Persson B E, Ronquist G
Department of Urology, University Hospital, Uppsala, Sweden.
Eur Urol. 1996;29(1):111-4. doi: 10.1159/000473728.
Non-bacterial prostatitis is a common problem in young men. It is a disease which is often recurrent and each episode lasts for several months. Different causative mechanisms of the disease have been discussed including identified and non-identified microorganisms, stone formation and psychological factors. It was shown in an earlier study that urinary reflux (as shown by a high creatinine concentration in prostatic fluid) took place to a varying extent in the prostatic ducts and this reflux was related to prostatic pain and urate concentration in expressed prostatic secretion (EPS). Allopurinol treatment lowered the urate concentration in EPS and relieved the subjective discomfort. This study reports serum (S) levels of prostate-specific antigen (PSA) in patients with non-bacterial prostatitis and the way in which S-PSA was affected by allopurinol treatment. It is also shown that the S-PSA level is age dependent. A correlation existed between the S-PSA concentration and EPS content of white blood cells. Patients with high EPS urate concentrations corresponded to low S-PSA levels and allopurinol treatment resulted in elevated S-PSA levels. PSA in EPS was also increased by allopurinol treatment. Hence, an increased release of PSA from the prostate gland was noted upon allopurinol treatment. The mechanism of the allopurinol-induced release is obscure. It might be explained by an induction of PSA synthesis via an allopurinol effect on the genome but an increased leakage of the prostatic cells elicited by allopurinol could no be ruled out.
非细菌性前列腺炎是年轻男性的常见问题。它是一种常复发的疾病，每次发作持续数月。人们已讨论了该疾病的不同致病机制，包括已识别和未识别的微生物、结石形成及心理因素。早期一项研究表明，前列腺导管中不同程度地发生了尿液反流（前列腺液中肌酐浓度升高可证明），这种反流与前列腺疼痛及前列腺按摩液（EPS）中的尿酸盐浓度有关。别嘌醇治疗降低了EPS中的尿酸盐浓度并缓解了主观不适。本研究报告了非细菌性前列腺炎患者的血清（S）前列腺特异性抗原（PSA）水平以及别嘌醇治疗对S-PSA的影响方式。还表明S-PSA水平与年龄有关。S-PSA浓度与EPS中白细胞含量之间存在相关性。EPS尿酸盐浓度高的患者对应较低的S-PSA水平，而别嘌醇治疗导致S-PSA水平升高。别嘌醇治疗也使EPS中的PSA增加。因此，别嘌醇治疗后发现前列腺中PSA的释放增加。别嘌醇诱导释放的机制尚不清楚。这可能是由于别嘌醇对基因组的作用诱导了PSA合成，但也不能排除别嘌醇引起前列腺细胞渗漏增加的可能性。
