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Upon binding, the receptor-ligand complex initiates intracellular signaling cascades involving pathways such as phosphoinositide 3-kinase (PI3K) and protein kinase B (Akt), as well as mitogen-activated protein kinase (MAPK) signaling

The most commonly accepted theory is that a defect in the glycosaminoglycan layer of the bladder urothelium allows solutes in the urine to penetrate through the urothelium into the bladder interstitium which causes an inflammatory reaction [1]

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