Department of Urology, Taichung Veterans General Hospital, Taichung 407, Taiwan.
Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
Int J Mol Sci. 2024 Jul 23;25(15):8015. doi: 10.3390/ijms25158015.
Interstitial cystitis/bladder pain Syndrome (IC/BPS) remains a mysterious and intricate urological disorder, presenting significant challenges to healthcare providers. Traditional guidelines for IC/BPS follow a hierarchical model based on symptom severity, advocating for conservative interventions as the initial step, followed by oral pharmacotherapy, intravesical treatments, and, in refractory cases, invasive surgical procedures. This approach embraces a multi-tiered strategy. However, the evolving understanding that IC/BPS represents a paroxysmal chronic pain syndrome, often involving extravesical manifestations and different subtypes, calls for a departure from this uniform approach. This review provides insights into recent advancements in experimental strategies in animal models and human studies. The identified therapeutic approaches fall into four categories: (i) anti-inflammation and anti-angiogenesis using monoclonal antibodies or immune modulation, (ii) regenerative medicine, including stem cell therapy, platelet-rich plasma, and low-intensity extracorporeal shock wave therapy, (iii) drug delivery systems leveraging nanotechnology, and (iv) drug delivery systems assisted by energy devices. Future investigations will require a broader range of animal models, studies on human bladder tissues, and well-designed clinical trials to establish the efficacy and safety of these therapeutic interventions.
间质性膀胱炎/膀胱疼痛综合征(IC/BPS)仍然是一种神秘而复杂的泌尿科疾病,给医疗保健提供者带来了重大挑战。IC/BPS 的传统指南遵循基于症状严重程度的分层模型,主张将保守干预作为初始步骤,随后是口服药物治疗、膀胱内治疗,以及在难治性病例中采用侵入性手术。这种方法采用了多层次的策略。然而,不断发展的认识表明,IC/BPS 代表一种阵发性慢性疼痛综合征,通常涉及膀胱外表现和不同亚型,这需要摒弃这种统一的方法。本综述提供了对动物模型和人类研究中实验策略的最新进展的深入了解。确定的治疗方法可分为四类:(i)使用单克隆抗体或免疫调节进行抗炎和抗血管生成,(ii)再生医学,包括干细胞治疗、富含血小板的血浆和低强度体外冲击波治疗,(iii)利用纳米技术的药物输送系统,以及(iv)能量装置辅助的药物输送系统。未来的研究将需要更广泛的动物模型、人类膀胱组织研究以及精心设计的临床试验,以确定这些治疗干预的疗效和安全性。