Doble A, Walker M M, Harris J R, Taylor-Robinson D, Witherow R O
Department of Urology, St Mary's Hospital, London.
Br J Urol. 1990 Jun;65(6):598-605. doi: 10.1111/j.1464-410x.1990.tb14827.x.
Sixty patients with chronic abacterial prostatitis and 21 men without prostatitis were studied. Transperineal prostatic biopsies taken under transrectal ultrasound control were examined for antibody, complement (C3) and fibrinogen deposition using a direct immunofluorescence (IF) technique; 34 patients (57%) had prostatic tissue that displayed IF staining compared with only 1 (5%) in the non-prostatitis group. IF staining for IgM was found in 85%, for C3 in 44%, for IgA in 35% and for fibrinogen in 24%, but the IgG subclass was not detected. Antibody deposition was mainly periglandular and glandular and in the wall of vessels. Five symptoms, particularly poor urinary flow, irritative voiding and urgency, were significantly correlated with IgM and C3 deposition and, to a lesser extent, fibrinogen deposition. The aetiology of chronic abacterial prostatitis remains obscure but several possible mechanisms are discussed. The link between symptomatology and immunology could rest with functional outflow obstruction causing intraprostatic reflux of urine, this in turn inciting an immunological response, the inducing antigens being organism remnants or products, urinary constituents or autoantibodies.
对60例慢性非细菌性前列腺炎患者和21例无前列腺炎的男性进行了研究。在经直肠超声引导下经会阴前列腺活检组织，采用直接免疫荧光（IF）技术检测抗体、补体（C3）和纤维蛋白原沉积；34例患者（57%）前列腺组织显示IF染色，而非前列腺炎组仅1例（5%）显示IF染色。发现IgM的IF染色阳性率为85%，C3为44%，IgA为35%，纤维蛋白原为24%，但未检测到IgG亚类。抗体沉积主要在腺周、腺体内和血管壁。五种症状，尤其是尿流不畅、刺激性排尿和尿急，与IgM和C3沉积显著相关，与纤维蛋白原沉积的相关性较小。慢性非细菌性前列腺炎的病因仍不清楚，但讨论了几种可能的机制。症状学与免疫学之间的联系可能在于功能性流出道梗阻导致尿液前列腺内反流，进而引发免疫反应，诱导抗原为微生物残余物或产物、尿液成分或自身抗体。
