前列腺液中免疫球蛋白、细胞因子及趋化因子水平与慢性前列腺炎的关系

Relevance of levels of immunoglobulins,cytokines,chemokines in the prostatic secretion to chronic prostatitis

探讨慢性前列腺炎(chronic prostatitis,CP)患者前列腺液(expressed prostatic secretion,EPS)中免疫球蛋白、细胞因子及趋化因子水平变化及它们在病理过程中的作用。将135例确诊的CP患者依据美国国立卫生研究院(NIH)制定的CP分类方法分为Ⅱ型(41例)、ⅢA型(50例)及ⅢB型(44例),另选40名体检合格的健康男性作为对照组。检测CP患者EPS中免疫球蛋白(IgG、IgM、IgA)、细胞因子(IL-1β、TNF-α、IL-6、IL-8、IL-10)及趋化因子(MCP-1、MIP-1α)水平,并与对照组检测结果比较。根据NIH-CP症状指数(NIH-CPSI)进行症状评分,分析各观察指标水平与症状严重程度的关系。(1)与健康人群比,CP患者EPS中各观察指标水平均明显升高(P<0.05)。(2)不同类型CP患者EPS中IL-1β、IL-8、MCP-1及MIP-1α水平高低趋势为:Ⅱ型>ⅢA型>ⅢB型(P<0.05);TNF-α、IL-6及IL-10水平在Ⅱ型、ⅢA型患者EPS中均明显高于ⅢB型(P<0.05),而在Ⅱ型与ⅢA型患者间无明显差异(P>0.05);3种类型患者间EPS中IgG、IgM及IgA水平均无明显差异(P>0.05)。(3)重度CP患者EPS中各观察指标水平均显著高于轻、中度患者(P<0.05);其中IL-6、IL-8、IL-10水平变化趋势为:重度>中度>轻度(P<0.05)。不同类型CP患者EPS中免疫球蛋白、细胞因子及趋化因子水平升高程度不同,其中IL-6、IL-8、IL-10水平与CP症状严重程度呈明显正相关。各观察指标水平检测有助于CP的诊断、分型以及疾病进展评估。

To explore the levels of immunoglobulins,cytokines and chemokines in the expressed prostatic secretion（EPS）and their relevance to chronic prostatitis（CP）,135 patients with CP were enrolled and divided into 3groups：the typeⅡ（41cases）,typeⅢA（50cases）and typeⅢB（44cases）groups according to the classification standard established by National Institutes of Health（NIH）.40 healthy individuals were set as the control group.The levels of immunoglobulins（IgG,IgM,IgA）,cytokines（IL-1β,TNF-α,IL-6,IL-8,IL-10）and chemokines（MCP-1,MIP-1α）in the EPS of CP patients were detected and compared with those of the control group.NIH CP symptom index（NIH-CPSI）was performed to score the symptoms of CP,and the relationship between each observation index and severity of symptoms was analyzed.Compared with the control group,levels of all the observation indexes in EPS of the CP patients were significantly enhanced（P 〈0.05）.When the 3patient groups were compared in terms of the levels of IL-1β,IL-8,MCP-1and MIP-α,the order always showed as：typeⅡ 〉typeⅢA 〉typeⅢB（P 〈 0.05）.Levels of TNF-α,IL-6and IL-10 in the EPS of typeⅡ and typeⅢA groups were significantly higher than those of typeⅢB patients（P 〈 0.05）.However,no significant differences in TNF-α,IL-6and IL-10 were found between the typeⅡand typeⅢA groups（P 〉0.05）.In addition,no obvious differences in IgG,IgM and IgA levels were found among different groups（P 〉 0.05）.Levels of all the observation indexes in the CP patients with severe symptoms were obviously higher than those in the CP patients with mild and moderate symptoms（P 〈 0.05）.Moreover,the levels of IL-6,IL-8and IL-10 were arranged in ascending order of disease severity severe〉 moderate〉 mild（P 〈 0.05）.The levels of immunoglobulins,cytokines and chemokines in the EPS of different types CP patients were increased,and the levels of IL-6,IL-8and IL-10 had a positive correlation with the severity of symptoms.Taken together,detection of immunoglobulins,cytokines and chemokines in the EPS could be conducive to the diagnosis,classification and assessment of disease progression in CP.