Exploring promising biomarkers based on pathogenic mechanisms in interstitial cystitis/bladder pain syndrome

Interstitial cystitis/bladder pain syndrome (IC/BPS), characterized by bladder discomfort and lower urinary tract symptoms, is often either overtreated or undertreated owing to the complexity and variability of symptoms and the lack of reliable diagnostic tools, leading to reduced quality of life and prolonged illness. The pathophysiology of IC/BPS remains unclear, with multiple hypotheses - such as autoimmune inflammation, oxidative stress and urothelial dysfunction - offering potential explanations. Consequently, a diverse range of urinary biomarkers has emerged, although their diagnostic reliability remains inconsistent. As technology advances, biomarkers are increasingly shifting towards multiplex assays, encompassing genomics, transcriptomics, proteomics and cell-based methods; however, cutting-edge research and clinical validation are not yet integrated into the limited diagnostic tools available. Clinical phenotypes from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network studies provide multi-level biomarker research - including molecular, imaging and other modalities - to support the diagnosis of IC/BPS. Integrating these observations will advance the development of precision medicine for the diagnosis of IC/BPS, thereby improving management of this complex condition.