[Role of cytokines in the diagnosis of chronic prostatitis]

Chronic prostatitis affects 30-60% males and significantly deteriorates quality of their life. Clinical and experimental investigations have revealed changes in immune status in the onset and development of prostatic inflammation. As some other urologists, we made an attempt to determine the role of cellular immunity and immunoglobulins in the diagnosis of chronic prostatitis. The study was made in 30 patients with chronic abacterial prostatitis (mean age 42.5 years, duration of the disease 1.8 years). In addition to standard examination, all the patients have undergone analysis of the immune status and measurement of proinflammatory cytokines (TNF alpha and IL-12b) in biological media: blood serum, urine, ejaculate, prostatic secretion. The patients had moderate symptoms: IPSS--10.4 scores, life quality index--4.3 scores, on the average. Prostamol-uno was given to all the patients in a standard dose 1 capsule (320 mg) a day for 3 to 6 months. The results were processed statistically. A good effect of prostamoluno was registered in 26 patients, a satisfactory one--in 2. Two patients refused to take prostamol-uno because of lack of a prominent effect. The scores of IPSS lowered from 10.4 to 6.3 (by 39%), life quality improved by 42%. Ultrasound monitoring of the size of the prostate showed no significant changes in the size. Tolerance was good in all 30 patients. Side effects were absent. After 3 months of the treatment serum, urine, ejaculate and prostatic secretion cytokines changed. TNF alpha elevated while IL-1 beta level lowered almost to normal value. In 6 months both IL-1 beta and TNF alpha returned to normal values confirming stabilization of cytokine system and the end of inflammation. Cellular immunity did not change much. Thus, as inflammation in prostatic tissue is characterized by elevation of proinflammatory cytokines, in diagnosis of chronic prostatitis it will be valid to use markers TNF alpha and IL-1 beta as criteria of immune prognosis of prostatic exacerbation. Prostamol-uno does not induce changes in lymphocyte populations and impairment of immune status.