1142 URINE CHEMOKINES REFLECT CONTRIBUTION OF BLADDER IN THE SYMPTOMS OF CHRONIC PROSTATITIS (2013)

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder (II)1 Apr 20131142 URINE CHEMOKINES REFLECT CONTRIBUTION OF BLADDER IN THE SYMPTOMS OF CHRONIC PROSTATITIS Pradeep Tyagi, Kim Killinger, Gregory McLennan, Jayabalan Nirmal, Naoki Yoshimura, Michael Chancellor, and Kenneth Peters Pradeep TyagiPradeep Tyagi Pittsburgh, PA More articles by this author , Kim KillingerKim Killinger Royal Oak, MI More articles by this author , Gregory McLennanGregory McLennan Royal Oak, MI More articles by this author , Jayabalan NirmalJayabalan Nirmal Royal Oak, MI More articles by this author , Naoki YoshimuraNaoki Yoshimura Pittsburgh, PA More articles by this author , Michael ChancellorMichael Chancellor Royal Oak, MI More articles by this author , and Kenneth PetersKenneth Peters Royal Oak, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.777AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The present study postulates that the pathophysiology of NIH category III Chronic Prostatitis (CP) or Chronic Pelvic Pain Syndrome (CPPS) may not be as prostate centric as for NIH categories I and II CP/CPPS. A preclinical study from our group recently reported sensitization of bladder afferents following induction of localized inflammation in prostate. Therefore, we hypothesized a contribution of bladder in the cardinal symptoms of NIH category III CP/CPPS patients which was assessed by levels of inflammatory cytokines/chemokines in their urine collected without expressing prostate. METHODS At baseline, urine was collected from 21 patients fulfilling the NIH definition of CP/CPPS without digital rectal exam or any other physical manipulation of prostate. 14 CP/CPPS patients consented to a prospective open-label, one arm 12 week therapy (NCT00701311) of PDE4 inhibitor and urine was collected at multiple visits and frozen during therapy and at 16 week followup. Urine from age matched 10 male asymptomatic subjects was also collected to serve as controls. Frozen specimens were analyzed after thawing 50μL by MILLIPLEX MAP immunoassay. RESULTS Urine dipstick done after each urine collection to rule out presence of urinary infection. Compared to controls, the urine levels of CXCL-1, IL-8, CXCL-10 and CCL5 (RANTES) were significantly (5-20 fold) elevated in CP/CPPS (Mann-Whitney U test; p<0.05)(attached fig). Higher levels of CXCL-10 (169.8 ± 46.38 vs. 31.45 ± 16.83pg/mL) and lower levels of sIL-1RA (43.10 ± 9.66 vs. 128.7 ± 49.37pg/mL) in CPPS relative to controls suggest involvement of T-lymphocytes in concert with chronic inflammation. Bivariate and multivariate association of improved symptom scores (Chronic Prostatitis Symptom Index (CPSI), visual analog scale (VAS) following PDE4 treatment demonstrated a strong correlation with reduced urine levels of CXCL-10, CXCL-8, CCL5, CCL2 and PDGF (Pearson r =0.83- 0.97; p<0.05). CONCLUSIONS These results support the consensus of CP/CPPS as a regional syndrome and akin to results from pre-clinical study, treatment associated reduction in urinary chemokines reveal a molecular contribution from bladder in the genesis of symptoms. Urine chemokines can be useful in monitoring patient response to new therapeutic intervention for CP/CPPS. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e466 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pradeep Tyagi Pittsburgh, PA More articles by this author Kim Killinger Royal Oak, MI More articles by this author Gregory McLennan Royal Oak, MI More articles by this author Jayabalan Nirmal Royal Oak, MI More articles by this author Naoki Yoshimura Pittsburgh, PA More articles by this author Michael Chancellor Royal Oak, MI More articles by this author Kenneth Peters Royal Oak, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...