Molecular pathogenesis of interstitial cystitis/bladder pain syndrome based on gene expression

Abstract

Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic bladder inflammation that leads to chronic bladder pain and urinary urgency and frequency. The presentation of IC/PBS is heterogeneous, and it is classified as ulcerative IC/PBS and nonulcerative IC/PBS. The main cause of IC/PBS is thought to be a persistent inflammatory condition in the bladder, though the actual pathophysiology has not been identified yet. Although the underlying pathophysiology of IC/PBS is not completely understood, several theories for the etiology of this syndrome have been suggested, including deficiency of the glycosaminoglycan covering urothelium surface that results in leaky urothelium infection, immunological etiology, activated mast cells, neural changes, and inflammation. In addition, there are no gold standards for the detection of this disorder to date. So, determination of gene expression and its role in different signaling pathways in the pathogenesis of this heterogeneous disorder contribute to the more efficient cognition of the pathophysiology of this disease and to the design of effective treatments and molecular diagnostic methods for IC/PBS.

Exploration of the core genes in ulcerative interstitial cystitis/bladder pain syndrome

“…A tissue-specific expression analysis of genes from the key modules was performed using the online tool BioGPS. The criteria for being highly tissue-specific were: [1] the tissue-specific expression level was over ten times greater than the median, and [2] the highest expression level was over three times greater than the second highest expression level (9).…”

“…Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a chronic infl ammatory disease characterized by chronic bladder pain and accompanying symptoms, such as frequent urination and urgency (1). The European Society for the Study of Interstitial Cystitis (ESSIC) defi nes its diagnosis based on chronic bladder pain and discomfort lasting for six months or longer, with at least one accompanying urinary tract symptom, such as frequent or urgent urination.…”

“…Ho-wever, it is necessary to rule out diseases with easily confusable symptoms, and to deal with other organ symptoms, as well as cognitive, behavioral, emotional and sexual factors (2). Female patients account for the majority of patients, the prevalence among women is between 2.7% and 6.5%, and the male--to-female prevalence ratio is roughly 5:1 or higher (1,3). Subtypes include ulcerative and non-ulcerative IC/BPS.…”

The relationship between illness perception and worsening of interstitial cystitis/painful bladder syndrome symptoms: A cross‐sectional study

“…19 Interestingly, participants identified inflammation as one of the causes of their illness, an outcome consistent with the mainstream understanding of IC/PBS pathogenesis, which is often characterised by activation of the bladder mast cells, cytokine, and nitric oxide release. 20,21 However, the unsatisfactory outcomes of available antihistamines and other immune-modulatory agents in the treatment of IC/ PBS confound this theory. The presence of both histaminergic receptors on IC/PBS biopsies and proinflammatory mediators in biological samples point to the fact that these cell membrane proteins are critical therapeutic targets.…”

The study on the function and cell source of interleukin‐6 in interstitial cystitis/bladder painful syndrome rat model

“…Among the numerous etiological theories about IC/BPS, the immune correlation theory has been recognized and concerned by the majority of peer experts 5,6 . Based on the theory that IC/BPS is an autoimmune disease, anti‐TNF α agents such as adalimumab, certolizumab pegol, and other biological agents have been proved to significantly improve the symptoms of IC/BPS through clinical trials 7,8 .…”