Elsevier

Urology

Volume 59, Issue 4, April 2002, Pages 603-608
Urology

Basic science
Nerve growth factor and chronic prostatitis/chronic pelvic pain syndrome

https://doi.org/10.1016/S0090-4295(01)01597-7Get rights and content

Abstract

Objectives. To investigate whether the pain experienced by patients with chronic prostatitis/chronic pelvic pain syndrome (CPPS) may be related to the expression of nerve growth factor (NGF), induced by inflammation and tissue injury experienced as a result of chronic inflammation. CPPS is a disease of unknown pathogenesis.

Methods. We measured the levels of NGF and the pro-inflammatory cytokine interleukin (IL)-6 and compared these with the levels of IL-8, interferon-gamma, IL-2, and IL-10 in the seminal plasma of 31 patients with CPPS and 14 controls using enzyme-linked immunosorbent assay technology. Results were correlated with health-related quality of life as measured by the multidimensional pain inventory, the McGill pain questionnaire, and the International Prostate Symptom Score.

Results. The cytokines analyzed were detectable in the seminal plasma from the patients with CPPS and controls. NGF correlated directly with pain severity (P <0.01) and IL-10 levels (P <0.04), and IL-6 correlated inversely with pain severity (P <0.03).

Conclusions. These results suggest that NGF and cytokines that regulate inflammation (IL-6 and IL-10) may play a role in the pain symptoms experienced by patients with CPPS.

Section snippets

Patient populations

All patients met the National Institutes of Health criteria for nonbacterial chronic prostatitis category III.6 Forty-eight patients with prostatitis underwent a basic history and physical examination by a physician, including a digital rectal examination and expressed prostatic secretions if obtainable. In addition, 14 normal male controls were recruited. Volunteers were examined by a physician and had no history of genitourinary symptoms, instrumentation, or surgery.

At the time of the

Cytokine levels in seminal plasma

For the present study, we established the presence of NGF and the pro-inflammatory cytokine IL-6 in the seminal plasma of the CPPS and control populations. These levels were compared with levels of the pro-inflammatory cytokines IL-8 and IFN-gamma, the immunoregulatory cytokine IL-2, and the anti-inflammatory cytokine IL-10 from the same patient population, as previously reported.3 The seminal plasma cytokines (NGF, IL-6, IL-8, IFN-gamma, IL-2, and IL-10) were all detectable in most of the CPPS

Comment

Chronic prostatitis is a complex condition of unknown etiology and pathogenesis. Currently, nothing is known about the presence or potential role of NGF in CPPS. Evidence suggests that NGF can induce and/or alter sensitivity to pain. For example, studies have indicated that NGF may be an important mediator of some forms of persistent pain and that NGF can alter pain-related behavior.10 In fact, a single dose of 1 mg/mL of NGF administered to animals resulted in increased sensitivity to both

Conclusions

Our studies have demonstrated that in patients with CPPS, increased pain is associated with increased seminal plasma IL-10 and NGF expression, but decreased IL-6 expression. We believe our present data support a model of tissue regulation in which chronic injury and inflammation to the prostate results in the expression of pro-inflammatory cytokines (IL-6 and IL-8) that, in response, leads to the expression of the anti-inflammatory cytokine IL-10. Although this IL-6/IL-8-induced expression of

Acknowledgements

To Drs. Scott Matson, Jeff Wong, and Willie Underwood for their help in recruiting patients.

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  • Cited by (0)

    These studies were supported in part by grant DK-52718 from the National Institutes of Health.

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