The Implications of Mental Health and Trauma in Interstitial Cystitis

Bendrick, Tyler; Sitenga, Graison; Booth, Cameron; Sacco, Matthew P.; Erie, Christine; Anderson, Danyon J.; Kaye, Alan D.; Urits, Ivan

doi:10.52965/001c.40321

Cited by 2 publications

(2 citation statements)

References 30 publications

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“…Predisposing risk factors that can increase susceptibility to IC include genetic vulnerability ( 12 ), family ( 104 , 119 ) medical ( 120 ) and mental health history ( 121 ), personality traits ( 122 ), ELA and RLA ( 14 ), age ( 119 ). and gender ( 123 ).…”

Section: Discussionmentioning

confidence: 99%

Interstitial cystitis—an imbalance of risk and protective factors?

Westropp,

Stella,

Buffington

2024

Front. Pain Res.

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Interstitial cystitis (IC) presents as a chronic pain condition with variable combinations of symptoms depending on the species and individual patient. It is diagnosed by the presence of lower urinary tract signs and symptoms in combination with a variety of comorbid health problems, a history of life adversities, and the absence of other conditions that could cause the lower urinary tract signs. IC occurs naturally in humans and cats as a dimensional condition, with patients presenting with mild, moderate, and severe symptoms. Most patients appear to recover without specific treatment. A number of rodent models of IC have been used to study its causes and treatments. Unfortunately, current therapies generally fail to ameliorate IC symptoms long-term. The recent classification of IC as a chronic primary pain disorder calls for a rethinking of current clinical and research approaches to it. Beginning when a patient encounters a clinician, precipitating, perpetuating, and palliating risk factors can be addressed until a cause or reliably effective therapy is identified, and identifying predisposing and preventive factors can inform epidemiological studies and health promotion interventions. Predisposing, precipitating, and perpetuating risk factors, including environmental, psychological, and biological, increase the activity of the central threat response system (CTRS), which plays a clinically important role in IC symptoms. Studies in cats and rodent models have revealed that environmental enrichment (EE), in the absence of bladder-directed therapies, leads to amelioration of IC symptoms, implying a central role for the CTRS in symptom precipitation and perpetuation. Conceptually moving the source of IC pain to the brain as a motivational state rather than one resulting from peripheral nociceptive input offers both clinicians and researchers novel opportunities to improve care for patients with IC and for researchers to use more ecologically valid rodent models. It may even be that IC results from an excess of risk to protective factors, making this imbalance a targetable cause rather than a consequence of IC.

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Section: Discussionmentioning

confidence: 99%

Interstitial cystitis—an imbalance of risk and protective factors?

Westropp,

Stella,

Buffington

2024

Front. Pain Res.

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“…With this in mind, chronic stress has been identified as a key risk factor in developing IC/BPS in otherwise healthy patients ( Birder, 2019 ), and a number of studies have reported higher incidences of early life stress in IC/BPS patients than healthy controls ( Fuentes and Christianson, 2018a ). The precise mechanisms regulating stress induced IC/BPS are unclear, however, evidence is accumulating that the functional impacts of stress on bladder function and the perception of painful stimuli are likely mediated by long-term perturbations of the HPA axis and the sympathetic-adrenal medulla pathway ( Figure 1 ) ( de Groat et al, 2015 ; Fuentes and Christianson, 2018b ; Bendrick et al, 2022 ). The downstream effectors of these pathways, including CRF, cortisol, and noradrenaline are well known regulators of urinary function and thought to be crucial in regulating centrally mediated changes that induce IC/BPS symptoms ( Ulrich-Lai and Herman, 2009 ; Pierce and Christianson, 2015 ).…”

Section: Mechanisms Underlying Ic/bpsmentioning

confidence: 99%

Animal models of interstitial cystitis/bladder pain syndrome

Tay,

Grundy

2023

Front. Physiol.

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Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic disorder characterized by pelvic and/or bladder pain, along with lower urinary tract symptoms that have a significant impact on an individual’s quality of life. The diverse range of symptoms and underlying causes in IC/BPS patients pose a significant challenge for effective disease management and the development of new and effective treatments. To facilitate the development of innovative therapies for IC/BPS, numerous preclinical animal models have been developed, each focusing on distinct pathophysiological components such as localized urothelial permeability or inflammation, psychological stress, autoimmunity, and central sensitization. However, since the precise etiopathophysiology of IC/BPS remains undefined, these animal models have primarily aimed to replicate the key clinical symptoms of bladder hypersensitivity and pain to enhance the translatability of potential therapeutics. Several animal models have now been characterized to mimic the major symptoms of IC/BPS, and significant progress has been made in refining these models to induce chronic symptomatology that more closely resembles the IC/BPS phenotype. Nevertheless, it's important to note that no single model can fully replicate all aspects of the human disease. When selecting an appropriate model for preclinical therapeutic evaluation, consideration must be given to the specific pathology believed to underlie the development of IC/BPS symptoms in a particular patient group, as well as the type and severity of the model, its duration, and the proposed intervention’s mechanism of action. Therefore, it is likely that different models will continue to be necessary for preclinical drug development, depending on the unique etiology of IC/BPS being investigated.

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The Implications of Mental Health and Trauma in Interstitial Cystitis

Cited by 2 publications

References 30 publications

Interstitial cystitis—an imbalance of risk and protective factors?

Interstitial cystitis—an imbalance of risk and protective factors?

Animal models of interstitial cystitis/bladder pain syndrome

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