HMN 2026: How Targeting cannabinoid receptors in bladder sensory pathways may alleviate pain of cystitis

The burning pain associated with cystitis affects millions of people around the world, and it can take days or even years for some patients to find relief from bladder pain, infection-related symptoms and the constant need to urinate. A new study led by Flinders University published in Autonomic Neuroscience, has shown how certain pain receptors in the bladder could be targeted to reduce the debilitating effects of this common condition.

Cystitis is an inflammation of the bladder, usually caused by a bacterial infection in the urinary tract. In some people, bladder pain and urinary urgency become chronic, as seen in interstitial cystitis/bladder pain syndrome (IC/BPS).

Researchers say IC/BPS affects up to 13% of the population, mainly women, but current treatments remain invasive or have limited success. At the same time, medicinal cannabis containing THC from plant-based drugs has shown strong pain-relieving effects, but its clinical use can be limited by negative psychoactive side effects.

“We have identified cannabinoid receptors located in peripheral bladder sensory pathways as potential targets,” says first author Flinders University neuroscience research fellow Dr. Stewart Ramsay. “When activated together in our preclinical model, these receptors effectively switch off the exaggerated pain response associated with cystitis.

“By using specially designed ‘peripherally restricted’ cannabinoid compounds that cannot cross the blood-brain barrier, this therapeutic approach eliminates any mind-altering and psychoactive effects that have been seen with cannabis use.”

Senior author Associate Professor Vladimir Zagorodnyuk, from the Flinders Health and Medical Research Institute (FHMRI) Neuroscience research group, says the findings show promise for developing more effective treatments for bladder pain and associated symptoms in IC/BPS.

“These findings provide strong support for the development of peripherally acting combination therapies for cystitis, targeting both cannabinoid receptors as a treatment strategy while minimizing central cannabinoid-related side effects,” says Zagorodnyuk, from the medical bioscience research group at Flinders.

Peripheral CB1 receptors have been connected to visceral and somatic pain, while CB2 receptors are increasingly recognized for their role in reducing inflammation.

The researchers say the next stage of the work will be to further evaluate the safety and efficacy of the therapeutic strategy, with the goal of translating the findings toward human clinical studies.

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