ELEVATED LEVELS OF PROINFLAMMATORY CYTOKINES IN THE SEMEN OF PATIENTSWITH CHRONIC PROSTATITIS CHRONIC PELVIC PAIN SYNDROME

Objectives. Chronic prostatitis/chronic pelvic pain syndrome is a comm on diagnosis, but the disease is poorly understood. The diagnosis is b ased only on symptoms, and no measurable parameter can help in definin g the presence of the disease, its severity, or its cause. Cytokines a re soluble proteins secreted by cells of the immune system that princi pally regulate inflammatory and immune responses. To provide an object ive measure of inflammation in the genital tract, we measured levels o f the proinflammatory cytokines, tumor necrosis factor-alpha (TNF-alph a) and interleukin-l beta (IL-l beta) in the semen of men with chronic prostatitis/chronic pelvic pain syndrome and compared these with leve ls in normal men. Methods. We obtained semen samples from 18 men with chronic prostatitis/chronic pelvic pain syndrome and from 8 normal mal e volunteers. Cytokine levels were measured in the seminal plasma by t wo-antibody enzyme-linked immunosorbent assay. Results. Men with prost atitis had higher mean levels of IL-l beta and TNF-alpha in seminal pl asma (mean +/- SEM) than normal men: TNF-alpha 98 +/- 39 versus 17 +/- 8; IL-1 beta 246 +/- 63 versus 27 +/- 10, respectively; P <0.05. Ther e was a strong correlation between the levels of TNF-alpha and IL-l be ta in the semen of men with chronic prostatitis/chronic pelvic pain sy ndrome. There was no correlation between either TNF-alpha or IL-l beta levels and the number of leukocytes per high power field in expressed prostatic secretions in patients. Conclusions. Some men with chronic prostatitis/chronic pelvic pain syndrome have elevated levels of TNF-a lpha and IL-l beta in the semen. This suggests that inflammation of th e genital tract is a feature of this disease, irrespective of the pres ence or absence of leukocytes in the expressed prostatic secretions. S eminal cytokine levels may provide an objective measure of disease in these patients and suggest specific therapeutic strategies to treat ch ronic prostatitis/chronic pelvic pain syndrome in such patients. (C) 1 998, Elsevier Science Inc. All rights reserved.