The potential role of folate metabolism in interstitial cystitis

Int Urogynecol J. 2019 Mar;30(3):363-370. doi: 10.1007/s00192-018-3771-7. Epub 2018 Oct 6.


The topic of interstitial cystitis (IC), also known as painful bladder syndrome (PBS), and folate/one carbon metabolism has previously been unaddressed in research. This narrative review highlights a potential connection for those with mast cell-related IC and histamine-mediated pain that is explored through four conceptual sections. The first section focuses on the nature of mast cell involvement and histamine-mediated pain in some interstitial cystitis patients. The second section reviews the literature on folate status in wider allergic conditions. The third section addresses the role of folate and methylation in general in histamine excretion. Finally, folate metabolism and vascular function are addressed because of the vascular abnormalities present in some IC bladders.

Keywords: Allergy; Folate; Histamine; Interstitial cystitis; Painful bladder syndrome; Vascular endothelial growth factor.

Publication types

  • Review

MeSH terms

  • Cystitis, Interstitial / metabolism*
  • Endothelium / physiopathology
  • Female
  • Folic Acid / metabolism*
  • Histamine / metabolism
  • Humans
  • Hypersensitivity / metabolism*
  • Mast Cells
  • Methylenetetrahydrofolate Reductase (NADPH2) / genetics
  • Microvessels
  • Pregnancy


  • Histamine
  • Folic Acid
  • MTHFR protein, human
  • Methylenetetrahydrofolate Reductase (NADPH2)