Castiglione Roberto, Bertino Gaetano, Vicari Beatrice Ornella, Rizzotto Agostino, Sidoti Giuseppe, D'Agati Placido, Salemi Michele, Malaguarnera Giulia, Vicari Enzo
Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
Research Center "The Great Senescence", University of Catania, 95100 Catania, Italy.
Diseases. 2024 Oct 18;12(10):260. doi: 10.3390/diseases12100260.
We recently demonstrated the effectiveness of long-term treatment with rifaximin and the probiotic DSF (De Simone formulation) in improving urogenital and gastrointestinal symptoms in patients with both chronic inflammatory prostatitis (IIIa prostatitis) and diarrhea-predominant irritable bowel syndrome (IBS-D), relative to patients with IBS-D alone. Because the low-grade inflammation of the intestine and prostate may be one of the reasons for co-developing both IIIa prostatitis and IBS-D, we designed the present study to once again evaluate the efficacy of combined rifaximin and DSF treatment in patients affected by IIIa prostatitis plus IBS-D, but we also measured seminal plasma pro-inflammatory (IL-6) and anti-inflammatory (IL-10) cytokines before and after treatment. Methods: We consecutively enrolled 124 patients with IIIa prostatitis and IBS-D (diagnosed using the Rome III criteria). Patients were randomized into two groups: group A (n = 64) was treated with rifaximin (seven days per month for three months) followed by DSF, and group B (n = 60) was treated with a placebo. By the end of the intervention, 68.7% and 62.5% of patients from group A reported improved NIH-CPSI (National Institute of Health's Chronic Prostatitis Symptom Index) and IBS-SSS (Irritable Bowel Syndrome Severity Scoring System) scores, respectively, compared to only 3.3% and 5% of the placebo group. Group A patients also had significantly lower mean seminal plasma levels of IL-6 (11.3 vs. 32.4 pg/mL) and significantly higher mean levels of IL-10 (7.9 vs. 4.4 pg/mL) relative to baseline, whereas the levels of IL-6 and IL-10 did not change in the placebo group. Conclusions: The combined treatment with rifaximin and DSF appears to represent the optimal approach for addressing a syndrome such as irritable bowel syndrome (IBS-D plus), which frequently co-occurs with prostatitis (IIIa prostatitis). This approach is particularly beneficial in cases where the symptoms are not always clearly delineated, the etiology is multifactorial, and the diagnosis is multilevel.
我们最近证明，与仅患有腹泻型肠易激综合征（IBS-D）的患者相比，利福昔明和益生菌DSF（德西蒙配方）长期治疗在改善慢性炎症性前列腺炎（IIIa型前列腺炎）和腹泻型肠易激综合征（IBS-D）患者的泌尿生殖系统和胃肠道症状方面具有有效性。由于肠道和前列腺的低度炎症可能是IIIa型前列腺炎和IBS-D共同发生的原因之一，我们设计了本研究，再次评估利福昔明和DSF联合治疗对IIIa型前列腺炎合并IBS-D患者的疗效，但我们也在治疗前后测量了精浆中的促炎细胞因子（IL-6）和抗炎细胞因子（IL-10）。方法：我们连续招募了124例符合罗马III标准诊断的IIIa型前列腺炎和IBS-D患者。患者被随机分为两组：A组（n = 64）先接受利福昔明治疗（每月7天，共3个月），随后接受DSF治疗；B组（n = 60）接受安慰剂治疗。到干预结束时，A组分别有68.7%和62.5%的患者报告其美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）和肠易激综合征严重程度评分系统（IBS-SSS）得分有所改善，而安慰剂组仅为3.3%和5%。与基线相比，A组患者精浆中IL-6的平均水平也显著降低（11.3对32.4 pg/mL），IL-10的平均水平显著升高（7.9对4.4 pg/mL），而安慰剂组中IL-6和IL-10的水平没有变化。结论：利福昔明和DSF联合治疗似乎是解决肠易激综合征（IBS-D加）等综合征的最佳方法，该综合征经常与前列腺炎（IIIa型前列腺炎）同时发生。这种方法在症状不总是清晰界定、病因是多因素的且诊断是多层面的情况下特别有益。
