The urothelial barrier in interstitial cystitis/bladder pain syndrome: its form and function, an overview of preclinical models.

Investigating bladder pain syndrome/interstitial cystitis (IC/BPS) preclinically is challenging. Various research models have been used to mimic the urothelial barrier closely and replicate the disease. The aim of this review is to discuss preclinical research related to the urothelial barrier in context of IC/BPS.

In vivo models mimic IC/BPS mainly with toxic substances in the urine, with protaminesulfate and proteoglycan deglycolysation resembling a temporary impaired barrier as seen in IC/BPS. This temporary increased permeability has also been found in vitro models. Glycosaminoglycan replenishment therapy has been described, in vivo and in vitro, to protect and enhance recover properties of the urothelium. The roles of immune and neurogenic factors in the pathogenesis of IC/BPS remains relatively understudied.

Preclinical studies provide opportunities to identify the involvement of specific pathologic pathways in IC/BPS. For further research is warranted to elucidate the primary or secondary role of permeability, together with inflammatory and neurogenic causes of the disease.

Current opinion in urology. 2023 Nov 03 [Epub ahead of print]

Charlotte van Ginkel, Robert E Hurst, Dick Janssen

Department of Urology, Radboud university medical Center, Nijmegen, The Netherlands., Glycologix, Inc., Boston, Massachusetts, USA.