Effection Of Proin Flammatory Cytokines And Heat Shock Protein On The Pathogenetic Mechanism Of Benign Prostate Hyperplasia With Prostatitis

PART Relative factor analysis of benign prostatic hyperplasiaassociated with histological prostatitisObjective： To provide feasible basis for clinical treatment throughanalysing and comparing relative factors of patients with benign prostatichyperplasia, and patients with benign prostatic hyperplasia and histologicalprostatitis.Methods： According to histopathological diagnosis, hospitalizedpatients(60cases) were divided into two groups,prostatic hyperplasia withprostatitis group (45cases) and BPH group(15cases). These60cases werereceived TURP surgical treatment due to urinary retention or LUTS.All dataincluding the patients’ age, history of urinary retention, complications, theinternational prostate symptom score (IPSS), quality of life score (QOL), andprostate volume, residual urine volume, maximum urine flow rate (Qmax),PSA, serum c-reactive protein (CRP), the total number of white blood cells inthe blood, white blood cell count in urine and other clinical parameters werecollected and compared.Results：1Comparing two groups of patients with complications: the cases(2/15,13%) with a history of urinary retention in simple BPH group werelower than the cases (18/45,40%) in BPH with inflammation group (P <0.05);the cases of diabetes mellitus in group of simple BPH patients weresignificantly lower than inflammation group (P <0.05), and othercomplications such as hypertension, coronary heart disease andhyperlipidemia between the two groups had no significant difference (P>0.05). 2General data comparison in two groups of patients: there weresignificant differences between two groups of patients in average age, Theaverage age among BPH patient was higher than that in BPH withinflammation group (P<0.05); IPSS and QOL score in inflammation groupwas higher than the score in BPH group (P<0.05), RUV, maximum urinaryflow rate (Qmax) and residual urine prostatic volume had significantdifference (P<0.05) between the two groups, the average residual urine andprostate volume in inflammation group were greater than BPH group, and themaximum urine flow rate was lower than that in BPH group.3Comparison of the PSA,CRP level and leucocyte counts in blood andurine in two groups: the leucocyte counts in the routine examination of bloodand urine between the two groups was no significant difference (P>0.05);The level of PSA and CRP in BPH with prostatic inflammation groupwere higher than that in simple BPH group (P<0.05).Conclusions：1The incidence of urinary retention, prostate volume, IPSS, QOL score,the level of blood PSA in BPH with histological prostatitis group weresignificantly higher than that of simple BPH. Prostatitis may promote theclinical progress of BPH, and increase the chance of surgical treatment inpatients with BPH.2Elevation of plasma C-reactive protein level in BPHwith prostatitisindicates prostatitis may be a systemic inflammatory response, CRP can beused as a clinical preoperative serum marker of selectivity of the existence ofprostatitis.3The increased incidence of diabetes mellitus in BPH with prosttitisindicated that metabolic disease may have a promoting effect on BPH withprostatitis.Part Ⅱ Association and expression study of proinflammatorycytokins in BPH with prostatitisObjective: To study the expression and clinical significance ofproinflammatory cytokins:tumor necrosis factor alpha (TNF-α), interleukin6 (IL-6) and CD3in prostate tissue and serum in60cases which received TURPsurgical treatment due to urinary retention or LUTS.Methods:60patients who received TURP surgery for urinary retentionor LUTS BPH patients, divided into BPH group (15cases) and BPH withprostatitis group (45cases), The patients’s general information were collected.Prostate tissue was obtained from the transition zone of the urethra duringTURP process,then immediately stored in the-80°c condition. Tumor necrosisfactor alpha (TNF-α), interleukin6(IL-6), and the content of CD3detectedthrough western blot method in prostate tissue and enzyme-linkedimmunosorbent assay (ELISA) in serum.and tumor necrosis factor alpha(TNF-α), the levels of interleukin6(IL-6). And expression of TNF-α, IL-6andCD3were detected through immunohistochemical method to insure site ofthese in prostate tissue.The BPH and BPH with prostatitis groups,urinaryretention and LUTS groups, high IPSS and low IPSS groups were compared inthe expression of TNF-α,IL-6,CD3in prostatic tissue and plasma.Results: Expression of TNF-α,IL-6,CD3in BPH with histologicalinflammation group is significantly higher than that in BPH. Proinflammatorycytokins levels in urinary retention group was significantly higher than thatof LUTS group, Expression of TNF-α,IL-6,CD3in high IPSS group (IPSS>25)was higher than low IPSS group(IPSS19-25). Expression of TNF-α,IL-6,CD3among Mild, moderate, severe inflammation in BPH also had significantlystatistical differences.Expression of TNF-α,IL-6,CD3in severe inflammationin BPH was highest.Conclusion: TNF-α,IL–6,CD3levels increased in BPH with prostatitis inlocal prostate tissue, the serum TNF–α and IL-6also increased. TNF-α,IL–6levels also increased in the urinary retention and high IPSS score groups inlocal prostate tissue and serum. Proinflammatory factor,TNF-α and IL-6,CD3were significantly increased in inflammatory stimuli reaction, they mayparticipate in the pathogenesis of chronic inflammation in prostate hyperplasiaand was induced by proinflammatory factor they could be used as evaluationof molecular biology in low urinary tract symptoms. Part Ⅲ Association and expression study of heat shock protein27inBPH with prostatitisObjective: To study the expression and clinical significance of heatshock protein27in prostate tissue and serum of patients in BPH and BPHwith prostatitis groupsMethods:60patients who received TURP surgery for urinary retentionor LUTS BPH patients, divided into BPH group (15cases) and BPH withprostatitis group (45cases).Prostate tissue was obtained from the transitionzone of the urethra during TURP process,then immediately stored in the-80°ccondition.HSP27was detected through western blot andimmunohistochemical staining methods in prostate tissue and enzyme-linkedimmunosorbent assay (ELISA) in serum.The BPH and BPH with prostatitisgroups,urinary retention and LUTS groups, high IPSS and low IPSS groupswere compared in the expression of HSP27in prostatic tissue and plasma.Thecorrelation analysis of the expression of HSP27with TNF-alpha, IL-6,CD3was underwent in BPH and BPH with prostatitis groups.Results: Expression of HSP27in BPH with histological inflammationgroup was significantly higher than that in BPH. HSP27levels in urinaryretention group was significantly higher than that of LUTS group, Expressionof HSP27in high IPSS group (IPSS>25) was higher than low IPSSgroup(IPSS19-25).Expression of HSP27among Mild, moderate, severeinflammation in BPH also had significantly statistical differences.Expressionof HSP27in severe inflammation in BPH was highest in three different degreeinflammation.Conclusions:1HSP27expression in BPH with prostatitis group was higher than that ofBPH group, and it in urinary retention and high IPSS group was higher thanthat in LUTS group and the low IPSS group, small molecule HSP27may be asa molecular chaperone to participate in the pathogenesis of inflammationstimulation to the prostate in BPH clinical symptoms progress.2The rise of TNF-α,IL-6,CD3in BPH with prostatitis had obviously correlation with HSP27.The molecular signaling pathway was needed furtherresearched about the relationship between HSP27and proinflammatoryfactors.