Cervigni Mauro
Interstitial Cystitis Referral Center, Catholic University, Rome, Italy.
Transl Androl Urol. 2015 Dec;4(6):638-42. doi: 10.3978/j.issn.2223-4683.2015.11.04.
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating chronic disease characterized by discomfort or recurrent abdominal and pelvic pains in the absence of urinary tract infections. Its symptomatology includes discomfort, increased bladder pressure, sensitivity and intense pain in the bladder and pelvic areas, increased voiding frequency and urgency, or a combination of these symptoms. For these reasons, this pathology has a very negative impact on quality of life. The etiology of IC/BPS is still not well understood and different hypotheses have been formulated, including autoimmune processes, allergic reactions, chronic bacterial infections, exposure to toxins or dietary elements, and psychosomatic factors. The finding of an effective and specific therapy for IC/BPS remains a challenge for the scientific community because of the lack of a consensus regarding the causes and the inherent difficulties in the diagnosis. The last recent hypothesis is that IC/BPS could be pathophysiologically related to a disruption of the bladder mucosa surface layer with consequent loss of glycosaminoglycans (GAGs). This class of mucopolysaccharides has hydrorepellent properties and their alteration expose the urothelium to many urinary toxic agents. It has been hypothesized that when these substances penetrate the bladder wall a chain is triggered in the submucosa. In order to improve the integrity and function of the bladder lining, GAG layer replenishment therapy is widely accepted as therapy for patients with IC/BPS who have poor or inadequate response to conventional therapy. Currently, Chondroitin sulfate (CS), heparin, hyaluronic acid (HA), and pentosan polysulphate (PPS), and combinations of two GAGs (CS and HA) are the available substances with different effectiveness rates in patients with IC/BPS. There are four different commercially available products for GAG replenishment including CS, heparin, HA and PPS. Each product has different concentrations and dosage formulations. Recently, a combination of CS and HA is the latest commercially available product with promising results.
间质性膀胱炎/膀胱疼痛综合征（IC/BPS）是一种使人衰弱的慢性疾病，其特征是在没有尿路感染的情况下出现不适或反复的腹部和盆腔疼痛。其症状包括不适、膀胱压力增加、膀胱和盆腔区域的敏感性和剧痛、排尿频率和紧迫性增加，或这些症状的组合。由于这些原因，这种病症对生活质量有非常负面的影响。IC/BPS的病因仍未得到很好的理解，并且已经提出了不同的假说，包括自身免疫过程、过敏反应、慢性细菌感染、接触毒素或饮食因素以及心身因素。由于对病因缺乏共识以及诊断中存在的固有困难，找到一种针对IC/BPS的有效且特异性的治疗方法仍然是科学界面临的挑战。最新的假说认为，IC/BPS在病理生理上可能与膀胱黏膜表层的破坏以及随之而来的糖胺聚糖（GAGs）的丢失有关。这类粘多糖具有疏水特性，它们的改变使尿路上皮暴露于许多尿液中的有毒物质。据推测，当这些物质穿透膀胱壁时，会在黏膜下层引发一系列反应。为了改善膀胱内衬的完整性和功能，GAG层补充疗法被广泛接受为对传统疗法反应不佳或不足的IC/BPS患者的治疗方法。目前，硫酸软骨素（CS）、肝素、透明质酸（HA）、戊聚糖多硫酸盐（PPS）以及两种GAG（CS和HA）的组合是IC/BPS患者中具有不同有效率的可用物质。有四种不同的可商购的用于GAG补充的产品，包括CS、肝素、HA和PPS。每种产品都有不同的浓度和剂型。最近，CS和HA的组合是最新的可商购产品，效果 promising。 （注：“promising”此处根据语境推测可能是“有前景的”意思，但原文表述不太完整准确）
