Us studies to be combined for a single participant or group to provide a comprehensive assessment of important features of IC/BPS. MAPP Research Network studies are yielding new insights into IC/BPS SB 202190 biological activity pathophysiology and clinical phenotypes. Findings from a neuroimaging study of 82 IC/BPS patients and 85 healthy controls at five sites suggest alterations in sensorimotor components of the central nervous system known to mediate bladder function, which differs from abnormalities observed in more classic pain regions reported for other persistent pain conditions (42). Biomarker studies suggest a loss of inflammatory control linked to hypothalamic-pituitary-adrenal (HPA) dysregulation and Toll-like receptor (TLR)-4 is associated with pain severity in IC/BPS patients (43). Analysis of self-report data reveals IC/BPS patients report diverse non-urological chronic pain syndromes and an association between thepresence of these conditions and urological and psychosocial symptom severity (44). Qualitative studies of symptom flares have revealed a much wider spectrum of symptom exacerbation characteristics and patient experiences than previously appreciated (45). Ongoing analyses of the MAPP Research Network data also suggest multiple, clinically relevant sub-groups of IC/BPS patients exist that may be differentiated by their pain and urologic dysfunction profiles. Furthermore, preliminary analyses reveal that some phenotypes are at a higher risk of symptom worsening. Further exploration of these and many other insights are ongoing by network investigators. In 2015, the MAPP Research Network initiated a second phase of integrated, collaborative studies designed to expand upon insights from initial efforts and continue to address the network’s central goals. Studies will further describe changes in UCPPS (i.e., IC/BPS and CP/CPPS) symptoms over time and identify corresponding, underlying biological factors associated with symptom profiles; examine the contributions of the microbiome; examine the relationship between treatment response (in the setting of usual clinical care) and phenotype; and further define clinically significant patient sub-groups; as well as other questions. The Interstitial Cystitis: Elucidation of Psychophysiologic and Autonomic Characteristics (ICEPAC) The ICEPAC study was initiated in 2009 as a multi-site, multi-disciplinary effort to assess the autonomic nervous system (ANS) and other potential psychophysiologic contributors to IC/BPS symptoms (46). The ICEPAC study hypothesized that IC/BPS has abnormalities in the ANS different from those in other female chronic pelvic pain disorders, such as myofascial pelvic pain (MPP), not characterized by bladder dysfunction. The Stattic biological activity investigators also proposed that previous findings in animal models and patients together suggest a correlation between increased sympathetic system (the “urgent response” branch of the ANS) outflow, dysregulation of the hypothalamic-pituitaryadrenal axis (e.g., lower circulating cortisol), and symptoms (e.g., pain and urgency) in IC/BPS, thus further supporting this scientific direction (46). ICEPAC investigators assessed female chronic pelvic pain subjects, including IC/BPS, MPP, and IC/BPS+MPP cohorts, and healthy controls through a cross-sectional study design that included measures of urologic function (e.g., voiding diaries, ultrasound, and uroflow measures), abdominal and pelvic floor tenderness, and patient report?Translational Andrology and Urology. All.Us studies to be combined for a single participant or group to provide a comprehensive assessment of important features of IC/BPS. MAPP Research Network studies are yielding new insights into IC/BPS pathophysiology and clinical phenotypes. Findings from a neuroimaging study of 82 IC/BPS patients and 85 healthy controls at five sites suggest alterations in sensorimotor components of the central nervous system known to mediate bladder function, which differs from abnormalities observed in more classic pain regions reported for other persistent pain conditions (42). Biomarker studies suggest a loss of inflammatory control linked to hypothalamic-pituitary-adrenal (HPA) dysregulation and Toll-like receptor (TLR)-4 is associated with pain severity in IC/BPS patients (43). Analysis of self-report data reveals IC/BPS patients report diverse non-urological chronic pain syndromes and an association between thepresence of these conditions and urological and psychosocial symptom severity (44). Qualitative studies of symptom flares have revealed a much wider spectrum of symptom exacerbation characteristics and patient experiences than previously appreciated (45). Ongoing analyses of the MAPP Research Network data also suggest multiple, clinically relevant sub-groups of IC/BPS patients exist that may be differentiated by their pain and urologic dysfunction profiles. Furthermore, preliminary analyses reveal that some phenotypes are at a higher risk of symptom worsening. Further exploration of these and many other insights are ongoing by network investigators. In 2015, the MAPP Research Network initiated a second phase of integrated, collaborative studies designed to expand upon insights from initial efforts and continue to address the network’s central goals. Studies will further describe changes in UCPPS (i.e., IC/BPS and CP/CPPS) symptoms over time and identify corresponding, underlying biological factors associated with symptom profiles; examine the contributions of the microbiome; examine the relationship between treatment response (in the setting of usual clinical care) and phenotype; and further define clinically significant patient sub-groups; as well as other questions. The Interstitial Cystitis: Elucidation of Psychophysiologic and Autonomic Characteristics (ICEPAC) The ICEPAC study was initiated in 2009 as a multi-site, multi-disciplinary effort to assess the autonomic nervous system (ANS) and other potential psychophysiologic contributors to IC/BPS symptoms (46). The ICEPAC study hypothesized that IC/BPS has abnormalities in the ANS different from those in other female chronic pelvic pain disorders, such as myofascial pelvic pain (MPP), not characterized by bladder dysfunction. The investigators also proposed that previous findings in animal models and patients together suggest a correlation between increased sympathetic system (the “urgent response” branch of the ANS) outflow, dysregulation of the hypothalamic-pituitaryadrenal axis (e.g., lower circulating cortisol), and symptoms (e.g., pain and urgency) in IC/BPS, thus further supporting this scientific direction (46). ICEPAC investigators assessed female chronic pelvic pain subjects, including IC/BPS, MPP, and IC/BPS+MPP cohorts, and healthy controls through a cross-sectional study design that included measures of urologic function (e.g., voiding diaries, ultrasound, and uroflow measures), abdominal and pelvic floor tenderness, and patient report?Translational Andrology and Urology. All.