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Drugs
Published in: Drugs 18/2015

01-12-2015 | Current Opinion

The Challenges of Interstitial Cystitis: Current Status and Future Prospects

Authors: Samuel Belknap, Eric Blalock, Deborah Erickson

Published in: Drugs | Issue 18/2015

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Abstract

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a syndrome of unpleasant bladder sensations and lower urinary tract symptoms. The three main proposed etiologies are bladder urothelial dysfunction, bladder inflammation (possible neurogenic), and neuropathic pain. Despite decades of basic and clinical research, IC/BPS remains difficult to treat. A variety of treatments are used, each aimed towards one etiology. For example, glycosaminoglycans are thought to improve the urothelial permeability barrier, anti-inflammatory agents are used to decrease general inflammation, and mast cell stabilizers and/or antagonists of mast cell products are used in the treatment of neurogenic inflammation. In the (unfortunately frequent) event that a treatment fails, possible reasons are that (1) the clinician is aiming towards the wrong etiology for that patient (i.e., the treatment is off target) or (2) the correct etiology is being targeted, but the treatment is not ameliorating it (i.e., the treatment is sub-therapeutic). This is a crucial distinction, because an off-target treatment should be abandoned, but a sub-therapeutic treatment should be escalated. Currently, our inability to make this crucial distinction is the greatest obstacle to effective treatment. An important future advance would be to identify urine or serum biomarkers specific to each etiologic target. Then, each biomarker could be used to select appropriate patients for each treatment and monitor the treatment’s effect on its intended target.
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Metadata
Title
The Challenges of Interstitial Cystitis: Current Status and Future Prospects
Authors
Samuel Belknap
Eric Blalock
Deborah Erickson
Publication date
01-12-2015
Publisher
Springer International Publishing
Published in
Drugs / Issue 18/2015
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.1007/s40265-015-0504-9

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