Bladder mast cell activation in interstitial cystitis

The bladder mast cell contains many granules, each one of which can secrete many vasoactive and nociceptive molecules. A number of conditions such as extreme cold, drugs, neuropeptides, stress, trauma, toxins, etcetera, can trigger the mast cell to secrete some of its contents. In turn, these chemicals can sensitize sensory neurons, which can further activate mast cells by releasing neurotransmitters or neuropeptides. Additionally, the mast cell can directly cause vasodilation and bladder mucosa damage while attracting inflammatory cells, thus causing many of the problems observed in IC. Clinicians may be at a distinct disadvantage because they are faced with a multitude of potential mast cell triggers and numerous mediators secreted. Therefore, it may be advisable to block or inhibit the mast cell from responding to many of these various stimuli. Specific mast cell mediators should be assayed as possible diagnostic tools, whereas potential inhibitors of mast cell secretion should be tried under controlled conditions to determine the extent of therapeutic benefit.