Microbiota of prostate secretion in patients with chronic category III nonbacterial prostatitis associated with herpesviruses
Authors:   RUDN University, Moscow, Stepanov V.S. , Kadyrov Z.A. ,   RUDN University, Moscow, Faniev M.V. ,   RUDN University, Moscow, Ishonakov Kh.S. ,   Tajik Institute of Postgraduate Training of Medical Personnel, Dushanbe
Published: January 2025

Background: in recent decades, advancements indiagnostic methods for viral infections have stimulated increased interest in studying the
role of herpesviruses in disorders of the reproductive system. Emerging evidence has suggested their potential involvement in the pathogenesis
of chronic nonbacterial prostatitis.
Aim: the study aimed to analyze the microbiota of prostatic secretions (MPS) in patients diagnosed with chronic nonbacterial prostatitis
associated with herpesviruses, utilizing mass spectrometry of microbial markers (MSMM).
Materials and Methods: a prospective comparative study was conducted from 2018 to 2023, which included two groups: study group —
61 male participants aged 25–50 years presenting with symptoms indicative of prostatitis and the presence of herpesviruses in the MPS;
control group — 70 healthy asymptomatic patients of the same age group had no complaints undergoing routine screening.
Results: average levels of Herpes simplex virus types 1 and 2 (HSV-1/2), cytomegalovirus, and Epstein–Barr virus (EBV) in prostatic
secretions, as determined by MSMM, were significantly higher in patients with chronic nonbacterial prostatitis associated with herpesviruses
compared to the control group. These values are presented as medians with interquartile ranges (×105 cells/mL): HSV-1/2: 36.5 (25;
64.5) vs. 2 (2; 2), respectively (p<0.0001); Cytomegalovirus: 51.5 (22.75; 124) vs. 6.5 (3.5; 11.75) (p<0.0001); EBV: 13.5 (5.75; 32.25) vs.
2 (0.2; 2.25) (p<0.0001).
Additionally, patients with chronic nonbacterial prostatitis exhibited a significant increase in the total microbial load (10566 (4809; 16654)
×105 cells/mL vs. 2152 (1196.75; 3612.5) ×105 cells/mL, p<0.0001). Subgroup analysis revealed elevated levels of the following microbial taxa in the study group: Cocci and bacilli: Streptococcus mutans (anaerobic) and Staphylococcus aureus (p<0.0001 and p=0.0004, respectively);
Anaerobes: Clostridium difficile, Clostridium ramosum, Eggerthella lenta, Lactobacillus spp., and Peptostreptococcus anaerobius (p<0.0001);
Actinobacteria: Actinomyces viscosus and Rhodococcus spp. (p<0.0001); Fungi and yeasts: Aspergillus spp. (p=0.0316) and Candida spp.
(p=0.0002).
Conclusion: the observed increase in viruses load in patients with chronic prostatitis underscores the critical need to examine
prostatic secretions for viral pathogens. These findings suggest that herpesviruses may act as a contributing factor in sustaining the
chronic inflammatory process. This evidence supports the inclusion of targeted antiviral therapy in the comprehensive management
of chronic nonbacterial prostatitis, with the potential to enhance diagnostic accuracy and therapeutic outcomes for affected
individuals.
Keywords: herpesviruses, microbiota, prostate secretion, mass spectrometry of microbial markers, microorganisms.
For citation: Stepanov V.S., Kadyrov Z.A., Faniev M.V., Ishonakov Kh.S. Microbiota of prostate secretion in patients with chronic category III
nonbacterial prostatitis associated with herpesviruses. RMJ. 2024;11:13–18. DOI: 10.32364/2225-2282-2024-11-3