We examined the relationship between the Arg16Gly polymorphism of β2-adrenoceptor (ADRB2) and the efficacy of tricyclic antidepressant therapy in patients with interstitial cystitis (IC). We studied 55 IC patients and 113 controls. The IC patients were treated with imipramine hydrochloride, and the efficacy of treatment was categorized by patients' satisfaction (no change, fair, or good). Genomic DNA was extracted from the controls and IC patients, and the Arg16Gly polymorphism of ADRB2 was analyzed. The Arg16Gly polymorphism showed a significant difference in prevalence between IC patients and controls, and Arg/Arg was associated with increase in the risk of IC than Arg/Gly or Gly/Gly. Regarding the tricyclic antidepressant therapy, there was a significant difference in the prevalence of this polymorphism between IC patients with no change or a fair response to treatment and controls, and Arg/Arg was associated with decrease in the response rate to tricyclic antidepressant therapy than Arg/Gly or Gly/Gly. Therefore, these results suggest that the Arg16Gly polymorphism of ADRB2 is related to down-regulation of ADRB2 expression in the detrusor muscle, so that the response of IC to tricyclic antidepressant therapy depends on the Arg16Gly polymorphism.Interstitial cystitis (IC) is a chronic disorder with symptoms that include urinary urgency, frequency, nocturia, and bladder pain (10, 12). On cystoscopy, petechial hemorrhages and/or Hunner's ulcers are found after distension of the bladder (9). Several possible causative factors have been proposed, but the etiology and pathophysiology of IC are still unknown. Epidemiological studies have shown that patients with IC are 100 times more likely to have inflammatory bowel disease than healthy persons (1). IC is often associated with allergic diseases, and 40 to 80% of these patients have allergies (16). These findings suggest that IC is an immunological disease of the bladder.Regarding the treatment of IC, a randomized trial showed the marked improvement of symptoms after 4 months of tricyclic antidepressant therapy (17). Tricyclic antidepressant blocks the active transport system that is involved in the re-uptake of serotonin and noradrenaline (4). The detrusor muscle of the bladder shows abundant expression of the β2-adrenoceptor (ADRB2), and polymorphisms of the ADRB2 gene have been suggested to show a close association with various allergic diseases. For example, an arginine-to-glycine substitution at codon 16 (Arg16Gly) is related to down-regulation of ADRB2 (6), which is thought to be one of the pathogenic factors in asthma (7). Therefore, the effect of tricyclic antidepressant on CI may be related to polymorphism of the ADRB2 (Arg16Gly) gene and to