Introduction: Literature data prove the important role of oxidative stress in the pathogenesis of Chronic Bacterial Prostatitis (CBP) and its recurrence, which reduces the effectiveness of standard etiotropic therapy of the disease. Aim of study: To improve the results of the pharmacotherapy of CBP by a comprehensive assessment of oxidative disorders in the prostate gland in a clinical and experimental study to provide evidence for antioxidant support. Material and methods: The results of experimental simulation of CBP in 60 male rats and examination of 90 patients with CBP (average age 38.2 ± 1.4; main group) and 30 clinically healthy men (average age 35.5±1.5; control group), which included history-taking, collecting complaints, questioning, general and special examinations, biochemical, cytological, microbiological, sonographic studies. In some experimental animals and patients with CBP, different modes of pharmacotherapy were tested (antimicrobial monochemotherapy; antimicrobial chemotherapy+zinc picolinate; antimicrobial chemotherapy+L–carnitine tartrate in standard doses). The data were processed using descriptive and comparative statistics. Results and discussion: Clinical and experimental findings showed the compensatory nature of the prostatic oxidative disorders after a standard antimicrobial monochemotherapy of the first episode of CBP and their continued persistence with a high risk of decompensation and development of mitochondrial dysfunction after a course of standard antimicrobial monochemotherapy in CBP recurrence. Zinc deficiency in the patients with CBP was detected on average 2.7 times more often than in the healthy men, so zinc determination in the prostatic fluid and subsequent drug compensation should be considered as first–line diagnostic and treatment measures. In the patients with CBP without zinc deficiency, L-carnitine may be an effective alternative to pharmacological correction of the prostatic oxidative disorders. Conclusion: To increase the effectiveness of standard etiotropic therapy of CBP, simultaneous antioxidant support is necessary, using differentiated administration of antioxidants/antihypoxants (zinc or L-carnitine).
Introduction: Zinc is a vital trace element, which regulates metabolism of a prostate gland. It has been established that a low plasma zinc level in men increases the risk of chronic prostatitis and vice versa, chronic prostatitis is often accompanied by zinc deficiency in the prostate gland. The purpose of this study is to research the features and possible correlations of zinc metabolism disorders at systemic (in blood) and local (in prostatic fluid) levels in healthy men and patients with chronic bacterial prostatitis (CBP). Materials and methods: Ninety patients with CBP (main group) and thirty healthy men (control group) were randomized by age (mean age 38.5±2.9 years) and examined. In addition to standard examinations, the zinc levels in blood serum and prostatic fluid were determined, and the oxidative status of the prostate gland was assessed (the level of reactive oxygen species (ROS), conjugated dienes, malondialdehyde, superoxide dismutase (SOD) activity in the prostatic fluid) according to standard methods. Results and discussion: In patients with CBP, the absolute deficiency of plasma and prostatic zinc was detected 2.89 and 2.5 times more often, respectively, than in healthy men (p < 0.05). At the same time, both the patients with CBP and healthy men had significant correlations between plasma zinc and zinc in prostatic fluid (r = 0.345; n = 37; p = 0.001 and r = 0.156; n = 30; p = 0.001; respectively). A significant positive correlation between the zinc level and the activity of SOD in prostatic fluid was revealed only in the patients with CBP (r = 0.389; n = 90; p = 0.001). Conclusion: Zinc concentration in blood plasma does not objectively reflect zinc metabolism disorders in the prostate gland, and therefore the determination of zinc in prostatic fluid is the most reliable and sensitive method for assessing zink disorders in patients with CBP.
Introduction: Nutritional supplementation is an integral part of modern pharmacotherapeutic strategies for prostate diseases with different levels of evidence for specific nutrients. Provitamin A (beta-carotene), vitamin A (retinol) and prostate diseases. Their effects have not been sufficiently studied, and the available data are conflicting to recommend them as a nutritional supplement. Vitamin E (tocopherol) and prostate diseases. Its effects have not been sufficiently studied, and the available data are conflicting to recommend it as a nutritional supplement. Vitamin C (ascorbic acid) and prostate diseases. Its effects have not been sufficiently studied, and the available data are conflicted to recommend it as a nutritional supplement. Vitamin K and prostate diseases. Its effects have not been sufficiently studied, and the available data are conflicted to recommend it as a nutritional supplement. Vitamin D and prostate diseases. The evidence base of the vitamin D prostatotropic effects has been accumulated, which allows us to consider its deficiency replacement as an effective nutritional supplement in prostate diseases. Omega-3 PUFAs and prostate diseases. They have universal physiological effects; however, the evidence base for their recommendation as a nutritional supplement for prostate diseases is still insufficient. Zinc and prostate diseases. Positive effects of zinc on the prostate gland are known for a fact and allow us to recommend it as a nutritional supplement for prostate diseases. Selenium and prostate diseases. The reliably proven positive effects of selenium on the prostate gland allow us to recommend it as a nutritional supplement for prostate diseases. Magnesium and prostate diseases. Its effects have not been sufficiently studied, and the available data are conflicting to recommend it as a nutritional supplement.
The review article, based on the results of modern clinical and experimental studies, discusses general issues of the pathophysiology of oxidative stress as a universal pathogenetic factor of human diseases and particular pathophysiological aspects of oxidative stress on the example of chronic bacterial prostatitis. Separately, the most studied mechanisms of oxidative stress in the pathogenesis of the infectious and inflammatory process associated with chronic bacterial prostatitis are highlighted, which contribute to the occurrence and persistence of oxidative disorders in the prostate gland and disrupt the full restoration of its anatomical and functional state after inflammation with a potentially negative effect on the results of standard chronic bacterial prostatitis pharmacotherapy.
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