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Al of manuscript: All authors. Correspondence to: Chris Mullins, PhD. Director of Basic Cell Biology Programs in Urologic and Kidney Disease, Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 2 Democracy Plaza, Room 637, 6707 Democracy Blvd., Bethesda, MD 20892-5458, USA. Email: [email protected]: Despite years of basic and clinical research focused on interstitial cystitis/bladder pain syndrome (IC/BPS), including clinical trials of candidate therapies, there remains an insufficient understanding of underlying cause(s), important clinical features and a lack of effective treatments for this syndrome. Progress has been limited and is likely due to many factors, including a primary focus on the bladder and lower urinary tract as origin of symptoms without adequately considering the potential influence of other local (pelvic) or systemic factors. Traditionally, there has been a lack of sufficiently diverse expertise and application of novel, integrated methods to study this syndrome. However, some important insights have been gained. For example, epidemiological studies have revealed that IC/BPS is commonly associated with other chronic pain conditions, including fibromyalgia, irritable bowel syndrome and chronic fatigue syndrome. These observations suggest that IC/BPS may involve systemic pathophysiology, including alterations of the central nervous system in some patients. Furthermore, there may be multiple causes and contributing factors that manifest in the symptoms of IC/BPS leading to multiple patient sub-groups or phenotypes. Innovative research is necessary to allow for a more complete description of the relationship between this syndrome and other disorders with overlapping symptoms. This report provides examples of such innovative research studies and their findings which have the potential to provide fresh insights into IC/BPS and disorders associated with chronic pain through characterization of broad physiologic systems, as well as assessment of the contribution of the bladder and lower urinary tract. They may also serve as models for future investigation of symptom-based urologic and non-urologic disorders that may remain incompletely characterized by previous, more traditional research approaches. Furthermore, it is anticipated a more holistic understanding of chronic urologic pain and dysfunction will ensue from productive interactions between IC/BPS studies like those described here and broader cutting-edge research endeavors focused on potentially A-836339 chemical information related chronic pain disorders. A more comprehensive vision for IC/BPS inquiry is anticipated to yield new insights into basic disease mechanisms and clinical characteristics that will inform future research studies that will lead to more effective therapies and improved clinical care for these patients.Keywords: Interstitial cystitis (IC); bladder pain syndrome (BPS); urologic chronic pelvic pain syndrome (UCPPS); research models; translational science Submitted Jul 29, 2015. EPZ004777MedChemExpress EPZ004777 Accepted for publication Aug 03, 2015. doi: 10.3978/j.issn.2223-4683.2015.08.01 View this article at: http://dx.doi.org/10.3978/j.issn.2223-4683.2015.08.?Translational Andrology and Urology. All rights reserved.www.amepc.org/tauTransl Androl Urol 2015;4(5):524-Translational Andrology and Urology, Vol 4, No 5 OctoberIntroduction Interstitial cystitis/bladder pain syndrome (IC/BPS) is de.Al of manuscript: All authors. Correspondence to: Chris Mullins, PhD. Director of Basic Cell Biology Programs in Urologic and Kidney Disease, Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 2 Democracy Plaza, Room 637, 6707 Democracy Blvd., Bethesda, MD 20892-5458, USA. Email: [email protected]: Despite years of basic and clinical research focused on interstitial cystitis/bladder pain syndrome (IC/BPS), including clinical trials of candidate therapies, there remains an insufficient understanding of underlying cause(s), important clinical features and a lack of effective treatments for this syndrome. Progress has been limited and is likely due to many factors, including a primary focus on the bladder and lower urinary tract as origin of symptoms without adequately considering the potential influence of other local (pelvic) or systemic factors. Traditionally, there has been a lack of sufficiently diverse expertise and application of novel, integrated methods to study this syndrome. However, some important insights have been gained. For example, epidemiological studies have revealed that IC/BPS is commonly associated with other chronic pain conditions, including fibromyalgia, irritable bowel syndrome and chronic fatigue syndrome. These observations suggest that IC/BPS may involve systemic pathophysiology, including alterations of the central nervous system in some patients. Furthermore, there may be multiple causes and contributing factors that manifest in the symptoms of IC/BPS leading to multiple patient sub-groups or phenotypes. Innovative research is necessary to allow for a more complete description of the relationship between this syndrome and other disorders with overlapping symptoms. This report provides examples of such innovative research studies and their findings which have the potential to provide fresh insights into IC/BPS and disorders associated with chronic pain through characterization of broad physiologic systems, as well as assessment of the contribution of the bladder and lower urinary tract. They may also serve as models for future investigation of symptom-based urologic and non-urologic disorders that may remain incompletely characterized by previous, more traditional research approaches. Furthermore, it is anticipated a more holistic understanding of chronic urologic pain and dysfunction will ensue from productive interactions between IC/BPS studies like those described here and broader cutting-edge research endeavors focused on potentially related chronic pain disorders. A more comprehensive vision for IC/BPS inquiry is anticipated to yield new insights into basic disease mechanisms and clinical characteristics that will inform future research studies that will lead to more effective therapies and improved clinical care for these patients.Keywords: Interstitial cystitis (IC); bladder pain syndrome (BPS); urologic chronic pelvic pain syndrome (UCPPS); research models; translational science Submitted Jul 29, 2015. Accepted for publication Aug 03, 2015. doi: 10.3978/j.issn.2223-4683.2015.08.01 View this article at: http://dx.doi.org/10.3978/j.issn.2223-4683.2015.08.?Translational Andrology and Urology. All rights reserved.www.amepc.org/tauTransl Androl Urol 2015;4(5):524-Translational Andrology and Urology, Vol 4, No 5 OctoberIntroduction Interstitial cystitis/bladder pain syndrome (IC/BPS) is de.

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