Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is a complex disease that is often accompanied by mental health disorders.However,the potential mechanisms underlying the heterogeneous clinical presentation of...Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is a complex disease that is often accompanied by mental health disorders.However,the potential mechanisms underlying the heterogeneous clinical presentation of CP/CPPS remain uncertain.This study analyzed widely targeted metabolomic data of expressed prostatic secretions(EPS)and plasma to reveal the underlying pathological mechanisms of CP/CPPS.A total of 24 CP/CPPS patients from The Second Nanning People’s Hospital(Nanning,China),and 35 asymptomatic control individuals from First Affiliated Hospital of Guangxi Medical University(Nanning,China)were enrolled.The indicators related to CP/CPPS and psychiatric symptoms were recorded.Differential analysis,coexpression network analysis,and correlation analysis were performed to identify metabolites that were specifically altered in patients and associated with various phenotypes of CP/CPPS.The crucial links between EPS and plasma were further investigated.The metabolomic data of EPS from CP/CPPS patients were significantly different from those from control individuals.Pathway analysis revealed dysregulation of amino acid metabolism,lipid metabolism,and the citrate cycle in EPS.The tryptophan metabolic pathway was found to be the most significantly altered pathway associated with distinct CP/CPPS phenotypes.Moreover,the dysregulation of tryptophan and tyrosine metabolism and elevation of oxidative stress-related metabolites in plasma were found to effectively elucidate the development of depression in CP/CPPS.Overall,metabolomic alterations in the EPS and plasma of patients were primarily associated with oxidative damage,energy metabolism abnormalities,neurological impairment,and immune dysregulation.These alterations may be associated with chronic pain,voiding symptoms,reduced fertility,and depression in CP/CPPS.This study provides a local-global perspective for understanding the pathological mechanisms of CP/CPPS and offers potential diagnostic and therapeutic targets.展开更多
This study aimed to assess the association between psychological disorders and erectile dysfunction(ED)in patients with different degrees of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).This was a retrosp...This study aimed to assess the association between psychological disorders and erectile dysfunction(ED)in patients with different degrees of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).This was a retrospective study conducted from June 2017 to October 2019 and included 182 outpatients.Patients were interviewed using the Structured Interview on Erectile Dysfunction(SIEDY)for pathogenic quantification.The National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI)and the International Index of Erectile Function-5(IIEF-5)were used for the evaluation of CP/CPPS and ED.The Generalized Anxiety Disorder-7(GAD-7)and Patient Health Questionnaire-9(PHQ-9)were used to assess anxiety symptoms and depressive symptoms.The number of patients with mild CP/CPPS and mild ED,mild CP/CPPS and moderate-to-severe ED,moderate-to-severe CP/CPPS and mild ED,and moderate-to-severe CP/CPPS and moderate-to-severe ED was 69(37.9%),36(19.8%),35(19.2%),and 42(23.1%),respectively.The corresponding PHQ-9 scores of the four groups were 6.22,7.19,10.69,and 7.71,respectively.The corresponding GAD-7 scores of the four groups were 5.26,6.31,8.77,and 6.36,respectively.Among patients with moderate-to-severe CP/CPPS,the PHQ-9 and GAD-7 scores of the moderate-to-severe ED group were significantly lower than those of the mild ED group(P=0.007 and P=0.010,respectively).The prevalence of ED and premature ejaculation(PE)in patients with moderate-to-severe CP/CPPS was significantly higher than that in patients with mild CP/CPPS(P=0.001 and P=0.024,respectively).Our findings proved that the severity of ED was negatively associated with psychological symptoms in outpatients with moderate-to-severe CP/CPPS.展开更多
The expressed prostatic secretions （EPSs） of men with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）, infertile men and normal men were subjected to microbiological study. EPSs were collected from the ...The expressed prostatic secretions （EPSs） of men with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）, infertile men and normal men were subjected to microbiological study. EPSs were collected from the subjects, which included 26 normal men, 11 infertile patients and 51 CP/CPPS patients. DNA was extracted from each specimen, and the V3 regions of the 16S rRNA genes were amplified using universal bacterial primers. The results showed that the EPS 16S rRNA gene-positive rate in the CP/CPPS and infertile patients was much higher than in the normal men, but without any difference among the three patient groups. The denaturing gradient gel electrophoresis （DGGE） method was used to characterize the EPS bacterial community structure of the prostate fluid from patients with CP/CPPS or infertility issues. Principal component analysis （PCA） and partial least squares （PLS） analyses of PCR-DGGE profiles revealed that the EPS bacterial community structure differed among the three groups. Three bands were identified as the key factors responsible for the discrepancy between CP/CPPS patients and infertile patients （P〈O.05）. Two bands were identified as priority factors in the discrepancy of category IliA and category IIIB prostatitis patients （P〈O.05）. According to this research, the ecological balance of the prostate and low urethra tract, when considered as a microenvironment, might play an important role in the maintenance of a healthy male reproductive tract.展开更多
Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is highly prevalent worldwide and poses a significant threat to men’s health,particularly affecting young men.However,the exact causes and mechanisms behind CP...Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is highly prevalent worldwide and poses a significant threat to men’s health,particularly affecting young men.However,the exact causes and mechanisms behind CP/CPPS remain unclear,leading to challenges in its treatment.In this research,a CP/CPPS rat model was established with complete Freund’s adjuvant(CFA),and berberine hydrochloride was administered through daily gavage to assess its therapeutic effects.The alterations in the gut microbiome induced by CP/CPPS and berberine hydrochloride were investigated through 16S ribosomal RNA sequencing of cecum content and colonic epithelial cells.To investigate the impact of the gut microbiome on CP/CPPS,a pseudo germ-free rat model was established,and fecal microbiome transplantation(FMT)was performed on these rats.In all,berberine hydrochloride demonstrated effective reduction of inflammation and oxidative stress in the prostate,offering significant therapeutic advantages for CP/CPPS.Through analysis of the gut microbiome using 16S ribosome RNA sequencing,distinct differences were observed between CP/CPPS rats and control rats,and Clostridium butyricum was identified as a key bacteria.Pseudo germ-free rats that underwent FMT from CP/CPPS rats or rats treated with berberine hydrochloride displayed varying levels of inflammatory cytokine production,oxidative stress,and activity of associated signaling pathways.In conclusion,the therapeutic potential of berberine hydrochloride in addressing CP/CPPS is highly significant.The gut microbiome has emerged as a critical factor in the development of CP/CPPS and plays a pivotal role in mediating the therapeutic effects of berberine hydrochloride.展开更多
The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness （UPOINT） phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prosta...The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness （UPOINT） phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CPICPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index （NIH-CPSI） was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores （r = 0.796, P 〈 0.001）. Symptom duration was associated with a greater number of positive domains （r = 0.589, P〈 0.001）. With 6 months follow-up at least, 75.0% （105/140） had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones： pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ±5.70 （all P〈 0.0001）. Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.展开更多
Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant...Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients （case group） and 341 nonCP/CPPS patients （control group）. Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin （odds ratio （OR）： 1.66, 95% confidence interval （CI）： 1.04-2.66）. In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 （95% CI, 1.2-2.88）. The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS.展开更多
We investigated the therapeutic effects of superoxide dismutase(SOD)from thermophilic bacterium HB27 on chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)and its underlying mechanisms.A Sprague–Dawley rat mode...We investigated the therapeutic effects of superoxide dismutase(SOD)from thermophilic bacterium HB27 on chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)and its underlying mechanisms.A Sprague–Dawley rat model of CP/CPPS was prepared and then administered saline or Thermus thermophilic(Tt)-SOD intragastrically for 4 weeks.Prostate inflammation and fibrosis were analyzed by hematoxylin and eosin staining,and Masson staining.Alanine transaminase(ALT),aspartate transaminase(AST),serum creatinine(CR),and blood urea nitrogen(BUN)levels were assayed for all animals.Enzyme-linked immunosorbent assays(ELISA)were performed to analyze serum cytokine concentrations and tissue levels of malondialdehyde,nitric oxide,SOD,catalase,and glutathione peroxidase.Reactive oxygen species levels were detected using dichlorofluorescein diacetate.The messenger ribonucleic acid(mRNA)expression of tissue cytokines was analyzed by reverse transcription polymerase chain reaction(RT-PCR),and infiltrating inflammatory cells were examined using immunohistochemistry.Nuclear factor-κB(NF-κB)P65,P38,and inhibitor of nuclear factor-κBα(I-κBα)protein levels were determined using western blot.Tt-SOD significantly improved histopathological changes in CP/CPPS,reduced inflammatory cell infiltration and fibrosis,increased pain threshold,and reduced the prostate index.Tt-SOD treatment showed no significant effect on ALT,AST,CR,or BUN levels.Furthermore,Tt-SOD reduced inflammatory cytokine expression in prostate tissue and increased antioxidant capacity.This anti-inflammatory activity correlated with decreases in the abundance of cluster of differentiation 3(CD3),cluster of differentiation 45(CD45),and macrophage inflammatory protein 1α(MIP1α)cells.Tt-SOD alleviated inflammation and oxidative stress by reducing NF-κB P65 and P38 protein levels and increasing I-κBαprotein levels.These findings support Tt-SOD as a potential drug for CP/CPPS.展开更多
Chronic prostatitis(CP)/chronic pelvic-pain syndrome(CPPS)is a common urinary-system disease with a high incidence in young and middle-aged men,seriously affecting patients'ability to work and their quality of lif...Chronic prostatitis(CP)/chronic pelvic-pain syndrome(CPPS)is a common urinary-system disease with a high incidence in young and middle-aged men,seriously affecting patients'ability to work and their quality of life(Qo L).Western medicine(WM)has some limitations in treating CP/CPPS.Acupuncture is an ancient Chinese medical method that is commonly used to treat this condition and has a relatively good effect on it.Many randomized controlled trials(RCTs)on this subject have been published.For this study,we searched the China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Periodical(VIP),Wanfang,Sino Med,and Pub Med databases for RCTs on acupuncture treatment of CP/CPPS in the last 5 years(2016/01/01-2021/12/01).In addition,we conducted analysis and research,aiming to summarize acupuncture treatment in CP/CPPS RCTs and the clinical efficacy,with the goal of providing clinical reference.A total of 466 related documents were retrieved in the search,and 62 articles were retained after screening.We obtained RCT information on acupuncture treatment of CP/CPPS.The results showed that several relevant clinical studies have been performed over the last 5 years and that acupuncture and moxibustion have better curative effect on CP/CPPS than WM.Due to the small number of included studies,more experimental evidence is needed to verify the clinical efficacy of acupuncture.展开更多
Objective:To assess the efficacy and safety of a treatment regimen based on rectal administration of Boswellia resin extract and propolis derived polyphenols in patients with type IIIa and type IIIb chronic prostatiti...Objective:To assess the efficacy and safety of a treatment regimen based on rectal administration of Boswellia resin extract and propolis derived polyphenols in patients with type IIIa and type IIIb chronic prostatitis and chronic pelvic pain syndrome(CP/CPPS).Methods:Patients with type IIIa and type IIIb CP/CPPS received one rectal suppository a day for 15 days per month for 3 consecutive months.Participants were evaluated with National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI),the International Prostate Symptom Scores(IPSS),International Index of Erectile Function(IIEF),four-glass test,uroflowmetry,and prostate-specific antigen assessments at baseline and at Week 4,and Week 12.Primary endpoints were improvement in pain domain of NIH-CPSI and improvement of NIH-CPSI total score.Secondary outcomes included improvement of micturition and quality of life(QoL)domains of NIH-CPSI questionnaire.Results:A total of 61 males were enrolled.No adverse events were reported.Significant improvements from baseline to Day 30 were reported for NIH-CPSI total score(mean difference:-9.2;p<0.01),NIH-CPSI pain domain(mean difference:-5.5;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score(mean difference:-5.6;p<0.01).No significant changes from baseline in terms of IIEF score or maximum flow rate were observed.At final follow-up(Day 90),further significant improvements in terms of NIH-CPSI total score(mean difference:-12.2;p<0.01),NIH-CPSI pain domain(mean difference:-6.6;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score were reported.Conclusion:Rectal administration of Boswellia resin extract and propolis derived polyphenols is well tolerated and delivers a significant symptomatic improvement in most patients with type IIIa and type IIIb CP/CPPS.展开更多
Prostatitis comprises of a group of syndromes that affect almost 50% of men at least once in their lifetime and makeup the majority of visits to the Urology Clinics.After much debate, it has been divided into four dis...Prostatitis comprises of a group of syndromes that affect almost 50% of men at least once in their lifetime and makeup the majority of visits to the Urology Clinics.After much debate, it has been divided into four distinct categories by National Institutes of Health namely(1) acute bacterial prostatitis;(2) chronic bacterial prostatitis;(3) chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) which is further divided into inflammatory and non-inflammatory CP/CPPS; and(4)asymptomatic inflammatory prostatitis. CP/CPPS has been a cause of great concern for both patients and physicians because of the lack of presence of thoroughinformation about the etiological factors along with the difficult-to-treat nature of the syndrome. For the presented manuscript an extensive search on PubM ed was conducted for CP/CPPS aimed to present an updated review on the evaluation and treatment options available for patients with CP/CPPS. Several diagnostic criteria's have been established to diagnose CP/CPPS, with prostatic/pelvic pain for at least 3 mo being the major classifying symptom along with the presence of lower urinary tract symptoms and/or ejaculatory pain. Diagnostic tests can help differentiate CP/CPPS from other syndromes that come under the heading of prostatitis by ruling out active urinary tract infection and/or prostatic infection with uropathogen by performing urine cultures, Meares-Stamey Four Glass Test, Preand Post-Massage Two Glass Test. Asymptomatic inflammatory prostatitis is confirmed through prostate biopsy done for elevated serum prostate-specific antigen levels or abnormal digital rectal examination. Researchers have been unable to link a single etiological factor to the pathogenesis of CP/CPPS, instead a cluster of potential etiologies including atypical bacterial or nanobacterial infection, autoimmunity, neurological dysfunction and pelvic floor muscle dysfunction are most commonly implicated. Initially monotherapy with anti-biotics and alpha adrenergic-blockers can be tried, but its success has only been observed in treatment nave population. Other pharmacotherapies including phytotherapy, neuromodulatory drugs and anti-inflammatories achieved limited success in trials. Complementary and interventional therapies including acupuncture, myofascial trigger point release and pelvic floor biofeedback have been employed. This review points towards the fact that treatment should be tailored individually for patients based on their symptoms. Patients can be stratified phenotypically based on the UPOINT system constituting of Urinary, Psychosocial, Organ-specific, Infectious, Neurologic/Systemic and symptoms of muscular Tenderness and the treatment algorithm should be proposed accordingly. Treatment of CP/CPPS should be aimed towards treating local aswell as central factors causing the symptoms. Surgical intervention can cause significant morbidity and should only be reserved for treatment-refractory patients that have previously failed to respond to multiple drug therapies.展开更多
Objective：To evaluate the efficacy and safety of the treatment of chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. Methods- The randomized controlled trials （RCTs） about the treatment for CP/CPPS all o...Objective：To evaluate the efficacy and safety of the treatment of chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. Methods- The randomized controlled trials （RCTs） about the treatment for CP/CPPS all over the world were searched. MEDLINE （January 1966 to June 2007）, EMBASE （January 1988 to June 2007）, and 4 Chinese databases were electronically searched. The studies included in the refer- ences of eligible studies were additionally searched. Two reviewers independently screened the studies for eli- gibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross- checking. Divergences of opinion were settled by discussion or consulted by the experts. Meta-analysis was performed by using RevMan 4.2 software. Results： Twelve original studies involving 1 003 participants met inclusion criteria. Compared with placebo, alpha-blockers could improve the symptoms of CP/CPPS obvious- ly with WMD of NIH-CPSI, total score and pain score were -4.10 （95%CI： -6. 92 to -1.28） and -1.68 （95 %CI： -2.54 to -0. 82）. Antibiotics could not improve the symptoms obviously with WMD of NIH-CP- SI; total score and pain score were -2.71 （95%CI： -4. 78 to -0. 64） and -0.86 （95%CI： -2.07 to 0.36）. Flavoxate could not improve the NIH-CPSI total score obviously, but could relieve the pain, with WMD of NIH-CPSI total score and pain score being -2.96 （95%CI： -5.17 to -0. 74） and --2.31 （95%CI.. -4.05 to 0.03）. Prostat could improve the NIH-CPSI total score obviously, but could not relieve the pain, with WMD of NIH-CPSI total score and pain score being --7. 60 （95%CI.. -9. 97 to -5.23） and -2. 02 （95%CI： -4.07 to 0. 04）. Conclusion： Drug intervention could improve total symptoms of CP/CPPS in some degree, but no universally effective treatment is available that can prove significant lasting benefit for all the symptoms of CP/CPPS. Future RCT must use an appropriate sample size and optimal duration and fol- low-up of participants. It is important to improve the quality of internal original studies.展开更多
Background:Chronic prostatitis(CP)/chronic pelvic pain syndrome is the most common urological disorder in young and middle-aged men.A previous study showed that melatonin attenuates prostate inflammation through Sirt1...Background:Chronic prostatitis(CP)/chronic pelvic pain syndrome is the most common urological disorder in young and middle-aged men.A previous study showed that melatonin attenuates prostate inflammation through Sirt1-dependent suppression of the nonobese diabetic–like receptor thermal protein domain-associated protein 3 inflammasome in mouse models of experimental autoimmune prosta-titis(EAP).However,the main differentially expressed proteins(DEPs)in melatonin-treated mice with EAP have not yet been fully identified.Materials and Methods:Mouse models of EAP were established.The pathological morphology of the prostate tissues was observed using hematoxylin-eosin staining.Chronic pelvic pain sensitivity was assessed using suprapubic allodynia.Inflammation-related cyto-kines were detected using an enzyme-linked immunosorbent assay.These methods were used to validate the successful establishment of the EAP mouse model.Tandem mass tag proteomics was used to identify the proteomic markers in melatonin-treated EAP mice.Next,we visualized the DEPs using bioinformatic analyses.Finally,we measured the expression of mitochondrial creatine kinase 1 and gap junctionβ-1,which were identified by the tandem mass tag in all groups,using Western blotting to explore the key proteins involved in the anti-inflammatory effects of melatonin on EAP.Results:We identified 5910 proteins,with quantitative information available for over 85%of the total.We found 53 DEPs in mice be-tween the EAP and control groups and 22 DEPs between the EAP-Melatonin and EAP groups.Bioinformatic analysis suggested sig-nificant alterations in immunosuppression,inflammatory chemotaxis,and energy metabolism signaling in EAP mice treated with mela-tonin.These alterations were confirmed using Western blotting.Conclusions:Melatonin effectively relieves CP/chronic pelvic pain syndrome-related symptoms in mice with EAP.Mitochondrial ki-nases are potential key proteins in the treatment of EAP with melatonin,and these biomarkers may provide direction for studying the molecular mechanisms of melatonin in the treatment of CP.展开更多
The aim of this study is to observe the therapeutic effect of Inonotus Obliquus Polysaccharide(IOP)on chronic nonbacterial prostatitis(CNP)and its effect on the helper T cells(Th17)and regulatory T cells(Treg)immune i...The aim of this study is to observe the therapeutic effect of Inonotus Obliquus Polysaccharide(IOP)on chronic nonbacterial prostatitis(CNP)and its effect on the helper T cells(Th17)and regulatory T cells(Treg)immune imbalance.The CNP rat models established by injecting Xiaozhiling injection were randomly divided into the model group,cernilton(40 mg/kg,i.g.)group and low-dose(35 mg/kg,i.g.),medium-dose(70 mg/kg,i.g.)and high-dose(140 mg/kg,i.g.)groups,with the same volume of saline injected into the same site as the control group.The prostate’s wet weight and body mass served as the basis for calculating the prostate index.The serum level of prostate-specific antigen(PSA)was detected by ELISA and the histopathology of prostate tissue was detected by HE staining.The protein expression of Foxp3,ROR-γt and STAT3 in rat prostatic tissue was determined by Western blot.The levels of Th17 and Treg cells infiltrated into the spleen were measured by flow cytometry.The results showed that treatment with IOP significantly reduced the levels of prostate index and serum PSA,and attenuated the pathological injury of the prostate tissue induced by CNP.With respect to samples induced by CNP alone,IOP treatment repressed the increased mRNA levels of IL-6,IL-17,IL-21,IL-23,ROR-γt and STAT3 in prostate tissue,while increasing the mRNA levels of IL-10,TGF-βand Foxp3 in prostate tissue.Meanwhile,IOP treatment attenuated the upregulation of the protein expression levels of ROR-γt and STAT3 in prostate tissue.Additionally,the protein expression of Foxp3 in prostate tissue was increased in the IOP-treated group.Flow cytometry analysis further demonstrated that IOP treatment regulated the balance between Th17 and Treg cells in the spleen in rat with CNP.Our study is the first to elucidate that IOP has significant therapeutic effects on CNP through regulation of Th17/Treg balance.Collectively,the study provides evidence for the potential of IOP to treat CNP.展开更多
OBJECTIVE:To investigate the protective effects of Guilong prescription(归龙方,GL)on chronic prostatitis(CP)and unravel the underlying mechanisms of its pharmacological effects.METHODS:The composition of GL was determ...OBJECTIVE:To investigate the protective effects of Guilong prescription(归龙方,GL)on chronic prostatitis(CP)and unravel the underlying mechanisms of its pharmacological effects.METHODS:The composition of GL was determined via linear ion trap/electrostatic field orbital trap tandem highresolution mass spectrometry,and the identified compounds were performed network pharmacological analysis to predict possible pathways of the effects of GL on CP.A CP rat model was established by carrageenan,and rats were randomly assigned into a Control group,Sham group,CP group,GL low dose(3.5 g/kg)group,GL medium dose(7 g/kg)group,and GL high dose(14 g/kg)group.Hematoxylin-eosin staining of the prostate,and prostate blood-perfusion measured by laser speckle contrast analysis were used to evaluate the efficacy of GL.Expression of intercellular cell adhesion molecule-1(ICAM-1)and induce nitric oxide synthase(i NOS)were determined by immunohistochemistry,and the content of interferon-γ(IFN-γ),interleukin-1β(IL-1β),interleukin-4(IL-4),interleukin-10(IL-10),chemokine ligand 1(CXCL1)and tumor necrosis factor-α(TNF-α)were determined by electro-chemiluminescence assays.The expression of p38 mitogen-activated protein kinase(p38 MAPK),phosphatidylinositol 3-kinase(PI3K),ribosomeassociated complex-alpha serine/threonine-protein kinase(Akt),nuclear factor-κ-gene binding p65(NF-κB p65),inhibitor of NF-κB-α(IκBα),glycogen synthase kinase-3β(GSK-3β),and their phosphorylated forms were tested by Western blot.RESULTS:In GL,a total of 48 compounds were identified,including 14 flavonoids,14 alkaloids,11 carboxylic acids,4 lactones,2 glycosides,2 terpenoids and 1 aldehyde.Network pharmacological analysis suggested that the mechanism of GL may be related to PI3K-Akt signaling pathway and cytokine expression.After treatment with GL,inflammatory pathological changes in the prostate of rats were significantly improved,and blood perfusion of the prostate was significantly decreased.GL reduced the expression of IFN-γ,CXCL1,TNF-α,IL-1β,i NOS,ICAM-1,p38 MAPK,p-p38 MAPK,PI3K,p-PI3K,NF-κB,p-NF-κB,IκBα,p-IκBα,GSK-3β,p-GSK-3β,p-Akt in CP rats,and increased the expression of IL-4 and IL-10 in CP rats.CONCLUSION:The chemical compositions of GL were first identified.GL can improve pathological changes in the prostate and recover the prostate blood perfusion of CP rats.The possible mechanisms of GL on CP involve increasing the expression of anti-inflammatory cytokines IL-4 and IL-10,inhibiting pro-inflammatory cytokines TNF-α,IL-1β,and IFN-γ,and down regulating the expression of CXCL1,i NOS,and ICAM-1 via inhibiting PI3K-Akt and NF-κB signaling pathway.展开更多
Objective: To evaluate the efficacy and safety of essential oil treatment for type Ⅲ chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods: A randomized controlled trial was conducted from December 2014 ...Objective: To evaluate the efficacy and safety of essential oil treatment for type Ⅲ chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods: A randomized controlled trial was conducted from December 2014 to October 2015. Seventy type Ⅲ CP/CPPS patients were assigned to the essential oil group(35 cases) or almond placebo oil control group(35 cases) by a random number table. The oil was smeared by self-massage on the suprapubic and sacral region once a day for 4 weeks. The National Institutes of Health Chronic Prostatitis Syndrome Index(NIH-CPSI) and expressed prostatic secretions(EPS) were examined. The primary outcome was NIH-CPSI pain domain. The secondary outcomes included other NIH-CPSI domains and laboratory examinations of EPS. Adverse events were also observed. Results: Sixty-six subjects completed the full 4-week treatment. There was no significant difference between almond oil control and essential oil groups in terms of the total score of NIH-CPSI, pain, quality of life and urination domain scores of NIH-CPSI and EPS examinations(P>0.05). In the essential oil group, pain between rectum and testicles(perineum) in the domain of pain or discomfort was significantly reduced at week 2 and week 4 compared with almond oil control group(P<0.01). No serious adverse events occurred. Conclusion: The essential oil may reduce the pain or discomfort in the perineum region in patients with CP/CPPS.展开更多
Background As one of the most commonly diagnosed diseases, chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） is characterized by a variety of complex symptoms. Anxiety and depression are two of the most pre...Background As one of the most commonly diagnosed diseases, chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） is characterized by a variety of complex symptoms. Anxiety and depression are two of the most prevalent clinical manifestations of patients with CP/CPPS, and have adverse effects on the health of the subjects and prognosis of comorbidities. Such psychological disorders, however, have not been deeply and thoroughly studied in China. The aim of this study was to investigate the prevalence and severity of psychological disorders in Chinese adults with CP/CPPS.Methods From April 2008 to June 2009, 80 patients and 40 age-matched healthy men participating in a voluntary health examination were recruited. The majority of the subjects completed the questionnaires on the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） as well as the hospital anxiety and depression scale （HADS）.Results Of all the participants, 77 （96.3%） patients and 37 （92.5%） healthy controls completed the questionnaires. The average NIH-CPSI total score was 21.0±9.5 for the patients and 2.2±1.5 for the controls （P=0.03）. Of the 77 patients with CP/CPPS, 48 （62.3%）, 5 （6.5%）, and 1 （1.2%） had anxiety symptoms, depression symptoms, or both anxiety and depression symptoms, respectively. For the controls, the average HADS anxiety and depression scores in patients were 14.5±6.8 and 5.2±4.5, which were both significantly higher than in controls. Moreover, the prevalence and the symptom scores of both the HADS anxiety and depression were higher for the younger age group （〈35 years） than for the older age group （〈35 years）.Conclusions This preliminary study revealed that male patients with CP/CPPS had a higher prevalence of psychological disorders than in the control subjects. Moreover, the differences of the prevalence and severity of the psychological symptoms between the two different age groups may imply that psychological disorders related to CP/CPPS may be relieved with increasing age. The present study indicated that psychological evaluation is important in men with CP/CPPS, especially in younger men.展开更多
Background:Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is a frequently encountered disorder characterized by voiding symptoms and pelvic or perineal pain.Proinflammatory T helper 17(Th17)cells are essenti...Background:Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is a frequently encountered disorder characterized by voiding symptoms and pelvic or perineal pain.Proinflammatory T helper 17(Th17)cells are essential for triggering the development of CP/CPPS.High-salt diet(HSD)consumption has been found to cause an accumulation of sodium chloride in peripheral organs,inducing autoimmune responses via the Th17 cell axis.It is currently unknown whether HSD affects the etiology and course of CP/CPPS.Methods:Patients diagnosed with CP/CPPS were evaluated with the National Institutes of Health Chronic Prostatitis Symptom Index scoring system,and the correlation between the symptoms of CP/CPPS with HSD was analyzed.The experimental autoimmune prostatitis(EAP)mouse was established and the mice were fed either a normal-salt diet(NSD)or HSD for 6 weeks to investigate the impact of HSD on CP/CPPS.Then,16S ribosomal RNA sequencing and untargeted metabolomics were introduced to detect the differences in the gut microflora composition and metabolite profiles between NSD-fed and HSD-fed mice,followed by fecal microbiota transplantation,5-hydroxyindole acetic acid(5-HIAA)supplementation,aryl hydrocarbon receptor(AHR)inhibition,and in vitro Th17 differentiation experiments,which were performed to explore the mechanisms underlying HSD-aggravated CP/CPPS.Finally,chromatin immunoprecipitation assay and quantitative polymerase chain reaction were conducted to validate whether AHR can serve as a transcription factor by interacting with the serum and glucocorticoid-regulated kinase 1(Sgk1)promoter in CD4^(+)T cells.Results:Increased salt consumption had a positive correlation with symptom scores of CP/CPPS patients,which was validated by feeding EAP mice with HSD,and HSD worsened the prostate inflammation and tactile allodynia in EAP mice through promoting the differentiation of CD4^(+)T cells to Th17 cells.HSD exacerbated EAP by significantly reducing the relative abundance of beneficial gut microflora,such as Lactobacillaceae,and gut microbiota metabolite 5-HIAA,which is related to tryptophan metabolism.The prostate inflammation,tactile allodynia,and proportion of Th17 cells in mice that received fecal suspensions from the EAP^(+)HSD group were significantly more severe or higher than those in mice that received fecal suspensions from the EAP^(+)NSD group.However,5-HIAA supplementation ameliorated the symptoms of EAP caused by HSD through inhibiting the differentiation of CD4^(+)T cells to Th17 cells,while AHR inhibition abrogated the protective effects of 5-HIAA supplementation on EAP mice fed a HSD through promoting the differentiation of CD4^(+)T cells to Th17 cells.Mechanistically,it has been revealed that the SGK1/forkhead box protein O1(FOXO1)pathway was significantly activated during cytokine-induced Th17 cell differentiation,and AHR has been shown to inhibit SGK1 transcription by interacting with the Sgk1 promoter in CD4^(+)T cells to inhibit FOXO1 phosphorylation,consequently restoring the equilibrium of Th17 cell differentiation.Conclusions:Our findings indicated that high salt intake represented a risk factor for the development of CP/CPPS as it promoted the differentiation of CD4^(+)T cells to Th17 cells through the 5-HIAA/AHR/SGK1/FOXO1 axis,which might be a potential therapeutic target for CP/CPPS.展开更多
Background:As one of the most common diseases in urology,a large number of preclinical studies have been accumulated to explore the etiological mechanism and potential intervention of chronic prostatitis/chronic pelvi...Background:As one of the most common diseases in urology,a large number of preclinical studies have been accumulated to explore the etiological mechanism and potential intervention of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).Methods:In this study,we systematically evaluated the current status of preclinical research on CP/CPPS through bibliometrics analysis using VOSviewer and Citespace.Characteristics of publication such as year,country/region,institution,author,journal,citation,and keywords were analyzed.Based on the bibliometrics analysis results of keywords,we summarized the possible mechanisms and promising treatments for CP/CPPS narratively.Results:According to the results of this study,the most common mechanisms involved in CP/CPPS were as follows:Disturbed immune and inflammation mediators,immune cell dysfunction,oxidative stress,dysregulated signaling pathways,apoptosis,gut microbiota,and testosterone metabolism.Traditional Chinese Medicine and extracorporeal shock wave therapy have important potential in the treatment of CP/CPPS.Conclusion:Further translational studies targeting the above mechanisms and validating the objective efficacy of potential treatments indicated by preclinical studies in clinical patients are needed in the future.展开更多
Objective To observe the clinical effects of chronic non-bacterial prostatitis treated with warm needling moxibustion. Methods One hundred and twenty-five cases were randomly divided into warm needling moxibustion gro...Objective To observe the clinical effects of chronic non-bacterial prostatitis treated with warm needling moxibustion. Methods One hundred and twenty-five cases were randomly divided into warm needling moxibustion group （42 cases）, acupuncture group （41 cases） and western medicine group （42 cases）. Of which, in warm needling moxibustion group, acupuncture combined with warming acupuncture were provided①puncture on Shènshū（肾俞 BL 23）, Gānshū （肝俞BL 18） and Zhìbiān （秩边BL 54） without retention of needles,②Guānyuán （关元CV 4）, Zhō ngjí （ 中极CV 3）, Yīnlíngquán （ 阴陵 GB 34） and Sānyīnjiāo （三阴交 SP 6） ,with warming acupuncture, once a day; in acupuncture group, the prescriptions and needling technique were the same as those in warm needling moxibustion group, without moxibustion; in western medicine group, Cernilton was applied twice a day, one pill for each time. After one course treatment, the therapeutic effects and NIH-Chronic Prostatitis Symptom Index （NIH-CPSI） of 3 groups were compared. Results The total effective rate was 88. 10% in warm needling moxibustion group, 63.41% in acupuncture group, and 66.67% in western medicine group. The clinical effect in warm needling moxibustion group was superior to that in either acupuncture group or western medicine group （both P〈0.05）. The score of NIH-CPSI was 11.92 ±7.11 in warm needling moxibustion group, 16.08±6.83 in acupuncture group, and 15.66±5.88 in western medicine group. The score of each group was obviously reduced （both P〈0.01 ） after treatments, in which, the reduction in warm needling moxibustion group was most obvious （both P〈0.0t）. Conclusion A good therapeutic effect of chronic non-bacterial prostatitis was received by warm needling moxibustion.展开更多
We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis （CBP）. The aim of this study is to retrospectively compare the microbi...We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis （CBP）. The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin （500 rag, thrice-weekly） with a once-daily 500- or 750-mg dose of ciprofloxacin （Cipro-500 or Cipro-750 cohort, respectively）. Combined administration of azithromycin （1500 mg week^-1） with ciprofloxacin at the rate of 750 mg day^- 1 for 4 weeks rather than at 500 mg day^- 1 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen （PSA） were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction （ED） at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.展开更多
基金supported by the National Natural Science Foundation of China(No.81770759 and No.82270806)Innovation Project of Guangxi Graduate Education(No.YCBZ2022094).
文摘Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is a complex disease that is often accompanied by mental health disorders.However,the potential mechanisms underlying the heterogeneous clinical presentation of CP/CPPS remain uncertain.This study analyzed widely targeted metabolomic data of expressed prostatic secretions(EPS)and plasma to reveal the underlying pathological mechanisms of CP/CPPS.A total of 24 CP/CPPS patients from The Second Nanning People’s Hospital(Nanning,China),and 35 asymptomatic control individuals from First Affiliated Hospital of Guangxi Medical University(Nanning,China)were enrolled.The indicators related to CP/CPPS and psychiatric symptoms were recorded.Differential analysis,coexpression network analysis,and correlation analysis were performed to identify metabolites that were specifically altered in patients and associated with various phenotypes of CP/CPPS.The crucial links between EPS and plasma were further investigated.The metabolomic data of EPS from CP/CPPS patients were significantly different from those from control individuals.Pathway analysis revealed dysregulation of amino acid metabolism,lipid metabolism,and the citrate cycle in EPS.The tryptophan metabolic pathway was found to be the most significantly altered pathway associated with distinct CP/CPPS phenotypes.Moreover,the dysregulation of tryptophan and tyrosine metabolism and elevation of oxidative stress-related metabolites in plasma were found to effectively elucidate the development of depression in CP/CPPS.Overall,metabolomic alterations in the EPS and plasma of patients were primarily associated with oxidative damage,energy metabolism abnormalities,neurological impairment,and immune dysregulation.These alterations may be associated with chronic pain,voiding symptoms,reduced fertility,and depression in CP/CPPS.This study provides a local-global perspective for understanding the pathological mechanisms of CP/CPPS and offers potential diagnostic and therapeutic targets.
基金the Fundamental Research Funds for the Central.Universities of Central South University(20191039 to ZCL)the National Natural Science of China(81570627 to ZYT)+1 种基金the Natural Science Foundation of Hunan Province,China(2020115906 to DIL)the China Postdoctoral Science Foundation(2020M670107ZX to DJL).
文摘This study aimed to assess the association between psychological disorders and erectile dysfunction(ED)in patients with different degrees of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).This was a retrospective study conducted from June 2017 to October 2019 and included 182 outpatients.Patients were interviewed using the Structured Interview on Erectile Dysfunction(SIEDY)for pathogenic quantification.The National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI)and the International Index of Erectile Function-5(IIEF-5)were used for the evaluation of CP/CPPS and ED.The Generalized Anxiety Disorder-7(GAD-7)and Patient Health Questionnaire-9(PHQ-9)were used to assess anxiety symptoms and depressive symptoms.The number of patients with mild CP/CPPS and mild ED,mild CP/CPPS and moderate-to-severe ED,moderate-to-severe CP/CPPS and mild ED,and moderate-to-severe CP/CPPS and moderate-to-severe ED was 69(37.9%),36(19.8%),35(19.2%),and 42(23.1%),respectively.The corresponding PHQ-9 scores of the four groups were 6.22,7.19,10.69,and 7.71,respectively.The corresponding GAD-7 scores of the four groups were 5.26,6.31,8.77,and 6.36,respectively.Among patients with moderate-to-severe CP/CPPS,the PHQ-9 and GAD-7 scores of the moderate-to-severe ED group were significantly lower than those of the mild ED group(P=0.007 and P=0.010,respectively).The prevalence of ED and premature ejaculation(PE)in patients with moderate-to-severe CP/CPPS was significantly higher than that in patients with mild CP/CPPS(P=0.001 and P=0.024,respectively).Our findings proved that the severity of ED was negatively associated with psychological symptoms in outpatients with moderate-to-severe CP/CPPS.
文摘The expressed prostatic secretions （EPSs） of men with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）, infertile men and normal men were subjected to microbiological study. EPSs were collected from the subjects, which included 26 normal men, 11 infertile patients and 51 CP/CPPS patients. DNA was extracted from each specimen, and the V3 regions of the 16S rRNA genes were amplified using universal bacterial primers. The results showed that the EPS 16S rRNA gene-positive rate in the CP/CPPS and infertile patients was much higher than in the normal men, but without any difference among the three patient groups. The denaturing gradient gel electrophoresis （DGGE） method was used to characterize the EPS bacterial community structure of the prostate fluid from patients with CP/CPPS or infertility issues. Principal component analysis （PCA） and partial least squares （PLS） analyses of PCR-DGGE profiles revealed that the EPS bacterial community structure differed among the three groups. Three bands were identified as the key factors responsible for the discrepancy between CP/CPPS patients and infertile patients （P〈O.05）. Two bands were identified as priority factors in the discrepancy of category IliA and category IIIB prostatitis patients （P〈O.05）. According to this research, the ecological balance of the prostate and low urethra tract, when considered as a microenvironment, might play an important role in the maintenance of a healthy male reproductive tract.
基金supported by grants from the National Natural Science Foundation of China(NSFC,No.82370701 and No.82002701).
文摘Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is highly prevalent worldwide and poses a significant threat to men’s health,particularly affecting young men.However,the exact causes and mechanisms behind CP/CPPS remain unclear,leading to challenges in its treatment.In this research,a CP/CPPS rat model was established with complete Freund’s adjuvant(CFA),and berberine hydrochloride was administered through daily gavage to assess its therapeutic effects.The alterations in the gut microbiome induced by CP/CPPS and berberine hydrochloride were investigated through 16S ribosomal RNA sequencing of cecum content and colonic epithelial cells.To investigate the impact of the gut microbiome on CP/CPPS,a pseudo germ-free rat model was established,and fecal microbiome transplantation(FMT)was performed on these rats.In all,berberine hydrochloride demonstrated effective reduction of inflammation and oxidative stress in the prostate,offering significant therapeutic advantages for CP/CPPS.Through analysis of the gut microbiome using 16S ribosome RNA sequencing,distinct differences were observed between CP/CPPS rats and control rats,and Clostridium butyricum was identified as a key bacteria.Pseudo germ-free rats that underwent FMT from CP/CPPS rats or rats treated with berberine hydrochloride displayed varying levels of inflammatory cytokine production,oxidative stress,and activity of associated signaling pathways.In conclusion,the therapeutic potential of berberine hydrochloride in addressing CP/CPPS is highly significant.The gut microbiome has emerged as a critical factor in the development of CP/CPPS and plays a pivotal role in mediating the therapeutic effects of berberine hydrochloride.
文摘The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness （UPOINT） phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CPICPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index （NIH-CPSI） was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores （r = 0.796, P 〈 0.001）. Symptom duration was associated with a greater number of positive domains （r = 0.589, P〈 0.001）. With 6 months follow-up at least, 75.0% （105/140） had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones： pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ±5.70 （all P〈 0.0001）. Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.
文摘Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients （case group） and 341 nonCP/CPPS patients （control group）. Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin （odds ratio （OR）： 1.66, 95% confidence interval （CI）： 1.04-2.66）. In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 （95% CI, 1.2-2.88）. The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS.
基金supported by the Medical Scientific Research Foundation of Zhejiang Province(2021RC129,2019KY694)the National Natural Science Foundation of China(82000230)+1 种基金the Jiaxing Medical Key Subject Funding of Zhejiang Province(2019-zc-07)the Jiaxing Key Laboratory of Precise Diagnosis and Treatment of Urological Tumor(2020-mnzdsys).
文摘We investigated the therapeutic effects of superoxide dismutase(SOD)from thermophilic bacterium HB27 on chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)and its underlying mechanisms.A Sprague–Dawley rat model of CP/CPPS was prepared and then administered saline or Thermus thermophilic(Tt)-SOD intragastrically for 4 weeks.Prostate inflammation and fibrosis were analyzed by hematoxylin and eosin staining,and Masson staining.Alanine transaminase(ALT),aspartate transaminase(AST),serum creatinine(CR),and blood urea nitrogen(BUN)levels were assayed for all animals.Enzyme-linked immunosorbent assays(ELISA)were performed to analyze serum cytokine concentrations and tissue levels of malondialdehyde,nitric oxide,SOD,catalase,and glutathione peroxidase.Reactive oxygen species levels were detected using dichlorofluorescein diacetate.The messenger ribonucleic acid(mRNA)expression of tissue cytokines was analyzed by reverse transcription polymerase chain reaction(RT-PCR),and infiltrating inflammatory cells were examined using immunohistochemistry.Nuclear factor-κB(NF-κB)P65,P38,and inhibitor of nuclear factor-κBα(I-κBα)protein levels were determined using western blot.Tt-SOD significantly improved histopathological changes in CP/CPPS,reduced inflammatory cell infiltration and fibrosis,increased pain threshold,and reduced the prostate index.Tt-SOD treatment showed no significant effect on ALT,AST,CR,or BUN levels.Furthermore,Tt-SOD reduced inflammatory cytokine expression in prostate tissue and increased antioxidant capacity.This anti-inflammatory activity correlated with decreases in the abundance of cluster of differentiation 3(CD3),cluster of differentiation 45(CD45),and macrophage inflammatory protein 1α(MIP1α)cells.Tt-SOD alleviated inflammation and oxidative stress by reducing NF-κB P65 and P38 protein levels and increasing I-κBαprotein levels.These findings support Tt-SOD as a potential drug for CP/CPPS.
基金funded by the Research on the Collation and Excavation of the Folk Characteristic Diagnosis and Treatment Technology of Cerebral Palsy,the Dominant Disease of Traditional Chinese Medicine(ZZ140516)。
文摘Chronic prostatitis(CP)/chronic pelvic-pain syndrome(CPPS)is a common urinary-system disease with a high incidence in young and middle-aged men,seriously affecting patients'ability to work and their quality of life(Qo L).Western medicine(WM)has some limitations in treating CP/CPPS.Acupuncture is an ancient Chinese medical method that is commonly used to treat this condition and has a relatively good effect on it.Many randomized controlled trials(RCTs)on this subject have been published.For this study,we searched the China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Periodical(VIP),Wanfang,Sino Med,and Pub Med databases for RCTs on acupuncture treatment of CP/CPPS in the last 5 years(2016/01/01-2021/12/01).In addition,we conducted analysis and research,aiming to summarize acupuncture treatment in CP/CPPS RCTs and the clinical efficacy,with the goal of providing clinical reference.A total of 466 related documents were retrieved in the search,and 62 articles were retained after screening.We obtained RCT information on acupuncture treatment of CP/CPPS.The results showed that several relevant clinical studies have been performed over the last 5 years and that acupuncture and moxibustion have better curative effect on CP/CPPS than WM.Due to the small number of included studies,more experimental evidence is needed to verify the clinical efficacy of acupuncture.
文摘Objective:To assess the efficacy and safety of a treatment regimen based on rectal administration of Boswellia resin extract and propolis derived polyphenols in patients with type IIIa and type IIIb chronic prostatitis and chronic pelvic pain syndrome(CP/CPPS).Methods:Patients with type IIIa and type IIIb CP/CPPS received one rectal suppository a day for 15 days per month for 3 consecutive months.Participants were evaluated with National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI),the International Prostate Symptom Scores(IPSS),International Index of Erectile Function(IIEF),four-glass test,uroflowmetry,and prostate-specific antigen assessments at baseline and at Week 4,and Week 12.Primary endpoints were improvement in pain domain of NIH-CPSI and improvement of NIH-CPSI total score.Secondary outcomes included improvement of micturition and quality of life(QoL)domains of NIH-CPSI questionnaire.Results:A total of 61 males were enrolled.No adverse events were reported.Significant improvements from baseline to Day 30 were reported for NIH-CPSI total score(mean difference:-9.2;p<0.01),NIH-CPSI pain domain(mean difference:-5.5;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score(mean difference:-5.6;p<0.01).No significant changes from baseline in terms of IIEF score or maximum flow rate were observed.At final follow-up(Day 90),further significant improvements in terms of NIH-CPSI total score(mean difference:-12.2;p<0.01),NIH-CPSI pain domain(mean difference:-6.6;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score were reported.Conclusion:Rectal administration of Boswellia resin extract and propolis derived polyphenols is well tolerated and delivers a significant symptomatic improvement in most patients with type IIIa and type IIIb CP/CPPS.
文摘Prostatitis comprises of a group of syndromes that affect almost 50% of men at least once in their lifetime and makeup the majority of visits to the Urology Clinics.After much debate, it has been divided into four distinct categories by National Institutes of Health namely(1) acute bacterial prostatitis;(2) chronic bacterial prostatitis;(3) chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) which is further divided into inflammatory and non-inflammatory CP/CPPS; and(4)asymptomatic inflammatory prostatitis. CP/CPPS has been a cause of great concern for both patients and physicians because of the lack of presence of thoroughinformation about the etiological factors along with the difficult-to-treat nature of the syndrome. For the presented manuscript an extensive search on PubM ed was conducted for CP/CPPS aimed to present an updated review on the evaluation and treatment options available for patients with CP/CPPS. Several diagnostic criteria's have been established to diagnose CP/CPPS, with prostatic/pelvic pain for at least 3 mo being the major classifying symptom along with the presence of lower urinary tract symptoms and/or ejaculatory pain. Diagnostic tests can help differentiate CP/CPPS from other syndromes that come under the heading of prostatitis by ruling out active urinary tract infection and/or prostatic infection with uropathogen by performing urine cultures, Meares-Stamey Four Glass Test, Preand Post-Massage Two Glass Test. Asymptomatic inflammatory prostatitis is confirmed through prostate biopsy done for elevated serum prostate-specific antigen levels or abnormal digital rectal examination. Researchers have been unable to link a single etiological factor to the pathogenesis of CP/CPPS, instead a cluster of potential etiologies including atypical bacterial or nanobacterial infection, autoimmunity, neurological dysfunction and pelvic floor muscle dysfunction are most commonly implicated. Initially monotherapy with anti-biotics and alpha adrenergic-blockers can be tried, but its success has only been observed in treatment nave population. Other pharmacotherapies including phytotherapy, neuromodulatory drugs and anti-inflammatories achieved limited success in trials. Complementary and interventional therapies including acupuncture, myofascial trigger point release and pelvic floor biofeedback have been employed. This review points towards the fact that treatment should be tailored individually for patients based on their symptoms. Patients can be stratified phenotypically based on the UPOINT system constituting of Urinary, Psychosocial, Organ-specific, Infectious, Neurologic/Systemic and symptoms of muscular Tenderness and the treatment algorithm should be proposed accordingly. Treatment of CP/CPPS should be aimed towards treating local aswell as central factors causing the symptoms. Surgical intervention can cause significant morbidity and should only be reserved for treatment-refractory patients that have previously failed to respond to multiple drug therapies.
文摘Objective：To evaluate the efficacy and safety of the treatment of chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. Methods- The randomized controlled trials （RCTs） about the treatment for CP/CPPS all over the world were searched. MEDLINE （January 1966 to June 2007）, EMBASE （January 1988 to June 2007）, and 4 Chinese databases were electronically searched. The studies included in the refer- ences of eligible studies were additionally searched. Two reviewers independently screened the studies for eli- gibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross- checking. Divergences of opinion were settled by discussion or consulted by the experts. Meta-analysis was performed by using RevMan 4.2 software. Results： Twelve original studies involving 1 003 participants met inclusion criteria. Compared with placebo, alpha-blockers could improve the symptoms of CP/CPPS obvious- ly with WMD of NIH-CPSI, total score and pain score were -4.10 （95%CI： -6. 92 to -1.28） and -1.68 （95 %CI： -2.54 to -0. 82）. Antibiotics could not improve the symptoms obviously with WMD of NIH-CP- SI; total score and pain score were -2.71 （95%CI： -4. 78 to -0. 64） and -0.86 （95%CI： -2.07 to 0.36）. Flavoxate could not improve the NIH-CPSI total score obviously, but could relieve the pain, with WMD of NIH-CPSI total score and pain score being -2.96 （95%CI： -5.17 to -0. 74） and --2.31 （95%CI.. -4.05 to 0.03）. Prostat could improve the NIH-CPSI total score obviously, but could not relieve the pain, with WMD of NIH-CPSI total score and pain score being --7. 60 （95%CI.. -9. 97 to -5.23） and -2. 02 （95%CI： -4.07 to 0. 04）. Conclusion： Drug intervention could improve total symptoms of CP/CPPS in some degree, but no universally effective treatment is available that can prove significant lasting benefit for all the symptoms of CP/CPPS. Future RCT must use an appropriate sample size and optimal duration and fol- low-up of participants. It is important to improve the quality of internal original studies.
基金the National Natural Science Foundation of China 82170787,81870519,81802827Scientific Research Foundation of the Institute for Translational Medicine of Anhui Province(2017ZHYX02)+2 种基金Natural Science Foundation of Anhui Province(grant number,2208085QH239)Natural Science Research in Colleges and Universities of Anhui Province(grant number,2022AH051133)Postgraduate Innovation Research and Practice Program of the Anhui Medical University(YJS20230077).
文摘Background:Chronic prostatitis(CP)/chronic pelvic pain syndrome is the most common urological disorder in young and middle-aged men.A previous study showed that melatonin attenuates prostate inflammation through Sirt1-dependent suppression of the nonobese diabetic–like receptor thermal protein domain-associated protein 3 inflammasome in mouse models of experimental autoimmune prosta-titis(EAP).However,the main differentially expressed proteins(DEPs)in melatonin-treated mice with EAP have not yet been fully identified.Materials and Methods:Mouse models of EAP were established.The pathological morphology of the prostate tissues was observed using hematoxylin-eosin staining.Chronic pelvic pain sensitivity was assessed using suprapubic allodynia.Inflammation-related cyto-kines were detected using an enzyme-linked immunosorbent assay.These methods were used to validate the successful establishment of the EAP mouse model.Tandem mass tag proteomics was used to identify the proteomic markers in melatonin-treated EAP mice.Next,we visualized the DEPs using bioinformatic analyses.Finally,we measured the expression of mitochondrial creatine kinase 1 and gap junctionβ-1,which were identified by the tandem mass tag in all groups,using Western blotting to explore the key proteins involved in the anti-inflammatory effects of melatonin on EAP.Results:We identified 5910 proteins,with quantitative information available for over 85%of the total.We found 53 DEPs in mice be-tween the EAP and control groups and 22 DEPs between the EAP-Melatonin and EAP groups.Bioinformatic analysis suggested sig-nificant alterations in immunosuppression,inflammatory chemotaxis,and energy metabolism signaling in EAP mice treated with mela-tonin.These alterations were confirmed using Western blotting.Conclusions:Melatonin effectively relieves CP/chronic pelvic pain syndrome-related symptoms in mice with EAP.Mitochondrial ki-nases are potential key proteins in the treatment of EAP with melatonin,and these biomarkers may provide direction for studying the molecular mechanisms of melatonin in the treatment of CP.
基金Shanxi Province Traditional Chinese Medicine Administration Research Project(Grant No.2022ZYYC094)Science and technology innovation project of universities in Shanxi Province(Grant No.2022L342)+1 种基金Shanxi Leader Team of Medical Science&Technology Innovations(Grant No.2020TD02)Discipline Construction Project of Chinese Medicine Chemistry(Grant No.2024XKJS-25).
文摘The aim of this study is to observe the therapeutic effect of Inonotus Obliquus Polysaccharide(IOP)on chronic nonbacterial prostatitis(CNP)and its effect on the helper T cells(Th17)and regulatory T cells(Treg)immune imbalance.The CNP rat models established by injecting Xiaozhiling injection were randomly divided into the model group,cernilton(40 mg/kg,i.g.)group and low-dose(35 mg/kg,i.g.),medium-dose(70 mg/kg,i.g.)and high-dose(140 mg/kg,i.g.)groups,with the same volume of saline injected into the same site as the control group.The prostate’s wet weight and body mass served as the basis for calculating the prostate index.The serum level of prostate-specific antigen(PSA)was detected by ELISA and the histopathology of prostate tissue was detected by HE staining.The protein expression of Foxp3,ROR-γt and STAT3 in rat prostatic tissue was determined by Western blot.The levels of Th17 and Treg cells infiltrated into the spleen were measured by flow cytometry.The results showed that treatment with IOP significantly reduced the levels of prostate index and serum PSA,and attenuated the pathological injury of the prostate tissue induced by CNP.With respect to samples induced by CNP alone,IOP treatment repressed the increased mRNA levels of IL-6,IL-17,IL-21,IL-23,ROR-γt and STAT3 in prostate tissue,while increasing the mRNA levels of IL-10,TGF-βand Foxp3 in prostate tissue.Meanwhile,IOP treatment attenuated the upregulation of the protein expression levels of ROR-γt and STAT3 in prostate tissue.Additionally,the protein expression of Foxp3 in prostate tissue was increased in the IOP-treated group.Flow cytometry analysis further demonstrated that IOP treatment regulated the balance between Th17 and Treg cells in the spleen in rat with CNP.Our study is the first to elucidate that IOP has significant therapeutic effects on CNP through regulation of Th17/Treg balance.Collectively,the study provides evidence for the potential of IOP to treat CNP.
基金National Major Scientific and the Technological Special Project:Establishment of a Clinically Oriented Preclinical Research and Development Technology Platform for New Chinese Medicines based on Famous Doctors'Prescriptions(No.2017ZX09301011)"Decoding Traditional Chinese Medicine"Project of Beijing University of Chinese Medicine:New Drugs Research and Development of Chinese Medicine based on Famous Doctors and Famous Prescriptions(No.90010961020020)the Horizontal Project:Preclinical Pharmacology and Pharmacodynamic Research of a New Chinese Medicine—Guilong Granules(No.2016110031007799)。
文摘OBJECTIVE:To investigate the protective effects of Guilong prescription(归龙方,GL)on chronic prostatitis(CP)and unravel the underlying mechanisms of its pharmacological effects.METHODS:The composition of GL was determined via linear ion trap/electrostatic field orbital trap tandem highresolution mass spectrometry,and the identified compounds were performed network pharmacological analysis to predict possible pathways of the effects of GL on CP.A CP rat model was established by carrageenan,and rats were randomly assigned into a Control group,Sham group,CP group,GL low dose(3.5 g/kg)group,GL medium dose(7 g/kg)group,and GL high dose(14 g/kg)group.Hematoxylin-eosin staining of the prostate,and prostate blood-perfusion measured by laser speckle contrast analysis were used to evaluate the efficacy of GL.Expression of intercellular cell adhesion molecule-1(ICAM-1)and induce nitric oxide synthase(i NOS)were determined by immunohistochemistry,and the content of interferon-γ(IFN-γ),interleukin-1β(IL-1β),interleukin-4(IL-4),interleukin-10(IL-10),chemokine ligand 1(CXCL1)and tumor necrosis factor-α(TNF-α)were determined by electro-chemiluminescence assays.The expression of p38 mitogen-activated protein kinase(p38 MAPK),phosphatidylinositol 3-kinase(PI3K),ribosomeassociated complex-alpha serine/threonine-protein kinase(Akt),nuclear factor-κ-gene binding p65(NF-κB p65),inhibitor of NF-κB-α(IκBα),glycogen synthase kinase-3β(GSK-3β),and their phosphorylated forms were tested by Western blot.RESULTS:In GL,a total of 48 compounds were identified,including 14 flavonoids,14 alkaloids,11 carboxylic acids,4 lactones,2 glycosides,2 terpenoids and 1 aldehyde.Network pharmacological analysis suggested that the mechanism of GL may be related to PI3K-Akt signaling pathway and cytokine expression.After treatment with GL,inflammatory pathological changes in the prostate of rats were significantly improved,and blood perfusion of the prostate was significantly decreased.GL reduced the expression of IFN-γ,CXCL1,TNF-α,IL-1β,i NOS,ICAM-1,p38 MAPK,p-p38 MAPK,PI3K,p-PI3K,NF-κB,p-NF-κB,IκBα,p-IκBα,GSK-3β,p-GSK-3β,p-Akt in CP rats,and increased the expression of IL-4 and IL-10 in CP rats.CONCLUSION:The chemical compositions of GL were first identified.GL can improve pathological changes in the prostate and recover the prostate blood perfusion of CP rats.The possible mechanisms of GL on CP involve increasing the expression of anti-inflammatory cytokines IL-4 and IL-10,inhibiting pro-inflammatory cytokines TNF-α,IL-1β,and IFN-γ,and down regulating the expression of CXCL1,i NOS,and ICAM-1 via inhibiting PI3K-Akt and NF-κB signaling pathway.
文摘Objective: To evaluate the efficacy and safety of essential oil treatment for type Ⅲ chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods: A randomized controlled trial was conducted from December 2014 to October 2015. Seventy type Ⅲ CP/CPPS patients were assigned to the essential oil group(35 cases) or almond placebo oil control group(35 cases) by a random number table. The oil was smeared by self-massage on the suprapubic and sacral region once a day for 4 weeks. The National Institutes of Health Chronic Prostatitis Syndrome Index(NIH-CPSI) and expressed prostatic secretions(EPS) were examined. The primary outcome was NIH-CPSI pain domain. The secondary outcomes included other NIH-CPSI domains and laboratory examinations of EPS. Adverse events were also observed. Results: Sixty-six subjects completed the full 4-week treatment. There was no significant difference between almond oil control and essential oil groups in terms of the total score of NIH-CPSI, pain, quality of life and urination domain scores of NIH-CPSI and EPS examinations(P>0.05). In the essential oil group, pain between rectum and testicles(perineum) in the domain of pain or discomfort was significantly reduced at week 2 and week 4 compared with almond oil control group(P<0.01). No serious adverse events occurred. Conclusion: The essential oil may reduce the pain or discomfort in the perineum region in patients with CP/CPPS.
文摘Background As one of the most commonly diagnosed diseases, chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） is characterized by a variety of complex symptoms. Anxiety and depression are two of the most prevalent clinical manifestations of patients with CP/CPPS, and have adverse effects on the health of the subjects and prognosis of comorbidities. Such psychological disorders, however, have not been deeply and thoroughly studied in China. The aim of this study was to investigate the prevalence and severity of psychological disorders in Chinese adults with CP/CPPS.Methods From April 2008 to June 2009, 80 patients and 40 age-matched healthy men participating in a voluntary health examination were recruited. The majority of the subjects completed the questionnaires on the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） as well as the hospital anxiety and depression scale （HADS）.Results Of all the participants, 77 （96.3%） patients and 37 （92.5%） healthy controls completed the questionnaires. The average NIH-CPSI total score was 21.0±9.5 for the patients and 2.2±1.5 for the controls （P=0.03）. Of the 77 patients with CP/CPPS, 48 （62.3%）, 5 （6.5%）, and 1 （1.2%） had anxiety symptoms, depression symptoms, or both anxiety and depression symptoms, respectively. For the controls, the average HADS anxiety and depression scores in patients were 14.5±6.8 and 5.2±4.5, which were both significantly higher than in controls. Moreover, the prevalence and the symptom scores of both the HADS anxiety and depression were higher for the younger age group （〈35 years） than for the older age group （〈35 years）.Conclusions This preliminary study revealed that male patients with CP/CPPS had a higher prevalence of psychological disorders than in the control subjects. Moreover, the differences of the prevalence and severity of the psychological symptoms between the two different age groups may imply that psychological disorders related to CP/CPPS may be relieved with increasing age. The present study indicated that psychological evaluation is important in men with CP/CPPS, especially in younger men.
基金supported by the National Natural Science Foundation of China(82300872 and 82170787)the Anhui Provincial Natural Science Foundation(2408085Y038)+3 种基金the Supporting Projects for Innovative Leading Talents(T000529)the Distinguished Young Scholar of Anhui Colleges(2021-108-10)the Science Foundation for Outstanding Young Scholar of Anhui Colleges(2022AH020073)the Sanming Project of Medicine in Shenzhen Nanshan(SZSM20210300).
文摘Background:Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is a frequently encountered disorder characterized by voiding symptoms and pelvic or perineal pain.Proinflammatory T helper 17(Th17)cells are essential for triggering the development of CP/CPPS.High-salt diet(HSD)consumption has been found to cause an accumulation of sodium chloride in peripheral organs,inducing autoimmune responses via the Th17 cell axis.It is currently unknown whether HSD affects the etiology and course of CP/CPPS.Methods:Patients diagnosed with CP/CPPS were evaluated with the National Institutes of Health Chronic Prostatitis Symptom Index scoring system,and the correlation between the symptoms of CP/CPPS with HSD was analyzed.The experimental autoimmune prostatitis(EAP)mouse was established and the mice were fed either a normal-salt diet(NSD)or HSD for 6 weeks to investigate the impact of HSD on CP/CPPS.Then,16S ribosomal RNA sequencing and untargeted metabolomics were introduced to detect the differences in the gut microflora composition and metabolite profiles between NSD-fed and HSD-fed mice,followed by fecal microbiota transplantation,5-hydroxyindole acetic acid(5-HIAA)supplementation,aryl hydrocarbon receptor(AHR)inhibition,and in vitro Th17 differentiation experiments,which were performed to explore the mechanisms underlying HSD-aggravated CP/CPPS.Finally,chromatin immunoprecipitation assay and quantitative polymerase chain reaction were conducted to validate whether AHR can serve as a transcription factor by interacting with the serum and glucocorticoid-regulated kinase 1(Sgk1)promoter in CD4^(+)T cells.Results:Increased salt consumption had a positive correlation with symptom scores of CP/CPPS patients,which was validated by feeding EAP mice with HSD,and HSD worsened the prostate inflammation and tactile allodynia in EAP mice through promoting the differentiation of CD4^(+)T cells to Th17 cells.HSD exacerbated EAP by significantly reducing the relative abundance of beneficial gut microflora,such as Lactobacillaceae,and gut microbiota metabolite 5-HIAA,which is related to tryptophan metabolism.The prostate inflammation,tactile allodynia,and proportion of Th17 cells in mice that received fecal suspensions from the EAP^(+)HSD group were significantly more severe or higher than those in mice that received fecal suspensions from the EAP^(+)NSD group.However,5-HIAA supplementation ameliorated the symptoms of EAP caused by HSD through inhibiting the differentiation of CD4^(+)T cells to Th17 cells,while AHR inhibition abrogated the protective effects of 5-HIAA supplementation on EAP mice fed a HSD through promoting the differentiation of CD4^(+)T cells to Th17 cells.Mechanistically,it has been revealed that the SGK1/forkhead box protein O1(FOXO1)pathway was significantly activated during cytokine-induced Th17 cell differentiation,and AHR has been shown to inhibit SGK1 transcription by interacting with the Sgk1 promoter in CD4^(+)T cells to inhibit FOXO1 phosphorylation,consequently restoring the equilibrium of Th17 cell differentiation.Conclusions:Our findings indicated that high salt intake represented a risk factor for the development of CP/CPPS as it promoted the differentiation of CD4^(+)T cells to Th17 cells through the 5-HIAA/AHR/SGK1/FOXO1 axis,which might be a potential therapeutic target for CP/CPPS.
基金The National Natural Science Foundation of China,Grant/Award Number:82160148The Cuiying Scientific Training Program for Undergraduates of Lanzhou University Second Hospital,Grant/Award Numbers:CYXZ2021-16,CYXZ2022-41。
文摘Background:As one of the most common diseases in urology,a large number of preclinical studies have been accumulated to explore the etiological mechanism and potential intervention of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).Methods:In this study,we systematically evaluated the current status of preclinical research on CP/CPPS through bibliometrics analysis using VOSviewer and Citespace.Characteristics of publication such as year,country/region,institution,author,journal,citation,and keywords were analyzed.Based on the bibliometrics analysis results of keywords,we summarized the possible mechanisms and promising treatments for CP/CPPS narratively.Results:According to the results of this study,the most common mechanisms involved in CP/CPPS were as follows:Disturbed immune and inflammation mediators,immune cell dysfunction,oxidative stress,dysregulated signaling pathways,apoptosis,gut microbiota,and testosterone metabolism.Traditional Chinese Medicine and extracorporeal shock wave therapy have important potential in the treatment of CP/CPPS.Conclusion:Further translational studies targeting the above mechanisms and validating the objective efficacy of potential treatments indicated by preclinical studies in clinical patients are needed in the future.
文摘Objective To observe the clinical effects of chronic non-bacterial prostatitis treated with warm needling moxibustion. Methods One hundred and twenty-five cases were randomly divided into warm needling moxibustion group （42 cases）, acupuncture group （41 cases） and western medicine group （42 cases）. Of which, in warm needling moxibustion group, acupuncture combined with warming acupuncture were provided①puncture on Shènshū（肾俞 BL 23）, Gānshū （肝俞BL 18） and Zhìbiān （秩边BL 54） without retention of needles,②Guānyuán （关元CV 4）, Zhō ngjí （ 中极CV 3）, Yīnlíngquán （ 阴陵 GB 34） and Sānyīnjiāo （三阴交 SP 6） ,with warming acupuncture, once a day; in acupuncture group, the prescriptions and needling technique were the same as those in warm needling moxibustion group, without moxibustion; in western medicine group, Cernilton was applied twice a day, one pill for each time. After one course treatment, the therapeutic effects and NIH-Chronic Prostatitis Symptom Index （NIH-CPSI） of 3 groups were compared. Results The total effective rate was 88. 10% in warm needling moxibustion group, 63.41% in acupuncture group, and 66.67% in western medicine group. The clinical effect in warm needling moxibustion group was superior to that in either acupuncture group or western medicine group （both P〈0.05）. The score of NIH-CPSI was 11.92 ±7.11 in warm needling moxibustion group, 16.08±6.83 in acupuncture group, and 15.66±5.88 in western medicine group. The score of each group was obviously reduced （both P〈0.01 ） after treatments, in which, the reduction in warm needling moxibustion group was most obvious （both P〈0.0t）. Conclusion A good therapeutic effect of chronic non-bacterial prostatitis was received by warm needling moxibustion.
文摘We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis （CBP）. The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin （500 rag, thrice-weekly） with a once-daily 500- or 750-mg dose of ciprofloxacin （Cipro-500 or Cipro-750 cohort, respectively）. Combined administration of azithromycin （1500 mg week^-1） with ciprofloxacin at the rate of 750 mg day^- 1 for 4 weeks rather than at 500 mg day^- 1 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen （PSA） were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction （ED） at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.
