Animal Models of Hunner-Type Interstitial Cystitis.

Abstract

BACKGROUND: Animal models are crucial for mechanistic studies and therapeutic development of human diseases. At present, the etiology of interstitial cystitis/bladder pain syndrome (IC/BPS), a chronic disease of the urinary bladder, remains undefined. Therefore, numerous theories of pathogenesis have been proposed, and various animal models have been developed based on these theories. This enigmatic human disease can be categorized into two subtypes: Hunner-type IC (HIC) and bladder pain syndrome (BPS). These two subtypes of IC/BPS have different pathological mechanisms, but their clinical symptoms overlap. Recent evidence indicates that HIC is an immune-mediated inflammatory disease of the urinary bladder, while BPS is a minimally inflamed bladder condition comprising various clinical phenotypes. Furthermore, increasing evidence suggests that autoimmunity may play a significant role in IC/BPS, particularly in HIC. Today, the rodent models of experimental autoimmune cystitis (EAC) are being used in HIC research. OBJECTIVE: This article provides an overview of immune-mediated inflammation and autoimmunity in IC/BPS, as well as EAC models that can be used for HIC research, with a focus on the URO-OVA model, a novel transgenic EAC model that effectively mimics HIC. CONCLUSION: The URO-OVA model develops chronic bladder inflammation, pelvic/bladder pain, and voiding dysfunction seen in human HIC patients. It responds to treatment with dimethyl sulfoxide (DMSO) and specific inhibitors, such as Toll-like receptor (TLR)4, mitogen-activated protein (MAP) kinase, and interferon (IFN)-γ inhibitors. The URO-OVA model is stable and reproducible, providing a unique EAC model for HIC research that incorporates immune/autoimmune components in its pathophysiology.