Mazzoli Sandra, Cai Tommaso, Rupealta Valentina, Gavazzi Andrea, Castricchi Pagliai Roberto, Mondaini Nicola, Bartoletti Riccardo
STDs Centre, Santa Maria Annunziata Hospital, Florence, Italy.
Eur Urol. 2007 May;51(5):1385-93. doi: 10.1016/j.eururo.2006.10.059. Epub 2006 Nov 3.
This study evaluates the role of interleukin 8 (IL-8) and anti-Chlamydia trachomatis (CT) immunoglobulin A (IgA) in total ejaculate (TE) of patients affected by chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) as potential markers in prostatic CT infection.
Seventy-eight consecutive patients with a diagnosis of CP/CPPS and CT infection were enrolled; 20 healthy volunteers represented the control group. All subjects underwent microbiologic analysis for common bacteria, yeasts, and viruses in TE, expressed prostatic secretion, and urine samples and molecular analysis for CT identification, anti-CT species-specific IgA, and IL-8 levels. Questionnaires regarding symptoms were given to each subject to determine correlations between clinical and laboratory data.
Thirty-five patients were positive for CT plasmid DNA, but none of the controls were positive. Mucosal IgA was detected in 69.2% of patients and significant levels of IL-8 were detected in 75.6% of them. Significant correlations between IL-8 and mucosal IgA (p<0.001) and between IL-8 levels and symptom score results (p<0.001) were found. IL-8 values strongly correlated with CP/CPPS (p<0.001). Moreover, the patients with higher levels of IL-8 and higher positivity for IgA reported the worst symptoms.
Our results clearly highlight the role of immune system activation in the pathophysiology of CP/CPPS and that seminal IL-8 and mucosal IgA levels specific to CT antigens appear to be the best immunologic markers of chronic chlamydial prostatitis status.
本研究评估白细胞介素8(IL-8)和抗沙眼衣原体(CT)免疫球蛋白A(IgA)在慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)患者的总射精量(TE)中作为前列腺CT感染潜在标志物的作用。
纳入78例连续诊断为CP/CPPS且伴有CT感染的患者;20名健康志愿者作为对照组。所有受试者均对TE、前列腺分泌物及尿液样本进行常见细菌、酵母菌和病毒的微生物学分析,并对CT鉴定、抗CT种特异性IgA和IL-8水平进行分子分析。向每位受试者发放症状问卷以确定临床和实验室数据之间的相关性。
35例患者CT质粒DNA呈阳性,而对照组均为阴性。69.2%的患者检测到黏膜IgA,75.6%的患者检测到显著水平的IL-8。发现IL-8与黏膜IgA之间存在显著相关性(p<0.001)以及IL-8水平与症状评分结果之间存在显著相关性(p<0.001)。IL-8值与CP/CPPS密切相关(p<0.001)。此外,IL-8水平较高且IgA阳性率较高的患者报告的症状最严重。
我们的结果清楚地突出了免疫系统激活在CP/CPPS病理生理学中的作用,并且精液中针对CT抗原的IL-8和黏膜IgA水平似乎是慢性衣原体前列腺炎状态的最佳免疫标志物。