van de Merwe Joop P
Erasmus MC, University Medical Center Rotterdam, Departments of Immunology and Internal Medicine, Dr Molewaterplein 50, Rotterdam, The Netherlands.
Nat Clin Pract Urol. 2007 Sep;4(9):484-91. doi: 10.1038/ncpuro0874.
The cause of interstitial cystitis, a chronic disease that affects the bladder, is unknown. Autoantibodies, such as those against nuclear and bladder epithelium antigens, have been found in patients with interstitial cystitis, but these are likely to be secondary to the disease. No data support a direct causal role of autoimmune reactivity in the pathogenesis of interstitial cystitis. Indirect evidence, however, does support a possible autoimmune nature of interstitial cystitis, such as the strong female preponderance and the clinical association between interstitial cystitis and other known autoimmune diseases within patients and families. The strongest association occurs between interstitial cystitis and Sjögren's syndrome. Increasing evidence suggests a possible role of autoantibodies to the muscarinic M3 receptor in Sjögren's syndrome. The M3 receptor is also located on the detrusor muscle cells of the bladder and mediates cholinergic contraction of the urinary bladder and other smooth muscle tissues. Autoantibodies to the M3 receptor might be important in both the early noninflammatory and the late inflammatory features of interstitial cystitis.
间质性膀胱炎是一种影响膀胱的慢性疾病，其病因尚不清楚。在间质性膀胱炎患者中已发现自身抗体，如抗核和膀胱上皮抗原的抗体，但这些可能是该疾病的继发表现。没有数据支持自身免疫反应在间质性膀胱炎发病机制中的直接因果作用。然而，间接证据确实支持间质性膀胱炎可能具有自身免疫性质，例如女性发病率高以及间质性膀胱炎与患者及其家族中的其他已知自身免疫性疾病之间的临床关联。间质性膀胱炎与干燥综合征之间的关联最为密切。越来越多的证据表明，自身抗体对毒蕈碱M3受体在干燥综合征中可能起作用。M3受体也位于膀胱逼尿肌细胞上，介导膀胱和其他平滑肌组织的胆碱能收缩。针对M3受体的自身抗体可能在间质性膀胱炎的早期非炎症和晚期炎症特征中都很重要。
