Promising Experimental Treatment in Animal Models and Human Studies of Interstitial Cystitis/Bladder Pain Syndrome

Abstract

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.

Keywords: bladder pain syndrome; interstitial cystitis; monoclonal antibody; nanotechnology; regenerative medicine.

Figure 1

Holistic management based on the complex etiologies and symptomology of interstitial cystitis/bladder pain syndrome (IC/BPS). The pain and urinary symptoms may arise from various pathological processes affecting the afferent and efferent pathways, as well as bladder damage. Based on the symptomology and understanding of pathogenesis, physicians can provide both traditional and novel treatments to alleviate patients’ symptoms.

Figure 2

Innovative therapies for IC/PBS. Researchers may explore new modalities to improve drug delivery systems through physical or chemical methods, regulate nociception, use immune modulation, and translate regenerative medicine for the management of IC/PBS.