Interstitial Cystitis (cont.)
What is the cause of interstitial cystitis?
No one knows what causes interstitial cystitis, but
doctors studying interstitial cystitis believe that it is a real, physical
problem and not a result, symptom, or sign of an emotional problem. Because the
symptoms of interstitial cystitis are varied, most researchers believe that it
represents a spectrum of disorders rather than one single disease.
One area of research on the cause of interstitial
cystitis has focused on the layer that coats the lining of the bladder called
the glycocalyx, made up primarily of substances called mucins and
glycosaminoglycans (GAGs). This layer normally protects the bladder wall from
toxic effects of urine and its contents. Researchers have found that this
protective layer of the bladder is "leaky" in about 70 percent of interstitial
cystitis patients and have hypothesized that this may allow substances in urine
to pass into the bladder wall where they might trigger interstitial cystitis.
Along with altered permeability of the bladder wall,
researchers are also examining the possibility that interstitial cystitis
results from decreased levels of protective substances in the bladder wall.
Reduced levels of GAGs (discussed previously) or other protective proteins might also be
responsible for the damage to the bladder wall seen in interstitial cystitis.
No matter what the
mechanism for disruption of the bladder lining, potassium is one
substance that
may be involved in damage to the bladder wall. Potassium is present in high
concentrations in urine and is normally not toxic to the bladder lining.
However, if the tissues lining the inside of the bladder (urothelium) are
disrupted or are abnormally leaky, potassium could then penetrate the lining
tissues and enter the muscle layers of the bladder where it can cause damage and
promote inflammation.
Researchers have isolated a substance known as antiproliferative factor (APF) that appears to block the normal growth of cells
that make up the lining of the bladder. APF has been identified almost
exclusively in the urine of people suffering with interstitial cystitis. Research is underway to
clarify the potential role of APF in the development of interstitial cystitis.
Increased activation of sensory nerves (neurologic hypersensitivity) in the bladder wall is also
thought to contribute to the symptoms of interstitial cystitis. Cells known as mast cells, which
play a role in the body's inflammatory response
to injury release chemicals that
are believed to be capable of contributing to the symptoms of interstitial
cystitis.
Other theories about the cause of interstitial cystitis
are that it is a form of autoimmune disorder or that
infection with an unidentified organism may be producing the damage to the
bladder and the accompanying symptoms.
Next: What are the signs and symptoms of interstitial cystitis? »
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