What are the possible etiology and pathogenesis of interstitial cystitis?


Several hypotheses have been proposed, none of which is completely satisfactory. There has been no report that specifically addresses the possible pathogenetic difference between the ulcer and nonulcer types. Several significant proposals have been presented in literature: increased urothelial permeability to urine contents due to the defective urothelial barrier; stress-induced heightened autonomic nervous system sharing co-morbidity with another vaguely defined disease complex; and neurogenic inflammation/activation of mast cells initiating the chain of events. These possibilities are not necessarily mutually exclusive but may be closely interrelated. Of the proposed mechanisms, the most attractive is the neurogenic inflammation hypothesis. Overactive sensory nerve fibers in the bladder send urge signals to the pontine micturition center, which in turn stimulates detrusor muscle contraction via the parasympathetic nerve. Locally, at the same time, the intrinsically abnormal urothelium exhibits a heightened neurosensory-like action by excessive release of adenosine triphosphate.


Mast Cell Nerve Growth Factor Irritable Bowel Syndrome Chronic Fatigue Syndrome Interstitial Cystitis 
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