Is autoimmunity the cause of male genital tract inflammation in Chronic Pelvic Pain Syndrome?

MOTRICH, RUBEN D.; BRESER, MARIA L.; MOLINA, ROSA; TISSERA, ANDREA; OLMEDO, JOSE J; RIVERO, VIRGINIA E.

Buenos Aires

Congreso; LXIII Reunión Anual de SAI, I Meeting LASID-SAI-FAIC, IV Meeting LASID, y II Meeting FAIC.; 2015

Sociedad Argentina de Inmunologia

BackgroundChronic Pelvic Pain Syndrome (CPPS) is the most prevalent disease in the urologic clinic affecting young men. CPPS patients experience pelvic pain and prostate inflammation for at least 3 months in the absence of infection. Its etiology is still unknown and autoimmunity has been proposed as a cause.MethodsT cell reactivity against prostate antigens (PAg) was analyzed in PBMCs from CPPS patients and healthy control volunteers. In parallel, levels of inflammatory cytokines, leukocyte counts, male accessory glands functionality markers, semen quality and sperm apoptosis in semen from patients and controls were analyzed. Also, the NIH chronic prostatitis symptom score index was assessed. ResultsCPPS patients showed elevated PAg-specific lymphoproliferative responses with the secretion of high levels of IFNg and IL-17 when compared with controls. Prostate Specific Antigen and other prostatic proteins were the main antigens involved. Local inflammation was revealed by increased levels of IFNg, IL-17, IL-8 and IL-1B, and elevated macrophages and T cell counts in semen. Pelvic pain was the main concern reported by patients. Besides, low levels of seminal citric acid and increased levels of serum PSA evidenced an altered prostate physiology in patients. Furthermore, patients showed increased levels of sperm apoptosis, and lower values of sperm viability and motility compared with controls.ConclusionsOur results support the notion that an autoimmune response to PAg may be the underlying cause of the chronic male genital tract inflammation in CPPS. This local inflammation alters the normal prostate functionality and impairs semen quality, thus compromising male fertility.