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Additionally, higher levels of vascular endothelial growth factor, substance P, and platelet-derived endothelial cell growth factor are often detected in the bladder endothelium of IC patients compared to controls Notably, bladder epithelial cells in individuals with IC exhibit intrinsic alterations in differentiation, neurotransmitter release, potassium channel activity, increased nitric oxide production, nuclear factor-B activation, nerve fiber density, serum C-reactive protein levels, and the production of neuropeptide Y and nerve growth factor

Front Immunol 12:739918

The immune response to this damage, characterized by M1 macrophage polarization, neutrophilic inflammation, and Th17 activation, further exacerbates lipid peroxidation and ferroptosis, creating a vicious cycle that drives disease progression

Multi-pathway therapy

PMID 36051294