Targeting the brain-gut-prostate axis in chronic prostatitis: mechanisms and therapeutics

Area of Science:

• Urology
• Neuroimmunology
• Microbiomics

Background:

• Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a challenging urinary disorder linked to brain-gut-prostate axis dysfunction.
• Gut microbiota dysbiosis and its neuroimmune interactions are increasingly recognized in CP/CPPS pathogenesis.

Purpose of the Study:

• To propose a theoretical framework for the brain-gut-prostate axis in CP/CPPS.
• To explore multi-dimensional therapeutic strategies targeting this axis beyond localized anti-inflammatory approaches.

Main Methods:

• Systematic review integrating microbiomics, neuroimmunology, and metabolomics.
• Analysis of microbiota-derived metabolites, neuroendocrine signaling, and immune crosstalk.
• Exploration of innovative therapies including microbiome modulation and neural interventions.

Main Results:

• Elucidation of mechanistic insights into the brain-gut-prostate axis in CP/CPPS.
• Identification of key factors like short-chain fatty acids (SCFAs), thyrotropin-releasing hormone (TRH), and Th17/Treg imbalance.
• Highlighting the potential of novel therapeutic avenues.

Conclusions:

• A holistic paradigm for understanding and treating CP/CPPS is proposed.
• This framework offers promising avenues for personalized management and translational research.
• Potential to overcome current therapeutic bottlenecks in CP/CPPS treatment.