Characterisation of inflammatory cells in benign prostatic hyperplasia

Area of Science:

• Urology
• Immunology
• Pathology

Background:

• Inflammation is frequently observed in benign prostatic hyperplasia (BPH).
• Prostatitis associated with BPH can be acute, chronic active, or chronic inactive.
• Understanding the sequence of inflammatory cell involvement is crucial for BPH pathogenesis.

Purpose of the Study:

• To immunohistochemically localize different inflammatory cell types within prostatic lesions.
• To elucidate the chronological sequence of cellular reactions in BPH-related inflammation.
• To correlate inflammatory cell presence with prostatic damage and regeneration markers.

Main Methods:

• Immunohistochemistry was used to identify T-lymphocytes (CD45RO, CD3), B-lymphocytes (CD20), and macrophages (CD68).
• Detection of kappa and lambda immunoglobulin light chains was performed.
• Antibodies against prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP) were utilized.

Main Results:

• Macrophages were abundant in damaged glands and periglandular areas in acute and chronic active prostatitis.
• T-lymphocytes accumulated around glands, associated with macrophages.
• B-lymphocytes were scarce in early stages but prominent in well-organized centers in chronic active prostatitis.
• Loss and subsequent reappearance of PSA and PSAP activity correlated with glandular damage and regeneration.

Conclusions:

• The initial response to prostatic injury involves macrophages, likely triggered by leakage of PSA and PSAP.
• T-lymphocytes are recruited, playing a significant role in the inflammatory response.
• B-lymphocyte involvement appears to be a late-stage event in the inflammatory cascade of BPH.