Toward therapnostic integration as a new paradigm for precision management of interstitial cystitis driven by...

Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a complex chronic inflammatory disease involving mucosal barrier defects, neurogenic inflammation, mast cell activation, and tissue remodeling. Current diagnosis lacks objective biomarkers, relying instead on symptom assessment and exclusion of confusable diseases. Cystoscopy is recommended for identifying Hunner lesions per ESSIC/AUA guidelines, and first-line intravesical GAG replacement therapies only achieve sustained response rates of 20-38% at 12 months. Medical-engineering integration and materials innovations propel IC management toward multi-scale regulation and intelligent repair. This article proposes intelligent materials and systems to advance IC from stepwise diagnosis to an integrated "sensing-feedback-execution" closed loop. At the diagnostic level, it integrates medical phenotyping with engineering multidimensional detection to construct a synergistic system of subjective symptoms, objective molecules, and physical function: attomolar long non-coding RNA(lncRNA) detection via CRISPR-graphene transistors, glycosaminoglycans (GAGs) quantification with ¹³C-FNDs, and real-time bladder monitoring with flexible electrodes and wireless sensing. At the therapeutic level, centering on targeted delivery, dynamic repair, functional remodeling, it integrates four pathways: inflammation-responsive engineered bacteria; DNA nanocages and dual-responsive hydrogels for precise release; bioprinted patches and digital twin scaffolds for personalized repair; and trimodal combination therapy for mucosa, inflammation, and fibrosis. It further envisions Material Intelligence Agent systems medicine integrating nanosensors, quantum computing, and micro-nanorobots to construct a cross-scale diagnostic and therapeutic closed loop, with dynamic individualized intervention via digital twins. This paper provides a systematic technological pathway for precision IC management and a transferable medical-engineering integration paradigm for chronic inflammatory diseases.