Autoimmune Prostatitis: State of the Art

Abstract

The prostate is one of the main male sex accessory glands and the target of many pathological conditions affecting men of all ages. Pathological conditions of the prostate gland range from infections, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) of a still unknown aetiology to benign hyperplasia and cancer. CP/CPPS is one of the most prevalent diseases in the urologic clinic and affects men younger than 50 years old. A significant advance in the understanding of CP/CPPS was made when an autoimmune response against prostate antigens was revealed in a considerable number of patients. During the last 30 years, extensive work has been done regarding the development and characterization of different rodent models of experimental autoimmune prostatitis (EAP). It has been demonstrated that tolerance to prostate antigens can be disrupted in some strains of rats and mice and cellular and humoral responses to prostate antigens are elicited. A Th1 pattern has been described and the cellular response seems to be the major pathogenic mechanism involved. Immune cells infiltrate the gland and induce prostate lesions. The genetic background and hormonal imbalance are factors that could contribute to the onset of the disease in susceptible young males. Moreover, spontaneous autoimmune prostatitis could also occur with advanced age in susceptible strains. In this review, we summarize the current knowledge regarding rodent models of EAP and the immunological alterations present in CP/CPPS patients. We also discuss the reliability of these experimental approaches as genuine tools for the study of human disease.

Heat-shock protein 70 expression in the seminal plasma of patients with chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome

“…4 Recent studies have demonstrated that autoimmune components are involved in the pathogenesis of CP/CPPS. [5][6][7][8] Heat-shock proteins (HSPs) are crucial for the maintenance of cell integrity during both normal cell growth and pathophysiological conditions. 9-12 By controlling binding and release, HSPs function mainly as molecular chaperones, which participate in the folding and assembly of nascent and unfolding proteins and facilitate protein transport to subcellular compartments.…”

Expression of CXCR3 on Specific T Cells Is Essential for Homing to the Prostate Gland in an Experimental Model of Chronic Prostatitis/Chronic Pelvic Pain Syndrome

“…Our laboratory has pioneered the development of animal models of experimental autoimmune prostatitis (EAP), which is achieved by immunization of animals with prostate Ags plus adjuvant. These models show almost all previously mentioned characteristics of human disease: the presence of IFN-g-secreting lymphocytes specific to prostate Ags, increased levels of cytokines in semen, pelvic pain, inflammation, and the type of infiltration and histological lesions seen in the target organ (13)(14)(15)(16). Studies focused on differential susceptibility to the development of EAP have shown that NOD, C57BL/6, SJL, A⁄J, and BALB/c mice exhibited different severity of prostatic inflammation after EAP induction, with NOD and BALB/c mice the most susceptible and the most resistant strains, respectively (4,13,17).…”

“…These models show almost all previously mentioned characteristics of human disease: the presence of IFN-g-secreting lymphocytes specific to prostate Ags, increased levels of cytokines in semen, pelvic pain, inflammation, and the type of infiltration and histological lesions seen in the target organ (13)(14)(15)(16). Studies focused on differential susceptibility to the development of EAP have shown that NOD, C57BL/6, SJL, A⁄J, and BALB/c mice exhibited different severity of prostatic inflammation after EAP induction, with NOD and BALB/c mice the most susceptible and the most resistant strains, respectively (4,13,17). NOD mice develop severe inflammation in the prostate, accompanied by specific T cell-mediated responses that could be assessed by in vitro-specific proliferation and IFN-g production, but not IL-4 secretion (14,18).…”

“…In addition, substantial evidence for an autoimmune cause in CP/CPPS comes from animal models of autoimmune prostatitis (13). Our laboratory has pioneered the development of animal models of experimental autoimmune prostatitis (EAP), which is achieved by immunization of animals with prostate Ags plus adjuvant.…”

Semen analysis in chronic bacterial prostatitis: diagnostic and therapeutic implications

“…The aetiology of abacterial prostatitis is mostly unknown; experts hypothesize neurological, psychological, anatomical, or immunological disorders as possible causes of this condition [3,4].…”