{
  "abstract": "Introduction and Hypothesis: Hunner lesions (HL) are distinctive ulcerative bladder lesions characterized by a central scar and surrounding erythema. Traditionally, HL has been used as a clinical diagnostic tool for a subset of patients with interstitial cystitis/bladder pain syndrome (IC/BPS); however, emerging evidence supports a unique pathophysiology for IC/BPS with HL (HIC) that is distinct from IC/BPS without HL (NHIC). This review is aimed at synthesizing current literature on the etiology of HL/HIC and evaluate whether HIC and NHIC warrant classification as separate clinical conditions with distinct management strategies.\n\nMethods: A comprehensive literature review using PubMed was conducted to identify literature surrounding HL etiology and pathophysiology. Case–control studies, cohort studies, experimental studies, case reports, and animal studies were included; editorial comments and literature reviews were excluded from this review.\n\nResults: Emerging data suggest that a subset of patients might be predisposed to HIC, including alteration in major histocompatibility complex (MHC) molecules, HLA amino acid positions, and additional protein expression alterations detected by RNA sequencing. Hypoxia-inducible factor activation and chronic ischemia have also been shown to play a role in HL development. Both local and systemic inflammation are seen in HIC, with clonal B-cell expansion influencing the upregulation of inflammatory cytokines, chemokines, and lymphoplasmacytic cells. With additional validation these biomarkers have the potential to serve as a diagnostic tool.\n\nConclusion: Hunner lesion with IC/BPS is a chronic condition likely caused by an upregulation of humoral immunity leading to an overexpression of inflammatory markers within the urothelium, suggesting an autoimmune-mediated pathology for this patient subgroup.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC USA",
    "Wake Forest Institute for Regenerative Medicine, 391 Technology Way NE, Winston-Salem, NC 27101 USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Eboni T. Acoff",
      "orcid": "0009-0000-3365-886X"
    },
    {
      "affs": [
        1
      ],
      "name": "Kaylee Ferrara",
      "orcid": "0009-0007-9079-0091"
    },
    {
      "affs": [
        1
      ],
      "name": "Hannah Ruetten",
      "orcid": "0000-0001-6263-6221"
    },
    {
      "affs": [
        0
      ],
      "name": "Gopal Badlani",
      "orcid": "0000-0002-3158-8092"
    },
    {
      "affs": [
        0
      ],
      "name": "Robert J. Evans",
      "orcid": "0000-0002-8191-5549"
    },
    {
      "affs": [
        0
      ],
      "name": "Amr El Haraki",
      "orcid": "0000-0001-8412-5967"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Stephen J. Walker",
      "orcid": "0000-0002-0732-2366"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8e4tcm2xksr89.bib",
  "cited_by": 0,
  "doi": "10.1007/s00192-026-06739-9",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13731508/",
  "id": "8e4tcm2xksr89",
  "issns": [
    "0937-3462",
    "1433-3023"
  ],
  "landing_url": "https://doi.org/10.1007/s00192-026-06739-9",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2748|Urinary Bladder and Prostate Research"
    ]
  ],
  "openalex": "W7165394903",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s00192-026-06739-9.pdf",
  "pmcid": "PMC13731508",
  "pmid": "42322402",
  "published": "2026-06-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8e4tcm2xksr89.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:21:41Z",
      "native_id": "PMC13731508",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00192-026-06739-9"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2748|Urinary Bladder and Prostate Research",
      "subfield": "general"
    }
  ],
  "title": "Etiology of Hunner Lesions: Linking Immune Dysregulation and Chronic Inflammation in Interstitial Cystitis/Bladder Pain Syndrome",
  "title_text": "Etiology of Hunner Lesions: Linking Immune Dysregulation and Chronic Inflammation in Interstitial Cystitis/Bladder Pain Syndrome",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:41Z",
  "url": "https://research.draconitic.com/paper/8e4tcm2xksr89",
  "venue": "International Urogynecology Journal",
  "versions": []
}