condition.
Details
- Title: Subtitle
- Interstitial cystitis/bladder pain syndrome: The evolving landscape, animal models and future perspectives
- Creators
- Yoshiyuki Akiyama - The University of TokyoYi Luo - University of IowaPhilip M Hanno - Stanford UniversityDaichi Maeda - Osaka UniversityYukio Homma - Japanese Red Cross Medical Center
- Resource Type
- Journal article
- Publication Details
- International journal of urology, Vol.27(6), pp.491-503
- DOI
- 10.1111/iju.14229
- PMID
- 32246572
- PMCID
- PMC7768977
- ISSN
- 0919-8172
- eISSN
- 1442-2042
- Grant note
- Japan Intractable Diseases Research Foundation R01-DK-111396 / NIDDK NIH HHS R01 DK111396 / NIDDK NIH HHS 19K07433 / Japanese Society for the Promotion of Science 19K18552 / Japanese Society for the Promotion of Science 18060798 / Ministry of Health, Labor and Welfare
- Language
- English
- Date published
- 06/2020
- Academic Unit
- Urology
- Record Identifier
- 9984320857302771
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