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Autoimmune prostatitis: Evidence of T cell reactivity with normal prostatic proteins

  • Richard B. Alexander
    Correspondence
    Reprint requests: Richard B. Alexander, Urology Section, VA Medical Center, 10 North Greene Street, Baltimore, MD 21201.
    Affiliations
    From the Urology Section, VA Maryland Health Care System, and Division of Urology, University of Maryland School of Medicine, Baltimore, Maryland, USA
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  • Francine Brady
    Affiliations
    From the Urology Section, VA Maryland Health Care System, and Division of Urology, University of Maryland School of Medicine, Baltimore, Maryland, USA
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  • Sathibalan Ponniah
    Affiliations
    From the Urology Section, VA Maryland Health Care System, and Division of Urology, University of Maryland School of Medicine, Baltimore, Maryland, USA
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      Abstract

      Objectives

      To determine whether men with chronic prostatitis/chronic pelvic pain syndrome have evidence of an autoimmune response to prostatic proteins. We examined men with a history of chronic prostatitis/ chronic pelvic pain syndrome for evidence of T lymphocyte reactivity to seminal plasma.

      Methods

      Patients underwent automated leukopheresis to obtain peripheral blood mononuclear cells. We performed a recall antigen proliferation assay to detect specific proliferation of peripheral helper T lymphocytes in men with chronic prostatitis/chronic pelvic pain syndrome and compared the results with those of normal men. The antigen for these studies consisted of seminal plasma from normal donors and men with seminal vesicle atresia.

      Results

      A specific recall proliferative response to seminal plasma was observed in 3 of 10 men with a history of chronic prostatitis/chronic pelvic pain syndrome compared with none of 15 normal men. The CD4 T cell proliferative response to seminal plasma was statistically significant when compared with medium alone in men with a history of chronic prostatitis/chronic pelvic pain syndrome but it was not statistically significant in normal men. The recall responses of both the chronic prostatitis/chronic pelvic pain syndrome group and normal subjects to the recall antigens tetanus toxoid and Candida extract were equivalent.

      Conclusions

      The data represent the first direct evidence that some men with chronic prostatitis/chronic pelvic pain syndrome have an autoimmune component to their disease. Autoimmunity is a potential etiology for chronic nonbacterial prostatitis.
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