Repeated intravesical injections of autologous platelet-rich plasma (PRP) have shown promise in alleviating symptoms of non-ulcer interstitial cystitis bladder pain syndrome (IC/BPS), but the underlying mechanisms remain unclear. In this single-center prospective study, 80 patients received four monthly PRP injections, with outcomes assessed by symptom scales, urodynamic parameters, and immune indices in urine and serum. PRP significantly reduced 24-h micturition frequency, numeric rating scale (NRS), O'Leary, pelvic pain and urgency/frequency patient symptom scale (PUF), and self-rating anxiety scale (SAS) scores at post-treatment follow-ups (all p < 0.05), while bladder capacity and voided volume remained unchanged. Serum and urinary inflammatory, iron metabolism, and oxidative stress markers were not significantly altered. PRP improved T-lymphocyte mitochondrial metabolic status, reducing CD4+ and CD8+ T-cell mitochondrial mass and decreasing CD8+ effector memory (Tem) T-cell counts, CD8+ Tem-MMPlow, and CD8+ PD-1+ Tem counts after the fourth injection (all p < 0.05). These immunological parameters positively correlated with symptom severity. Baseline NRS > 4 was associated with worse baseline profiles and selective post-treatment improvements, whereas global response assessment (GRA) stratification showed no significant differences. These findings indicate that repeated intravesical PRP alleviates IC/BPS-related pain and urinary symptoms primarily by reversing T-cell exhaustion and enhancing mitochondrial metabolic status, thus highlighting T-cell immunometabolic modulation as a key therapeutic mechanism.
Scientific reports. 2026 May 18 [Epub ahead of print]
Weilin Fang, Lin Liu, Xin Song, Jin Huang, Rong Lv, Ziwei Li, Tingting Lv, Zhikang Cai, Zhong Wang, Conghui Han, Jianwei Lv
Department of Urology, Pudong Gongli Hospital, Shanghai University of Medicine & Health Sciences, No. 219 Miaopu Road, Pudong New Area, Shanghai, 200135, China., Department of Urology, Xuzhou Central Hospital, No. 199 Jiefang South Road, Quanshan District, Xuzhou, 221009, Jiangsu Province, China., Department of Urology, Xuzhou Central Hospital, No. 199 Jiefang South Road, Quanshan District, Xuzhou, 221009, Jiangsu Province, China. ., Department of Urology, Pudong Gongli Hospital, Shanghai University of Medicine & Health Sciences, No. 219 Miaopu Road, Pudong New Area, Shanghai, 200135, China. .