| Background: Type Ⅲ Prostatitis is also called the Chronic nonbacterial Prostatitis(Chronic Prostatitis, CP)/Chronic Pelvic Pain Syndrome(Chronic Pelvic Pain Syndrome, CPPS), is one of the male urogenital system common disease. The clinical manifestations of chronic pelvic pain of area and urinary irritation or symptoms associated with urination, may be accompanied by anxiety, depression and other mental disorders, part can be associated with sexual dysfunction, most with a significant reduction in the quality of life. Pathogen infection, urine reflux, mental psychological factors, abnormal pelvic nerve muscle activity and the function of immune abnormalities and many factors are considered to be Ⅲ type primary causes of prostatitis. Its histopathological performance for prostate gland bubble near the cavity and interstitial inflammatory cell infiltration and interstitial inflammatory cell infiltration is often accompanied by infiltrating glands around, inflammatory cells are limited to the glandular epithelium and glands, within the glandular lumens are known as one of the inflammatory cells are mainly neutrophils, lymphocytes and macrophages, etc.Clinical treatment with the empirical use of antibiotics, anti-inflammatory and improve symptoms of comprehensive treatment. To merge the urinary tract obstruction of CP/CPPS patients, application of alpha blockers can have apparent curative effect; Nonsteroidal anti-inflammatory drugs can play a dual role of anti-inflammatory and relieving pain. Regular prostate massage can make part of CP/CPPS patients subjective symptoms improved, but the clinical compliance is poor; There are some other drug or treatment, such as ring oxidase inhibitors, plant medicine, spasmolysis medicine, antidepressants, biofeedback technology, physical therapy of prostate, etc., but the curative effect of individual differences, a lack of clear evidence of evidence-based medicine. All in all, CP/CPPS etiology is unknown, complex clinical manifestations, the treatment of any single method can’t for all the CP/CPPS patients to produce ideal curative effect.At the same time, some of the media on the society and medical institutions, one-sided exaggerated the dangers of the disease, patients with a heavy psychological burden and economic burden; And public medical institutions doctors suffer from a lack of effective treatment, and overlooked the individualized treatment for these patients, including the implementation of psychological counseling and health education, and lead to much Ⅲ type prostatitis patients is not comprehensive, personalized and effective treatment. So clear the pathogenesis of type Ⅲ prostatitis and to explore effective treatment is essential. Ⅲ type diversification, prostatitis disease factors and interweave each other, the current related research lacks pertinence and systemic, at the same time Ⅲ type prostatitis animal models of experimental research because of the lack of social psychological factors of building conditions, and type Ⅲ prostatitis patients pathologic physiology there are still some differences.The concept of "histological Prostatitis" by the us National Institutes of Health(National Institutes of Health, the NIH) Chronic Prostatitis Collaborative Research group(Chronic Prostatitis Collaborative Research Network, CPCRN) and International Prostatitis Collaborative Networks(International Prostatitis Collaborative Networks, IPCN) was proposed in 2001 by Chronic Prostatitis histological classification system, specific classification standard is: a. mild: prostate tissue in scattered inflammatory cells infiltration. B. moderate: concentrations of inflammatory cells in the prostate tissue, but without glandular epithelial tissue damage or lymphoid nodule formation; C. severe: concentrations of inflammatory cells in the prostate tissue, at the same time, with glandular epithelial tissue damage or lymphoid nodule formation. With inflammatory infiltration of prostate tissue for the classification system for the only dividing the basis, and Ⅲ histopathological manifestation of prostatitis is highly similarity, based on the research of the animal model of platform, will be further defined Ⅲ type the immunological mechanisms and clinical treatment of prostatitis provide a solid foundation.Objective: Start with Benign prostatic hyperplasia(Benign prostatic hyperplasia, BPH) merger histological prostatitis as the research object, based on immune regulation gene TIPE2 targets, to analyze its expression level in histological prostatitis and related influence factors, to reveal Ⅲ type prostatitis immunological mechanisms of the disease; Second histological prostatitis animal model is established, in view of the TIPE TNF alpha- 2 control downstream of inflammatory factor, Infliximab(remicade, application of xidan resistance(Infliximab) implementation of targeted therapy, analysis of prostate tissue levels of inflammatory treatment effect, analysis of related factors, explore the new methods of type Ⅲ prostatitis treatment.Method: 1. The immunohistochemical method to detect TIPE- 2 in BPH tissues and BPH with histological prostatitis expression in the organization, and reading scores after comparing its expression differences between groups, analyze TIPE- 2 associated with chronic prostatitis histological classification of different level and the relationship between clinical data. 2. 60 healthy male SD rats, 20 were randomly divided into experimental group and the control group, only 20 blank group and 20; Experimental group in downlink prostate surgery injected freund’s adjuvant histological prostatitis animal model is established, the control line the same surgical method prostate parts injection of saline control model is established, blank group only underwent surgical way but not the same for prostate parts injection; After 7 days by immunohistochemical method determination of three groups of TNF- a expression level; Infiliximab rats fed three groups respectively, 30 days after the execution, line prostate biopsy and immunohistochemical method and determination of the same set of TNF- a expression level, compare the level of TNF- a difference before and after the intervention, evaluating the effect of Infiliximab.Results: 1. BPH with histological prostatitis tissue TIPE- 2 protein expression significantly lower than the amount of expression in the BPH group, the difference between the two groups had significant statistical significance(P < 0.01); TIPE- 2 protein expression in mild and moderate prostatitis tissue staining scores than in its expression of dyeing score in severe group(P < 0.05), especially more obvious difference in the mild group(P < 0.01); And mild dyeing score is higher than moderate group(P < 0.05). With histological prostatitis patients with BPH, the incidence of urinary retention, prostate volume, IPSS, QOL score, blood PSA group were significantly higher than that of simple hyperplasia, etc. 2. The rats in the experimental group A of the expression of TNF alpha level was lower than that in group B(P < 0.05), A group of rats compared with group B color brightness, eating more and more active; Inflammation of the prostate in group A was significantly lower than that of group B(P < 0.01). Experimental prostate tissue inflammatory cell infiltration degree and TNF-a significantly lower than the control group and blank group(P < 0.01), no significant difference between control group and blank group(P > 0.05).Conclusion: 1. TIPE2 expression decreased significantly in the histological prostatitis, immune mechanisms involved in regulation of the histological prostatitis pathological physiological process, may play a role of negative control, and suggests the CP/CPPS and instability of the autoimmune mechanism; Histological prostatitis may promote the occurrence of BPH. 2. The application of immune technique can be successfully manufactured organized prostatitis animal model; In histological prostatitis animal model group, the application of TNF alpha Infiliximab monoclonal antibody drug treatment, experimental inflammatory factor TNF alpha was significantly reduced, Infiliximab organized prostatitis treatment pay off, and no obvious effect on normal prostate tissue, prompt Infiliximab could be a potential target therapy drug for the treatment of CP/CPPS. |
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