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doi: 10.1016/j.clnesp.2021.11.005 21 ZhengXZhengYChenTHouCZhouLLiuCFet al

the specific interaction of the antigen-interaction-side with its specific antigen may alternatively or additionally result in the initiation of a signal, e.g

5 Immune system irregularities (eg, autoimmunity, chronic inflammation), undetected chronic infection, inflammation and/or hyperexcitability of the bladder nerves, and altered signaling between the bladder and other pelvic tissues may also contribute

Of note, epigenetic and transcriptional priming are unlikely to be mutually exclusive, as changes in histone modifications can lead to transcriptional activation