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Research Illustrates Multiple Underlying Factors Contributing to Development of IC/BPS

Jhang JF, Kuo HC1. Pathomechanism of Interstitial Cystitis/Bladder Pain Syndrome and Mapping the Heterogeneity of Disease. Int Neurourol J. 2016 Nov;20(Suppl 2):S95-104. Epub 2016 Nov 22.

This educational article includes a review of recent investigations into what causes interstitial cystitis/bladder pain syndrome (IC/BPS), with the hope that such a review might help researchers and clinicians appreciate the heterogeneity of IC/BPS; in other words, that it has a variety of causes and mechanisms for development. The authors outline five types of functional changes associated with IC/BPS, including dysfunction of the uroepithelium (urinary tract lining); activation of mast cells, which play a key role in inflammation; autoimmunity, or the mounting of immune response directed at one’s own healthy tissues or cells; urinary tract infections; and inflammation associated with the nervous system. Through careful analysis of different IC/BPS presentations, it may be possible to better define IC/BPS subtypes, each of which may respond better to different types of treatment. Toward that end, it would help to have good biomarkers of IC/BPS, detectable in urine or blood, that match up with the various underlying causes. Although there has been extensive research into IC/BPS biomarkers, as is outlined and reviewed in this article, researchers don’t yet understand them well enough to say for sure that any of them could be used in clinical practice for diagnostic purposes.