| COMPARISON OF PROINFLAMMATORY
CYTOKINE LEVELS IN SEMEN AND URINE IN MEN WITH CHRONIC PROSTATITIS,
NON-SPECIFIC URETHRITIS AND HEALTHY CONTROLS
Dr Abbas Khadra MRCGP FRCS St George's Hospital Medical School, University of London |
Summary
Nonbacterial prostatitis, recently defined as chronic pelvic pain syndrome (CPPS) is characterised by pelvic or perineal pain that may be associated with pro static inflammation. In published clinical series, true chronic bacterial prostatitis is reported to account for around 5% of symptomatic patients, with CPPS accounting for the remaining 95%. CPPS is the most common urologic diagnosis in men less than 50 years of age, yet little is known about its aetiology and treatment.
The most exciting research findings on the pathogenesis of CPPS have related to the demonstration of elevated pro-inflammatory cytokines in the prostate. Recent studies have shown that men with CPPS frequently have elevated prostatic cytokines in semen samples. Cytokines interleukin-1 beta and tumour necrosis factor-alpha levels are greater in expressed prostatic secretions (EPS) in men with CPPS when compared to healthy men or those with benign prostatic hyperplasia. However none of the studies looked at cytokine levels in first pass urine or midstream urine samples which are easier to collect in practice. Cytokines can be detected in the urine and thus looking at urine levels as a marker of prostatitis would seem feasible. Also there has been no work comparing elevated cytokine levels between patients with CPPS and those with non-specific urethritis.
The proposed study will compare cytokine levels in first pass urine, midstream urine and semen from men with CPPS, non-specific urethritis (NSU) and healthy controls. This will be the first study investigating the feasibility of measuring cytokine profiles in simple urine specimens in men with CPPS and NSU. This may become applicable in General Practice and may be used as a diagnostic tool. In addition the results will enhance our understanding of the mechanisms of these illnesses.
Approved by Prostate Research Campaign UK Medical and Scientific Advisory Panel, and Principal Committee.