Taidi Zhinoos, Mansfield Kylie J, Bates Lucy, Sana-Ur-Rehman Hafiz, Liu Lu
School of Medical Sciences, The University of New South Wales, Sydney NSW 2052, Australia.
School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia.
Bladder (San Franc). 2019 Apr 8;6(1):e38. doi: 10.14440/bladder.2019.789. eCollection 2019.
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic lower urinary tract condition. Patients with IC/BPS suffer from debilitating pain and urinary urgency. The underlying etiology of IC/BPS is unknown and as such current treatments are mostly symptomatic with no real cure. Many theories have been proposed to describe the etiology of IC/BPS, but this review focuses on the role of inflammation. In IC/BPS patients, the permeability of the urothelium barrier is compromised and inflammatory cells infiltrate the bladder wall. There are increased levels of many inflammatory mediators in patients with IC/BPS and symptoms such as pain and urgency that have been associated with the degree of inflammation. Recent evidence has highlighted the role of purinergic receptors, specifically the P2X7 receptor, in the process of inflammation. The results from studies in animals including cyclophosphamide-induced hemorrhagic cystitis strongly support the role of P2X7 receptors in inflammation. Furthermore, the deletion of the P2X7 receptor or antagonism of this receptor significantly reduces inflammatory mediator release from the bladder and improves symptoms. Research results from IC/BPS patients and animal models of IC/BPS strongly support the crucial role of inflammation in the pathophysiology of this painful disease. Purinergic signaling and purinergic receptors, especially the P2X7 receptor, play an undisputed role in inflammation. Purinergic receptor antagonists show positive results in treating different symptoms of IC/BPS.
间质性膀胱炎/膀胱疼痛综合征（IC/BPS）是一种慢性下尿路疾病。IC/BPS患者遭受使人衰弱的疼痛和尿急。IC/BPS的潜在病因尚不清楚，因此目前的治疗大多是对症治疗，没有真正的治愈方法。已经提出了许多理论来描述IC/BPS的病因，但本综述重点关注炎症的作用。在IC/BPS患者中，尿路上皮屏障的通透性受损，炎症细胞浸润膀胱壁。IC/BPS患者中许多炎症介质的水平升高，并且疼痛和尿急等症状与炎症程度相关。最近的证据强调了嘌呤能受体，特别是P2X7受体，在炎症过程中的作用。包括环磷酰胺诱导的出血性膀胱炎在内的动物研究结果有力地支持了P2X7受体在炎症中的作用。此外，P2X7受体的缺失或该受体的拮抗作用可显著减少膀胱炎症介质的释放并改善症状。IC/BPS患者和IC/BPS动物模型的研究结果有力地支持了炎症在这种疼痛性疾病病理生理学中的关键作用。嘌呤能信号传导和嘌呤能受体，特别是P2X7受体，在炎症中发挥着无可争议的作用。嘌呤能受体拮抗剂在治疗IC/BPS的不同症状方面显示出积极结果。
