Negative bacterial polymerase chain reaction (PCR) findings in prostate tissue from patients with symptoms of chronic pelvic pain syndrome (CPPS) and localized prostate cancer

Leskinen, Markku; Rantakokko‐Jalava, Kaisu; Manninen, Raija; Leppilahti, Mikael; Marttila, Timo; Kylmälä, Timo; Tammela, Teuvo L.J.

doi:10.1002/pros.10218

Cited by 37 publications

(24 citation statements)

References 19 publications

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“…Referred visceral hyperalgesia was measured as responses to mechanical stimulation of the pelvic region using von Frey filaments of five calibrated forces. Data are reported as the mean percentages of positive responses Ϯ SEMs at 14,16,18,20,22,24,26, and 28 weeks of age. (A) Responses to pelvic stimulation from 14 to 28 weeks of age (n ϭ 10).…”

Section: Discussionmentioning

confidence: 99%

“…Despite the predominantly nonbacterial nature of CP/CPPS, up to 8% of patients with CP/CPPS harbor uropathogens that have traditionally been deemed to be of no significance (25). Numerous studies have also identified bacterial DNA in prostate samples from CP/ CPPS patients (9,19,20,22,25). CP/CPPS accompanied by uropathogens is differentiated from chronic bacterial prostatitis by the requirement for clinical symptoms of pelvic pain and the lack of recurrent urinary tract infections (UTIs).…”

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Uropathogenic Escherichia coli Induces Chronic Pelvic Pain

et al. 2011

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Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a debilitating syndrome of unknown etiology often postulated, but not proven, to be associated with microbial infection of the prostate gland. We hypothesized that infection of the prostate by clinically relevant uropathogenic Escherichia coli (UPEC) can initiate and establish chronic pain. We utilized an E. coli strain newly isolated from a patient with CP/CPPS (strain CP1) and examined its molecular pathogenesis in cell culture and in a murine model of bacterial prostatitis. We found that CP1 is an atypical isolate distinct from most UPEC in its phylotype and virulence factor profile. CP1 adhered to, invaded, and proliferated within prostate epithelia and colonized the prostate and bladder of NOD and C57BL/6J mice. Using behavioral measures of pelvic pain, we showed that CP1 induced and sustained chronic pelvic pain in NOD mice, an attribute not exhibited by a clinical cystitis strain. Furthermore, pain was observed to persist even after bacterial clearance from genitourinary tissues. CP1 induced pelvic pain behavior exclusively in NOD mice and not in C57BL/6J mice, despite comparable levels of colonization and inflammation. Microbial infections can thus serve as initiating agents for chronic pelvic pain through mechanisms that are dependent on both the virulence of the bacterial strain and the genetic background of the host.Prostatitis is a common urologic disease that results in over 2 million outpatient visits per year in the United States, including 8% of all visits to urologists and 1% of those to primary care physicians (5). The disease is classified into four categories, including acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and asymptomatic inflammatory prostatitis.The third disease category, CP/CPPS, accounts for approximately 90% of all chronic prostatitis cases and is clinically manifested as chronic pain in the perineum, rectum, prostate, penis, testicles, and abdomen (5). Despite the predominantly nonbacterial nature of CP/CPPS, up to 8% of patients with CP/CPPS harbor uropathogens that have traditionally been deemed to be of no significance (25). Numerous studies have also identified bacterial DNA in prostate samples from CP/ CPPS patients (9,19,20,22,25). CP/CPPS accompanied by uropathogens is differentiated from chronic bacterial prostatitis by the requirement for clinical symptoms of pelvic pain and the lack of recurrent urinary tract infections (UTIs).It has been suggested that the virulence of major uropathogens such as UPEC is dependent on the expression of multiple virulence factors (10, 15). Phylogenetic analysis suggests that prostatitis-causing uropathogenic Escherichia coli (UPEC) strains largely belong to the B2 phylogenetic group and exhibit a wide variety of virulence traits, including nonhemagglutinin adhesin-siderophore receptor (ihA), type 1 fimbriae (fimH), the salmochelin siderophore receptor (iroN), and outer membrane protease T (ompT) (1,12,...

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Section: Discussionmentioning

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Uropathogenic Escherichia coli Induces Chronic Pelvic Pain

et al. 2011

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“…No definitive targetable pathogen or pattern of microbial dysbiosis within prostate tissue has been identified that was clearly correlated with CP/CPPS in the absence of other confounding variables such as prostate cancer or other proper controls (82)(83)(84). A recent study by Nickel et al compared urethral and bladder urine specimens from CP/CPPS patients in the Multi-Disciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Network Study, and found differences in the CP/CPPS urinary microbiome as compared to control patients, more specifically an increase in Burkholderia cenocepacia in urethral specimens.…”

Section: The Microbiome In Urologic Chronic Pain Syndromesmentioning

confidence: 99%

Gut microbiome and chronic prostatitis/chronic pelvic pain syndrome

Arora¹,

Eng²,

Shoskes³

2017

Ann. Transl. Med.

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“…The 16S rDNA-based techniques have been proven to be more substantially sensitive and accurate than traditional techniques that depend on microbial culture (11,12). Several studies have evaluated the presence of multiple and diverse bacterial 16S rDNA sequences in prostate biopsy tissue from BPH and PC patients (15,(24)(25)(26). In the present study, we used PCR-DGGE with 16S rDNA finger printing analysis to investigate bacterial composition in the biopsy of PC patients in the PSA grey-zone with or without hypertension.…”

Section: Discussionmentioning

confidence: 99%

Effect of hypertension on bacteria composition of prostate biopsy in patients with benign prostatic hyperplasia and prostate cancer in PSA grey-zone

Meng

Zhou

et al. 2016

Biomedical Reports

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Abstract. Diagnostic prostate cancer (PC) is difficult to diagnose by prostate biopsy, even in patients with markedly elevated PSA levels. Therefore, we aimed to identify a new, better technique to detect PC in a more consistent manner. A variety of steps were employed to validate this proposed method, including DNA extraction, polymerase chain reaction (PCR) amplification, denaturing gradient gel electrophoresis (DGGE) and DGGE band sequencing. Four transperineal prostate biopsy specimens were obtained from male patients. The patients were under the age of 65 and PSA levels were 4-10 ng/ml. We also investigated the bacteria composition of transperineal prostate biopsy in patients with benign prostatic hyperplasia (BPH) and PC by PCR-DGGE profiling. Sequences from selected bands 2 and 4 both matched with Sphingomonas, which is present in lower amounts in PC without hypertension as compared to PC with hypertension, while there were no particular differences in the BPH group. Specific bacteria from the prostate biopsy tissues provide further confidence in PC diagnosis based on a PCR approach as a diagnostic tool, while hypertension was found to be a disturbing factor that can affect the diagnosis of BPH and PC in grey-zone.

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Negative bacterial polymerase chain reaction (PCR) findings in prostate tissue from patients with symptoms of chronic pelvic pain syndrome (CPPS) and localized prostate cancer

Abstract: A bacterial etiology for CPPS symptoms could not be demonstrated in patients with prostate cancer. The results also suggest that the prostate is unlikely to harbor bacterial normal flora.

Cited by 37 publications

References 19 publications

Uropathogenic Escherichia coli Induces Chronic Pelvic Pain

Uropathogenic Escherichia coli Induces Chronic Pelvic Pain

Gut microbiome and chronic prostatitis/chronic pelvic pain syndrome

Effect of hypertension on bacteria composition of prostate biopsy in patients with benign prostatic hyperplasia and prostate cancer in PSA grey-zone

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