Together, the current study highlights the significance of defected mucosal insulin signalling in MS-associated OAB; at the same time, suggests the mucosal IR/IRS/PI3K/AKT/eNOS pathway and detrusor cGMP production in the therapeutic action of metformin and tadalafil for the treatment of OAB under the condition of MS-associated insulin resistance. The gene discussed is IARS1; the disease is myeloid sarcoma.