The diagnostic value of the immunologic response in bacterial and nonbacterial prostatitis

Using a solid-phase radioimmunoassay that permits quantitation of specific antibodies to infecting bacteria in the prostatic fluid of patients with bacterial prostatitis we measured the immunologic response to common gram-negative urinary pathogens in 6 patients with bacterial prostatitis, 4 with nonbacterial prostatitis and 10 normal volunteer controls. The results show that true bacterial prostatitis is clearly distinguishable immunologically from nonbacterial inflammation of the prostate. Normal volunteer controls, like patients with nonbacterial inflammation of the prostate, have no antigen-specific antibodies to gram-negative urinary pathogens in the prostatic secretion. In clinical situations when bacteriologic localization data are confusing, immunologic analysis provides a specific tool for definitive diagnosis. Data from bacterial absorption studies show that antigen-specific antibodies determined by solid-phase radioimmunoassay can be measured in milligrams per deciliter rather than units of dilutional titers. This approximation of antigen-specific antibodies in milligram quantities permits a more quantitative approach to understanding surface mucosal immunity in terms of the class-specific immunologic response.