Researchers at the University of Tokyo headed by Yoshiyuki Akiyama have made a remarkable discovery about a puzzling and rare bladder disease called Hunner-type interstitial cystitis (HIC). This chronic and inflammatory condition affects the urinary bladder and has long remained a mystery due to its unknown cause and genetic background. However, through a groundbreaking study, scientists have successfully identified genetic factors that contribute to the risk of developing HIC.

Bladder Disease

Key Findings

  • The study utilized a genome-wide association approach and revealed a connection between specific genetic variants and HIC risk.
  • Common genetic variations were found to increase susceptibility to this rare and enigmatic bladder disease.
  • Researchers identified specific amino acid variations in HLA-DQβ1 and HLA-DPβ1 chains, which are associated with the risk of HIC.
  • These amino acid positions suggest alterations in antigen presentation, potentially influencing the development of HIC.


HIC is a rare and persistent inflammatory disease characterized by ongoing bladder pain, lower urinary tract symptoms, and the presence of Hunner lesions—a distinctive reddened mucosal lesion in the bladder. To unravel the genetic basis of HIC, researchers conducted a genome-wide association study involving 144 patients with HIC and 41,516 individuals of Japanese ancestry who served as controls.

During the study, a specific genetic variant known as rs1794275 was identified within the major histocompatibility complex (MHC) region on chromosome 6p21.3, which exhibited a significant association with the risk of developing HIC. The presence of the A allele of rs1794275 was found to increase the likelihood of developing HIC.

Moreover, the researchers conducted fine mapping of the MHC region and discovered that certain amino acid variations in HLA-DQβ1 and HLA-DPβ1 chains played a crucial role in the susceptibility to HIC. Notably, three amino acid positions (71, 74, and 75) in the HLA-DQβ1 chain and one amino acid position (178) in the HLA-DPβ1 chain were strongly associated with the risk of HIC. The presence of specific amino acid variants at these positions heightened the chances of developing the disease. These amino acid positions are strategically located in the peptide binding groove, indicating their functional significance in antigen presentation.

Implications and Future Directions

The identification of genetic variants associated with HIC provides valuable insights into the underlying mechanisms of this rare bladder disease. These findings suggest that HIC may have an immune-mediated nature, potentially involving autoimmune factors. Consequently, this study paves the way for targeted therapies aimed at modulating immune responses and antigen presentation, leading to improved treatment options for patients with HIC.

Furthermore, the genetic variants discovered in this study hold promise as potential diagnostic markers, facilitating the differentiation of HIC from other conditions with similar symptoms. This could significantly enhance diagnostic accuracy and enable timely interventions for individuals affected by HIC.

While the study focused on the Japanese population, further research involving diverse populations is necessary to validate these findings and determine the generalizability of the genetic associations. Additionally, future investigations could delve into the functional mechanisms through which these genetic variants influence antigen presentation and immune responses in the context of HIC.


This groundbreaking study conducted at the University of Tokyo represents a significant advancement in our understanding and management of HIC. The findings offer hope for improved patient care, targeted treatments, and continued progress in the field of interstitial cystitis.

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