1091 Imaging Diagnosis, Transurethral Endoscopic Observation and Management of 43 Cases of Persistent and Refractory Hematospermia

Abstract

INTRODUCTION AND OBJECTIVES: The purpose of this study was to assess the diagnostic value and potentially protective capacity of heat-shock protein 70 (HSP70) in chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).METHODS: In this study, seminal plasma levels of cytokines (tumor necrosis factor-alpha (TNF-alpha) and interleukin 1beta (IL-1beta)) and HSP70 were evaluated by enzyme-linked immunosorbent assay in 80 men: 15 healthy controls, 16 men with chronic bacterial prostatitis, 23 men with CP/CPPS IIIA and 26 with CP/CPPS IIIB. The HSP70 levels in chronic bacterial prostatitis and CP/CPPS patients were correlated with chronic prostatitis symptom index (CPSI).RESULTS: Significantly increased levels of cytokines (TNFalpha and IL-1beta) and HSP70 were observed in seminal plasmas from patients with chronic bacterial prostatitis compared with CP/CPPS patients and controls. However, only IL-1beta was significantly elevated compared with CP/CPPS IIIB and controls in patients with CP/CPPS IIIA. HSP70 levels in CP/CPPS patients were significantly lower than that in controls. HSP70 concentration in seminal plasma was negatively correlated with CPSI in chronic bacterial prostatitis. Whereas,the expression of HSP70 did not correlate with the NIH-CPSI total scores in CP/CPPS patients.CONCLUSIONS: In conclusion, HSP70 and IL-1b are measurable in human semen plasma and they provide useful information in diagnosing prostatic inflammatory conditions and categorizing CPPS III subclasses, respectively. Levels of HSP70 expression are feasible to regard as diagnosis and prognostic indicators for chronic bacterial prostatitis. HSP70 levels may be suggested to assess the severity of prostatic inflammation in these patients.IL-1b appears to represent a useful biomarker in CP/CPPS and can be used to discriminate CP/ CPPS IIIA from IIIB. HSP70 provided cellular protection capacity that has pivotal roles in the regulation of cell functions in chronic bacterial prostatitis. CP/CPPS may disrupt the ability of T cells to suppress the immune system and consequently decrease HSP70 expression in these patients.It is further proved that the CP/CPPS is a kind of immune disease. Autoimmune may have a prominent role in the induction and progression of CP/CPPS. It should be novel treatments for chronic bacterial prostatitis and CP/CPPS and merit further study by enhancing HSP70 expression and exogenous HSP70 administration.