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In this single-center prospective study, 80 patients received four monthly PRP injections, with outcomes assessed by symptom scales, urodynamic parameters, and immune indices in urine and serum. PRP significantly reduced 24-h micturition frequency, numeric rating scale (NRS), O\u2019Leary, pelvic pain and urgency\/frequency patient symptom scale\u00a0(PUF), and self-rating anxiety scale (SAS) scores at post-treatment follow-ups (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), while bladder capacity and voided volume remained unchanged. Serum and urinary inflammatory, iron metabolism, and oxidative stress markers were not significantly altered. PRP improved T-lymphocyte mitochondrial metabolic status, reducing CD4\n                    <jats:sup>+<\/jats:sup>\n                    \u2009and CD8\n                    <jats:sup>+<\/jats:sup>\n                    \u2009T-cell mitochondrial mass and decreasing CD8\n                    <jats:sup>+<\/jats:sup>\n                    \u2009effector memory (Tem) T-cell counts, CD8\n                    <jats:sup>+<\/jats:sup>\n                    \u2009Tem-MMP\n                    <jats:sup>low<\/jats:sup>\n                    , and CD8\n                    <jats:sup>+<\/jats:sup>\n                    \u2009PD-1\n                    <jats:sup>+<\/jats:sup>\n                    \u2009Tem counts after the fourth injection (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). These immunological parameters positively correlated with symptom severity. Baseline NRS\u2009&gt;\u20094 was associated with worse baseline profiles and selective post-treatment improvements, whereas global response assessment (GRA) stratification showed no significant differences. These findings indicate that repeated intravesical PRP alleviates IC\/BPS-related pain and urinary symptoms primarily by reversing T-cell exhaustion and enhancing mitochondrial metabolic status, thus highlighting T-cell immunometabolic modulation as a key therapeutic mechanism.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-52272-6","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T12:16:02Z","timestamp":1779106562000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Repeated intravesical platelet-rich plasma injections alleviate symptoms via T-cell modulation and mitochondrial dysfunction in non-ulcer interstitial cystitis\/bladder pain syndrome"],"prefix":"10.1038","volume":"16","author":[{"given":"Weilin","family":"Fang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziwei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhikang","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conghui","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwei","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"52272_CR1","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1016\/j.juro.2015.01.086","volume":"193","author":"PM Hanno","year":"2015","unstructured":"Hanno, P. 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