The etiology of interstitial cystitis (IC) is not very clear to date, and the following hypotheses exist:
1、Vascular and lymphatic obstruction
It has been suggested that bladder fibrosis may be caused by pelvic surgery or infection, leading to obstruction of lymphatic vessels in the bladder wall and causing thrombotic angiitis or persistent small artery spasm due to vasculitis, but there is a lack of sufficient evidence.
2、Infection
It has been proposed that bacterial, viral, or fungal infections may be the cause of IC, but none of the above have been detected in IC patients.3There have been reports of pathogens.
3、Nervous and humoral factors
Mast cells are increased in the bladder固有膜 and detrusor muscle of IC patients. Cold, neuropeptides, drugs, trauma, toxins, etc., can activate mast cells, and the release of vasoactive substances can sensitize sensory neurons, which further activate mast cells by releasing neurotransmitters or neuropeptides; mast cells can also directly cause vasodilation or bladder mucosal damage and inflammation.
4、Immunological factors
The disease responds well to corticosteroid therapy, and some patients may detect anti-bladder mucosal antibodies in the blood. Many scholars have also found that autoantibodies or immune complexes produced against vascular antigens may deposit in the vascular wall, activate the complement system, and participate in the pathogenesis of IC.
5、Mucosal permeability
It is speculated that IC is caused by the dysfunction of the bladder epithelium, the increased permeability of which allows urine to leak into the bladder wall through the transitional epithelium, causing bladder inflammation. Some people have confirmed that the bladder superficial epithelium of IC patients has an increase in TH protein, indicating an increased permeability of the mucosa.
