The immune system in Interstitial Cystitis/Bladder Pain Syndrome and therapeutic agents
John Fallon,
Inna Tabansky Stern,
Micheline Laurent,
Lori Birder,
Robert M. Moldwin,
Joel N.H. Stern
Affiliations
John Fallon
Department of Urology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; The Smith Institute for Urology, Northwell Health, 450 Lakeville Road, New Hyde Park, NY, USA
Inna Tabansky Stern
Department of Urology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11790, USA
Micheline Laurent
Departments of Neurology and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
Lori Birder
Department of Medicine, University of Pittsburgh School of Medicine, PA, USA
Robert M. Moldwin
Department of Urology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; The Smith Institute for Urology, Northwell Health, 450 Lakeville Road, New Hyde Park, NY, USA
Joel N.H. Stern
Department of Urology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Departments of Neurology and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Institute of Molecular Medicine, The Feinstein Institutes for Medical Research, Manhasset, NY, USA; Corresponding author at: Department of Urology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is defined by bladder pain and lower urinary tract symptoms (LUTS) in the absence of a definable etiology. Urinary tract infection is not the only definable etiology. Multiple clinical phenotypes appear within the IC/BPS patient population (Clemens, 2019) . This is likely the reason that an etiology for the disorder has not yet been identified. The heterogeneity of this population is also the probable cause for multiple failures of therapeutic trials (Nickel and Moldwin, 2018). One IC/BPS phenotype that is readily distinguishable on cystoscopy is characterized by Hunner lesions: focal, erythematous mucosal patches with abnormal capillary architecture, edema, and scattered hemorrhages. (Akiyama et al., 2019) Current evidence suggests both local and/or centralized pathologic processes may be associated with pain experienced in IC/BPS (IC/BPS), the formation of bladder lesions is an identifiable local event in patients with IC/BPS with Hunner lesion (IC/BPS-HL). (Lai, 2021) This review will highlight recent developments in understanding the pathophysiology of IC/BPS as it relates to the immune system. We will discuss relevant immune cells, gene expression profiles, cytokine milieu, and relevant treatment modalities.
