Current Pharmacologic Approaches in Painful Bladder Research: An Update
نویسندگان
چکیده
The symptoms of interstitial cystitis (IC)/bladder pain syndrome (BPS) may have multiple causes and involve many contributing factors. Traditional treatments (intravesical instillations) have had a primary focus on the bladder as origin of symptoms without adequately considering the potential influence of other local (pelvic) or systemic factors. Systemic pharmacological treatments have had modest success. A contributing factor to the low efficacy is the lack of phenotyping the patients. Individualized treatment based on is desirable, but further phenotype categorization is needed. There seems to be general agreement that IC is a unique disease and that BPS is a syndrome with multiple pathophysiologies, but this has so far not been not been well reflected in preclinical research with the aim of finding new pharmacological treatments. Current research approaches, including anti-nerve growth factor treatment, anti-tumor necrosis factor-α treatment, activation of SHIP1 (AQX-1125), and P2X3 receptor antagonists, and α1-adrenoceptor antagonists are potential systemic treatments, implying that not only the bladder is exposed to the administered drug, which may be beneficial if the IC/BPS is a bladder manifestation of a systemic disease, or negative (adverse effects) if it is a local bladder condition. Local treatment approaches such as the antagonism of Toll-like receptors (which still is only experimental) and intravesical liposomes (with positive proof-of-concept), may have the advantages of a low number of systemic adverse effects, but cannot be expected to have effects on symptoms generated outside the bladder. Assessment of which of the treatment approaches discussed in this review that can be developed into useful therapies requires further studies.
منابع مشابه
Response to Current Pharmacologic Approaches in Painful Bladder Research: An Update
Copyright © 2018 Korean Continence Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Corresponding author: Jayoung Kim https://orcid....
متن کاملA Quick update from the Past to Current Status of Human Pluripotent Stem Cell-derived Hepatocyte culture systems
Pluripotent stem cells (PSCs) may be offered as an unlimited cell source for the hepatocyte generation. The generation of hepatocytes from stem cells in vitro would provide an alternative cell source for applications in drug discovery and cell transplantation. In this review, we discuss different approaches to generate pluripotent stem cell-derived hepatocytes, advantages, limitations for each ...
متن کامل'Omics' Approaches to Understanding Interstitial Cystitis/Painful Bladder Syndrome/Bladder Pain Syndrome
Recent efforts in the generation of large genomics, transcriptomics, proteomics, metabolomics and other types of 'omics' data sets have provided an unprecedentedly detailed view of certain diseases, however to date most of this literature has been focused on malignancy and other lethal pathological conditions. Very little intensive work on global profiles has been performed to understand the mo...
متن کاملNew Evidence for Exogenous Glycosaminoglycans Treatment of ‘cystitis’: Is the Future Now?
Chronic cystitis may be due to different known causes. Current basic science research has revealed a wide consensus that chronic cystitis may arise from a primary defective urothelium lining and in particular from a damage of its glycosaminoglycans (GAGs) component. The GAG layer is composed mainly of heparin, dermatan, the glycosaminoglycans, chondroitin sulphate (CS), and hyaluronic acid (HA)...
متن کامل