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International Journal of Molecular... Nov 2021Fibrogenic and inflammatory processes in the prostate are linked to the development of lower urinary tract symptoms (LUTS) in men. Our previous studies identified that...
Fibrogenic and inflammatory processes in the prostate are linked to the development of lower urinary tract symptoms (LUTS) in men. Our previous studies identified that osteopontin (OPN), a pro-fibrotic cytokine, is abundant in the prostate of men with LUTS, and its secretion is stimulated by inflammatory cytokines potentially to drive fibrosis. This study investigates whether the lack of OPN ameliorates inflammation and fibrosis in the mouse prostate. We instilled uropathogenic (UTI89) or saline (control) transurethrally to C57BL/6J (WT) or /J (OPN-KO) mice and collected the prostates one or 8 weeks later. We found that OPN mRNA and protein expression were significantly induced by -instillation in the dorsal prostate (DP) after one week in WT mice. Deficiency in OPN expression led to decreased inflammation and fibrosis and the prevention of urinary dysfunction after 8 weeks. RNAseq analysis identified that -instilled WT mice expressed increased levels of inflammatory and fibrotic marker RNAs compared to OPN-KO mice including , , and which were confirmed by RNAscope. Our results indicate that OPN is induced by inflammation and prolongs the inflammatory state; genetic blockade of OPN accelerates recovery after inflammation, including a resolution of prostate fibrosis.
Topics: Animals; Chondroitin Sulfate Proteoglycans; Collagen Type III; Disease Models, Animal; Escherichia coli Infections; Extracellular Matrix Proteins; Fibrosis; Gene Expression Regulation; Humans; Inflammation; Lumican; Male; Matrix Metalloproteinase 3; Mice; Mice, Inbred C57BL; Mice, Knockout; Osteopontin; Prostate; RNA, Messenger; Signal Transduction; Urinary Tract Infections; Uropathogenic Escherichia coli
PubMed: 34830342
DOI: 10.3390/ijms222212461 -
Frontiers in Cellular and Infection... 2023To explore whether type III prostatitis is related to bacterial infection by detecting the composition and function of microorganisms in expressed prostatic secretion...
OBJECTIVE
To explore whether type III prostatitis is related to bacterial infection by detecting the composition and function of microorganisms in expressed prostatic secretion (EPS) of patients with chronic prostatitis (CP) and healthy people.
METHODS
According to the inclusion and exclusion criteria, 57 subjects were included in our study, divided into the healthy group, type II prostatitis group, and type III prostatitis group. 16s rRNA sequencing technique was used to detect and analyze the microbial composition of EPS in each group. Additionally, the metagenomics sequencing technique was used to further explore the function of different bacteria in the type III prostatitis group. Data analysis was performed by bioinformatics software, and the results were statistically significant when P<0.05.
RESULTS
Many microorganisms exist in EPS in both CP patients and healthy populations. However, the relative abundance of , , , , and in CP patients (including type II and III) were significantly different. Still, the relative abundance of different bacteria in type II prostatitis patients was much higher than in type III. The metagenomics sequencing results for the type III prostatitis group showed that the different bacteria had certain biological functions.
CONCLUSION
Based on our sequencing results and previous studies, we suggest that type III prostatitis may also be caused by bacterial infection.
Topics: Male; Humans; Prostatitis; RNA, Ribosomal, 16S; Chronic Disease; Bacterial Infections; Bacteria
PubMed: 37465760
DOI: 10.3389/fcimb.2023.1189081 -
Surgical Infections Apr 2020Monopolar transurethral resection of prostate (m-TURP) remains the gold standard for benign prostate obstruction (BPO). Recently developed laser surgical technique...
Monopolar transurethral resection of prostate (m-TURP) remains the gold standard for benign prostate obstruction (BPO). Recently developed laser surgical technique provides fewer peri-operative complications with equivalent outcomes. Diode laser vaporesection (DiLRP) offers better hemostasis, shorter catheterization duration, and shorter hospital stay, however, deep thermal penetration might cause prolonged prostatic urethra inflammation and subsequent complications. We conducted a retrospective study to compare the pyuria duration and post-operative urinary tract infection sequelae (POUTIs) between DiLRP and m-TURP. From July 2011 to September 2015, we retrieved medical records for patients with lower urinary tract symptoms resulting from prostate obstruction who underwent m-TURP and DiLRP. Demographic characteristics were recorded from a computerized database. The duration of pyuria after operation was compared by Kaplan-Meier analysis and risk factors were evaluated by Cox regression analysis. One hundred twelve patients underwent DiLRP and 81 underwent m-TURP performed by the same surgeon during the same period. The mean age of the patients was 72 ± 7.3 years in the DiLRP group and 70 ± 7.6 years in the m-TURP group (p = 0.069). There was a higher percentage of anticoagulant used in the DiLRP group than in the m-TURP group (18.5% vs. 7.4%, p = 0.028). Operation time was longer but post-operative normal saline irrigation interval was shorter in DiLRP compared with m-TURP, respectively (62.8 ± 20.6 vs. 47.4 ± 22.1 minutes, p < 0.001; 2.1 ± 0.3 vs. 2.5 ± 0.9 days, p < 0.001). The post-operative infections were statistically significantly higher in the DiLRP group, including epididymitis (10.2% vs. 1.2%, p = 0.013) and POUTIs-related hospitalization (8.3% vs. 1.2%, p=0.031).The DiLRP resulted in longer pyuria period (16 vs. 12 weeks, p = 0.0014), with factors including operative method by DiLRP (hazard ratio [HR]: 1.828, p = 0.003) and age (HR: 0.665, p = 0.040). According to our study, DiLRP associated with more POUTIs is possibly caused by a longer pyuria period. Further larger prospective studies are necessary for the evaluation of the association between post-operative pyuria and POUTIs.
Topics: Aged; Aged, 80 and over; Epididymitis; Hospitalization; Humans; Laser Therapy; Lasers, Semiconductor; Male; Middle Aged; Postoperative Complications; Proportional Hazards Models; Prostatic Hyperplasia; Prostatitis; Pyuria; Surgical Wound Infection; Transurethral Resection of Prostate; Urethral Stricture; Urinary Bladder Neck Obstruction; Urinary Tract Infections
PubMed: 31621501
DOI: 10.1089/sur.2019.117 -
European Journal of Medical Research Sep 2022Prostate cancer (PCa) and benign prostatic hyperplasia (BPH) are the most common prostate disorders in the UK, which cause considerable ill health in older men.... (Observational Study)
Observational Study
Selective biomarkers for inflammation and infection are associated with post-operative complications following transperineal template prostate biopsy (TTPB): a single-centre observational clinical pilot-study.
BACKGROUND
Prostate cancer (PCa) and benign prostatic hyperplasia (BPH) are the most common prostate disorders in the UK, which cause considerable ill health in older men. Transperineal template prostate biopsy (TTPB) has emerged as a reliable procedure for the histopathological diagnosis of PCa and BPH due to its higher cancer detection rates. Although antiseptic preparation and antibiotic prophylaxis are used to ensure safety in patients undergoing surgical intervention, post-operative complications, such as infection and bleeding are still unavoidable, resulting in re-admissions, with resource implications. Currently, there is no biomarker profile to predict outcomes or monitor patients during the post-operative course. The main aim of this single-centre observational clinical pilot-study was to investigate the role of inflammatory and infection biomarkers following TTPB and their association with post-operative complications.
METHODS
Forty-five patients scheduled for elective TTPB were recruited after informed consent at the Wrexham Maelor and Glan Clwyd Hospitals, North Wales, UK (n = 45). Prior to surgery, venous blood samples were collected at baseline and subsequently at 30, 120, and 240 min post-operatively. Urine samples were collected before and 120 min after the procedure. Serum procalcitonin (PCT), serum ferritin, and urine BMG analysis were done using enzyme-linked fluorescent assay (ELFA) and the magnetic Luminex multiplex performance assay was used to analyse IL-6, IL-8, IL-10 and TNF-α plasma concentrations. Data on clinical outcomes were collected from patients' medical records.
RESULTS
Following TTPB, significant (p ≤ 0.05) increases were observed in uBMG, IL-6, IL-8, IL-10 and TNF-α. Significant decreases were observed in ferritin (p ≤ 0.05). No significant change was observed in PCT concentration (p ≥ 0.05). One patient developed an infection and severe haematuria post-operatively following TTPB.
CONCLUSION
Although not confirmative, changes seen in biomarkers such as uBMG, IL-10 and TNF-α in our observational clinical pilot-study may warrant further investigation, involving larger cohorts, to fully understand the role of these biomarkers and their potential association with post-operative complications such as infection and bleeding which can develop following TTPB for the diagnosis of PCa and BPH.
Topics: Aged; Anti-Infective Agents, Local; Biomarkers; Biopsy; Ferritins; Humans; Inflammation; Interleukin-10; Interleukin-6; Interleukin-8; Male; Pilot Projects; Postoperative Complications; Procalcitonin; Prostate; Prostatic Hyperplasia; Prostatic Neoplasms; Tumor Necrosis Factor-alpha
PubMed: 36154663
DOI: 10.1186/s40001-022-00807-8 -
Expert Opinion on Drug Safety Feb 2022Chronic bacterial prostatitis (CBP) is a difficult-to-eradicate infection. Antibacterial therapy with currently licensed agents is hindered due to the increasing... (Review)
Review
INTRODUCTION
Chronic bacterial prostatitis (CBP) is a difficult-to-eradicate infection. Antibacterial therapy with currently licensed agents is hindered due to the increasing emergence of pathogen resistance worldwide and to frequent infection relapse. With limited treatment options, physicians are investigating new agents, which, however, may raise safety concerns.
AREAS COVERED
Antibacterial agents currently licensed for CBP were not considered. Available reports about the safety and efficacy of antibacterial agents that have been clinically tested or tentatively used to treat CBP in single cases were evaluated. This review also focused on agents targeting Gram-positive pathogens, whose prevalence as causative agents of CBP is increasing.
EXPERT OPINION
(i) Most antibacterial agents considered in this review have been administered off-label in the interest of patients, and their use requires particular caution. (ii) Reports describing the usage of many of the drugs reviewed here are still scant, and readers should be warned of the limited published evidence supporting therapy for CBP with these agents. (iii) As treatment must extend over several weeks, medium-term adverse events may occur and therapy should be individualized, taking into account the dosage and the potential toxicity of each specific antibiotic. Regarding dangerous drug-drug interactions, particular attention should be paid to the risk of ECG-QT-interval elongation.
Topics: Animals; Anti-Bacterial Agents; Bacterial Infections; Chronic Disease; Dose-Response Relationship, Drug; Humans; Male; Off-Label Use; Prostatitis
PubMed: 34260337
DOI: 10.1080/14740338.2021.1956459 -
Annals of Oncology : Official Journal... Aug 2020Cell entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) depends on binding of the viral spike (S) proteins to angiotensin-converting enzyme 2 and on S...
BACKGROUND
Cell entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) depends on binding of the viral spike (S) proteins to angiotensin-converting enzyme 2 and on S protein priming by TMPRSS2. Inhibition of TMPRSS2 may work to block or decrease the severity of SARS-CoV-2 infections. Intriguingly, TMPRSS2 is an androgen-regulated gene that is up-regulated in prostate cancer where it supports tumor progression and is involved in a frequent genetic translocation with the ERG gene. First- or second-generation androgen-deprivation therapies (ADTs) decrease the levels of TMPRSS2. Here we put forward the hypothesis that ADTs may protect patients affected by prostate cancer from SARS-CoV-2 infections.
MATERIALS AND METHODS
We extracted data regarding 9280 patients (4532 males) with laboratory-confirmed SARS-CoV-2 infection from 68 hospitals in Veneto, one of the Italian regions that was most affected by the coronavirus disease 2019 (COVID-19) pandemic. The parameters used for each COVID-19-positive patient were sex, hospitalization, admission to intensive care unit, death, tumor diagnosis, prostate cancer diagnosis, and ADT.
RESULTS
There were evaluable 9280 SARS-CoV-2-positive patients in Veneto on 1 April 2020. Overall, males developed more severe complications, were more frequently hospitalized, and had a worse clinical outcome than females. Considering only the Veneto male population (2.4 million men), 0.2% and 0.3% of non-cancer and cancer patients, respectively, tested positive for SARS-CoV-2. Comparing the total number of SARS-CoV-2-positive cases, prostate cancer patients receiving ADT had a significantly lower risk of SARS-CoV-2 infection compared with patients who did not receive ADT (OR 4.05; 95% CI 1.55-10.59). A greater difference was found comparing prostate cancer patients receiving ADT with patients with any other type of cancer (OR 4.86; 95% CI 1.88-12.56).
CONCLUSION
Our data suggest that cancer patients have an increased risk of SARS-CoV-2 infections compared with non-cancer patients. However, prostate cancer patients receiving ADT appear to be partially protected from SARS-CoV-2 infections.
Topics: Aged; Aged, 80 and over; Androgen Antagonists; Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Italy; Male; Middle Aged; Pandemics; Pneumonia, Viral; Population Surveillance; Prostatic Neoplasms; Risk Factors; SARS-CoV-2
PubMed: 32387456
DOI: 10.1016/j.annonc.2020.04.479 -
P. gingivalis in oral-prostate axis exacerbates benign prostatic hyperplasia via IL-6/IL-6R pathway.Military Medical Research May 2024Benign prostatic hyperplasia (BPH) is the most common disease in elderly men. There is increasing evidence that periodontitis increases the risk of BPH, but the specific...
BACKGROUND
Benign prostatic hyperplasia (BPH) is the most common disease in elderly men. There is increasing evidence that periodontitis increases the risk of BPH, but the specific mechanism remains unclear. This study aimed to explore the role and mechanism of the key periodontal pathogen Porphyromonas gingivalis (P. gingivalis) in the development of BPH.
METHODS
The subgingival plaque (Sp) and prostatic fluid (Pf) of patients with BPH concurrent periodontitis were extracted and cultured for 16S rDNA sequencing. Ligature-induced periodontitis, testosterone-induced BPH and the composite models in rats were established. The P. gingivalis and its toxic factor P. gingivalis lipopolysaccharide (P.g-LPS) were injected into the ventral lobe of prostate in rats to simulate its colonization of prostate. P.g-LPS was used to construct the prostate cell infection model for mechanism exploration.
RESULTS
P. gingivalis, Streptococcus oralis, Capnocytophaga ochracea and other oral pathogens were simultaneously detected in the Pf and Sp of patients with BPH concurrent periodontitis, and the average relative abundance of P. gingivalis was found to be the highest. P. gingivalis was detected in both Pf and Sp in 62.5% of patients. Simultaneous periodontitis and BPH synergistically aggravated prostate histological changes. P. gingivalis and P.g-LPS infection could induce obvious hyperplasia of the prostate epithelium and stroma (epithelial thickness was 2.97- and 3.08-fold that of control group, respectively), and increase of collagen fibrosis (3.81- and 5.02-fold that of control group, respectively). P. gingivalis infection promoted prostate cell proliferation, inhibited apoptosis, and upregulated the expression of inflammatory cytokines interleukin-6 (IL-6; 4.47-fold), interleukin-6 receptor-α (IL-6Rα; 5.74-fold) and glycoprotein 130 (gp130; 4.47-fold) in prostatic tissue. P.g-LPS could significantly inhibit cell apoptosis, promote mitosis and proliferation of cells. P.g-LPS activates the Akt pathway through IL-6/IL-6Rα/gp130 complex, which destroys the imbalance between proliferation and apoptosis of prostate cells, induces BPH.
CONCLUSION
P. gingivalis was abundant in the Pf of patients with BPH concurrent periodontitis. P. gingivalis infection can promote BPH, which may affect the progression of BPH via inflammation and the Akt signaling pathway.
Topics: Male; Prostatic Hyperplasia; Porphyromonas gingivalis; Rats; Humans; Animals; Interleukin-6; Receptors, Interleukin-6; Prostate; Periodontitis; Aged; Middle Aged; Rats, Sprague-Dawley; Disease Models, Animal; Signal Transduction
PubMed: 38764065
DOI: 10.1186/s40779-024-00533-8 -
The Pan African Medical Journal 2020the occurrence of urinary tract infection in patients with obstructing prostate causes reduction in their health-related quality of life and overall well-being. The...
INTRODUCTION
the occurrence of urinary tract infection in patients with obstructing prostate causes reduction in their health-related quality of life and overall well-being. The objective of this study was to determine the prevalence, risk factors and antimicrobial sensitivity pattern of pathogens causing urinary tract infection in patients with benign prostatic hyperplasia and prostate cancer.
METHODS
all patients who presented to our urology division with bladder outlet obstruction secondary to benign prostatic hyperplasia or prostate cancer between January 2016 and January 2019 were included. Information on age, co-morbid conditions, presence of an indwelling catheter, bacteriologic analysis, imaging findings and histological diagnosis were obtained and analyzed using SPSS version 20.
RESULTS
de-novo urinary tract infection occurred in 35.6% of patients while recurrent infection occurred in 5.9% of them. The most commonly isolated organisms were gram-negative bacteria with Escherichia coli, Klebsiella spp, Citrobacter spp and Aerobacter spp accounting for 62.2%, 27.0%, 8.1% and 2.7% respectively. Nitrofurantoin (64.3%), Ceftriaxone (46.3%) and Genticin (42.9%) were the three most sensitive antimicrobials to the organisms isolated. Only the presence of an indwelling catheter in the bladder was an independent predictor of urinary tract infection in the study population.
CONCLUSION
about one-third of patients with benign prostatic hyperplasia and prostate cancer develop urinary tract infection. The predominant bacterial cause was Escherichia coli, which had a high degree of sensitivity to Nitrofurantoin. The presence of an indwelling catheter was the only independent predictor of this infection. Appropriate measures should be re-enforced to prevent the occurrence of catheter-associated infections.
Topics: Acute Disease; Aged; Bacteria; Catheter-Related Infections; Catheters, Indwelling; Cross-Sectional Studies; Humans; Male; Middle Aged; Prostatic Hyperplasia; Prostatic Neoplasms; Quality of Life; Risk Factors; Urinary Bladder Neck Obstruction; Urinary Catheters; Urinary Tract Infections
PubMed: 32952813
DOI: 10.11604/pamj.2020.36.169.21038 -
Medicina (Kaunas, Lithuania) May 2023To assess the effects of fosfomycin compared with other antibiotics as a prophylaxis for urinary tract infections (UTIs) in men undergoing transrectal prostate... (Meta-Analysis)
Meta-Analysis Review
To assess the effects of fosfomycin compared with other antibiotics as a prophylaxis for urinary tract infections (UTIs) in men undergoing transrectal prostate biopsies. We searched multiple databases and trial registries without publication language or status restrictions until 4 January 2022. Parallel-group randomized controlled trials (RCTs) and non-randomized studies (NRS) were included. The primary outcomes were febrile UTI, afebrile UTI, and overall UTI. We used GRADE guidance to rate the certainty of evidence of RCTs and NRSs. The protocol was registered with PROSPERO (CRD42022302743). We found data on five comparisons; however, this abstract focuses on the primary outcomes of the two most clinically relevant comparisons. Regarding fosfomycin versus fluoroquinolone, five RCTs and four NRSs with a one-month follow-up were included. Based on the RCT evidence, fosfomycin likely resulted in little to no difference in febrile UTIs compared with fluoroquinolone. This difference corresponded to four fewer febrile UTIs per 1000 patients. Fosfomycin likely resulted in little to no difference in afebrile UTIs compared with fluoroquinolone. This difference corresponded to 29 fewer afebrile UTIs per 1000 patients. Fosfomycin likely resulted in little to no difference in overall UTIs compared with fluoroquinolone. This difference corresponded to 35 fewer overall UTIs per 1000 patients. Regarding fosfomycin and fluoroquinolone combined versus fluoroquinolone, two NRSs with a one- to three-month follow-up were included. Based on the NRS evidence, fosfomycin and fluoroquinolone combined may result in little to no difference in febrile UTIs compared with fluoroquinolone. This difference corresponded to 16 fewer febrile UTIs per 1000 patients. Compared with fluoroquinolone, fosfomycin or fosfomycin and fluoroquinolone combined may have a similar prophylactic effect on UTIs after a transrectal prostate biopsy. Given the increasing fluoroquinolone resistance and its ease to use, fosfomycin may be a good option for antibiotic prophylaxis.
Topics: Male; Humans; Fosfomycin; Antibiotic Prophylaxis; Prostate; Anti-Bacterial Agents; Urinary Tract Infections; Biopsy; Fluoroquinolones
PubMed: 37241143
DOI: 10.3390/medicina59050911 -
World Journal of Urology Nov 2023To collect a multicentric, global database to assess current preferences and outcomes for endoscopic enucleation of the prostate (EEP).
Results from a global multicenter registry of 6193 patients to refine endoscopic anatomical enucleation of the prostate (REAP) by evaluating trends and outcomes and nuances of prostate enucleation in a real-world setting.
PURPOSE
To collect a multicentric, global database to assess current preferences and outcomes for endoscopic enucleation of the prostate (EEP).
METHODS
Endourologists experienced in EEP from across the globe were invited to participate in the creation of this retrospective registry. Surgical procedures were performed between January 2020 and August 2022.
INCLUSION CRITERIA
lower urinary tract symptoms not responding to or worsening despite medical therapy and absolute indication for surgery.
EXCLUSION CRITERIA
prostate cancer, concomitant lower urinary tract surgery, previous prostate/urethral surgery, pelvic radiotherapy.
RESULTS
Ten centers from 7 countries, involving 13 surgeons enrolled 6193 patients. Median age was 68 [62-74] years. 2326 (37.8%) patients had large prostates (> 80 cc). The most popular energy modality was the Holmium laser. The most common technique used for enucleation was the 2-lobe (48.8%). 86.2% of the procedures were performed under spinal anesthesia. Median operation time was 67 [50-95] minutes. Median postoperative catheter time was 2 [1, 3] days. Urinary tract infections were the most reported complications (4.7%) followed by acute urinary retention (4.1%). Post-operative bleeding needing additional intervention was reported in 0.9% of cases. 3 and 12-month follow-up visits showed improvement in symptoms and micturition parameters. Only 8 patients (1.4%) required redo surgery for residual adenoma. Stress urinary incontinence was reported in 53.9% of patients and after 3 months was found to persist in 16.2% of the cohort.
CONCLUSION
Our database contributes real-world data to support EEP as a truly well-established global, safe minimally invasive intervention and provides insights for further research.
Topics: Male; Humans; Aged; Prostate; Retrospective Studies; Laser Therapy; Prostatectomy; Transurethral Resection of Prostate; Prostatic Hyperplasia; Lasers, Solid-State; Treatment Outcome
PubMed: 37782323
DOI: 10.1007/s00345-023-04626-2