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Cervigni M. Interstitial cystitis/bladder pain syndrome and glycosaminoglycans replacement therapy. Transl Androl Urol. 2015 Dec;4(6):638-42. doi: 10.3978/j.issn.2223-4683.2015.11.04.

What exactly causes interstitial cystitis/bladder pain syndrome (IC/BPS) is a matter of continued debate and discussion. One of the most recent theories is that the condition could be caused by a disruption of the mucosal bladder surface layer, leading to a loss or alteration of glycosaminoglycans (GAGs), a class of molecules that repel water. When GAGs are not present, the bladder wall may be penetrated by substances that trigger an inflammatory response. One treatment that could help is replenishment of the GAG layer. This treatment is commonly used for patients with IC/BPS who don’t respond (or have poor response) following more conventional treatments. The key treatments that help achieve GAG replenishment include heparin, chondroitin sulfate, pentosan polysulphate, and hyaluronic acid. One of the most recent promising developments is a combination of chondroitin sulphate and hyaluronic acid that has had promising results. However, encouraging results from all of these therapies need more study in randomized, controlled studies with a larger number of patients so the treatments can be optimized to deliver more long-term therapeutic effects.