Combined treatment of patients with chronic abacterial prostatitis and depressive syndrome
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Abstract
Chronic abacterіal prostatitis (CAP) - the most common variant of chronic inflammation of the prostate. The disorders of the nervous system, in particular depression, play an important role in the pathogenesis of the CAP.
The objective. Evaluate the effectiveness of an inhibitor of serotonin reuptake (sertraline) in treatment of patients with chronic abacterial prostatitis and depressive syndrome in conjunction with the contents of proinflammatory and anti-inflammatory cytokines in the ejaculate. Patients and methods. Sixty-four patients with CAP aged 19 to 38 years were included in the study. Patients of the main groups (n=32) received rectal electrostimulation (10 sessions a day later) in combination with oral sertraline (50–200 mg/day) for 1 month. Patients of the control group (n=32) received only physiotherapy.
To assess the symptoms of chronic prostatitis using questionnaire NIH-CPSI. Symptoms of depression were studied using the PHQ-9 questionnaire. Concentration of cytokines in the ejaculate was determined by ELISA.
Results. Under the influence of the treatment showed a significant reduction in the symptoms of chronic prostatitis and depression, a statistically significant (p <0.05) reduction in the concentration of antiinflammatory cytokines ejaculate (IL-1в, IL-8, TNF-б) in the study and control groups. A significant increase in the concentration of anti-inflammatory cytokines ejaculate (IL-10, TGF-в) was only observed in patients of the main group. Clinical efficacy in the symptoms of chronic prostatitis in the study group was significantly greater (p<0,05) than the control group and was 84% versus 63%, and in respect of the symptoms of depression – that 63 34%, respectively.
Conclusion. The results demonstrate the effectiveness (84%) of the combination of physiotherapy and antidepressant (sertraline) in the treatment of CAP, and also show the role of neuro-immune regulation and its disorders (including depressive disorders) in the pathogenesis of СAP.
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References
Nickel J.C., Roehrborn C.G., O’Leary M.P. et al. The relationship between prostate inflammation and lower urinary tract symptoms: examination of baseline data from the reduce trial // Eur. Urol. – 2008. – No 54. – P. 1379–1384.
Schaeffer A.J., Knauss J.S., Landis J.R. et al. Chronic Prostatitis Collaborative Research Network Study Group. Leukocyte and bacterial counts do not correlate with severity of symptoms in men with chronic prostatitis: the national institutes of health chronic prostatitis cohort study // J. Urol. – 2002. – No 168. – P. 1048–1053.
Krsmanovic A., Tripp D.A., Nickel J.C. et al. Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) // Can. Urol. Assoc. J. – 2014. – No 8 (11–12). – P. 403–408.
Нуріманов К.Р. Вплив лейкоцитів та гінтерферонусперми на показники фертильності у хворих на хронічний абактеріальний простатит // Здоровье мужчины. – 2015. – No 4. – С. 82–84.
Горпинченко И.И., Нуриманов К.Р., Порошина Т.В., Савченко В.С., Дранник Г.Н. Проблемы идиопатического мужского бесплодия // Здоровье мужчины. – 2016. – No 1. – С. 133-136.
Pontari M.A., McNaughton-Collins M., O’leary M.P. et.al. CPCRN Study G A case-control study of risk factors in men with chronic pelvic pain syndrome // B.J.U. Int. – 2005. – N.96. – P. 559–565.
Rakoff-Nahoum S. Why cancer and inflammation? // Yale J. Biol. Med. – 2006. – No 79. – P. 123–130.
Reyes-Gibby C.C., Aday L.A., Anderson K.O., Mendoza T.R., Cleeland C.S. Pain, depression, and fatigue in community-dwelling adults with and without a history of cancer // J. Pain Symptom Manage. – 2006. – No 32. – P. 118–128.
Mao J.J., Armstrong K., Bowman M.A., Xie S.X., Kadakia R., Farrar J.T. Symptom burden among cancer survivors: impact of age and comorbidity // J. Am. Board Fam. Med. – 2007. – No 20. – P. 434–443.
Isik A., Koca S.S., Ozturk A., Mermi O. Anxiety and depression in patients with rheumatoid arthritis // Clin. Rheumatol. – 2007. – No 26. – P. 872–878.
Kessler R.C., Berglund P., Demler O., Jin R., Merikangas K.R., Walters E.E. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication // Arch Gen Psychiatry. – 2005. – No 62. – P. 593–602.
Fava M., Davidson K.G. Definition and epidemiology of treatment-resistant depression // Psychiatr. Clin. North. Am. – 1996. – No 19. – P. 179–200.
Kroenke K., Bair M.J., Damush T.M., Wu J., Hoke S., Sutherland J., Tu W. Optimized antidepressant therapy and pain self-management in primary care patients with depression and musculoskeletal pain: a randomized controlled trial // J.A.M.A. – 2009. – No 301. – P. 2099–2110.
Walker A.K., Kavelaars A., Heijnen C.J., and Dantzer R. Neuroinflammation and Comorbidity of Pain and Depression // Pharmacol. Rev. – 2014 – No 66 (1). – P. 80–101.
Banks W.A., Kastin A.J. Blood to brain transport of interleukin links the immune and central nervous systems // Life Sci. – 1991. – No 48. – PL117–PL121.
Gutierrez E.G., Banks W.A., Kastin A.J. Murine tumor necrosis factor alpha is transported from blood to brain in the mouse // J. Neuroimmunol. – 1993. – No 47. – P. 169–176.
Banks W.A. Blood-brain barrier transport of cytokines: a mechanism for neuropathology // Curr. Pharm. Des. – 2005. – No 11. – P. 973–984.
Watkins L.R., Maier S.F, Goehler L.E. Cytokine-to-brain communication: a review & analysis of alternative mechanisms // Life Sci. – 1995. – No 57. – P. 1011–1026.
Dantzer R. Cytokine-induced sickness behaviour: a neuroimmune response to activation of innate immunity // Eur. J. Pharmacol. – 2004. – No 500. – P. 399–411.
Kent S., Bluthй R.M., Kelley K.W., Dantzer R. Sickness behavior as a new target for drug development // Trends Pharmacol. Sci. – 1992. – No 13. – P. 24–28.
Goehler L.E., Gaykema R.P., Nguyen K.T., Lee J.E., Tilders F.J., Maier S.F., Watkins L.R. Interleukin-1beta in immune cells of the abdominal vagus nerve: a link between the immune and nervous systems? // J. Neurosci. – 1999. – No 19. – P. 2799–2806.
Wan W., Janz L., Vriend C.Y., Sorensen C.M., Greenberg A.H., Nance D.M. Differential induction of c-Fos immunoreactivity in hypothalamus and brain stem nuclei following central and peripheral administration of endotoxin // Brain Res. Bull. – 1993. – No 32. – P. 581–587.
Brady L.S., Lynn A.B., Herkenham M., Gottesfeld Z. Systemic interleukin-1 induces early and late patterns of c-fos mRNA expression in brain // J. Neurosci. – 1994. – No 14. – P. 4951–4964.
Konsman J.P., Tridon V., Dantzer R. Diffusion and action of intracerebroventricularly injected interleukin-1 in the CNS // Neuroscience. – 2000. – No 101. – P. 957–967.
Maes M., Lambrechts J., Bosmans E., Jacobs J., Suy E., Vandervorst C., de Jonckheere C., Minner B., Raus J. Evidence for a systemic immune activation during depression: results of leukocyte enumeration by flow cytometry in conjunction with monoclonal antibody staining // Psychol. Med. – 1992. – No 22. – P. 45–53.
Capuron L., Ravaud A., Dantzer R. Early depressive symptoms in cancer patients receiving interleukin 2 and/or interferon alfa-2b therapy // J. Clin. Oncol. – 2000. – No 18. – P. 2143–2151.
Kraus J., Engelhardt B., Chatzimanolis N., Bauer R., Tofighi J., Kuehne B.S., Laske C., Stolz E., Frielinghaus P., Schaefer C., et al. Cell surface bound and soluble adhesion molecules in CSF and blood in multiple sclerosis: correlation with MRI-measures of subclinical disease severity and activity // J. Neuroimmunol. – 2002. – No 122. – P. 175–185.
Raison C.L., Woolwine B.J., Demetrashvili M.F., Borisov A.S., Weinreib R., Staab J.P., Zajecka J.M., Bruno C.J., Henderson M.A., Reinus J.F., et al. Paroxetine for prevention of depressive symptoms induced by interferon-alpha and ribavirin for hepatitis C // Aliment. Pharmacol. Ther. – 2007. – 25. – P. 1163–1174.
Musselman D.L., Lawson D.H., Gumnick J.F., Manatunga A.K., Penna S., Goodkin R.S., Greiner K., Nemeroff C.B., Miller A.H. Paroxetine for the prevention of depression induced by high-dose interferon alfa // N. Engl. J. Med. 2001. – No 344. – P. 961–966.
Capuron L., Ravaud A., Neveu P.J., Miller A.H., Maes M., Dantzer R. Association between decreased serum tryptophan concentrations and depressive symptoms in cancer patients undergoing
cytokine therapy // Mol. Psychiatry. – 2002. – No 7. – P. 468–473.
Kent S., Kelley K.W., Dantzer R. Effects of lipopolysaccharide on food-motivated behavior in the rat are not blocked by an interleukin-1 receptor antagonist // Neurosci. Lett. – 1992. – No 145. – P. 83–86.
Yirmiya R. Endotoxin produces a depressive-like episode in rats // Brain Res. – 1996. – No 711. – P. 163–174.
O’Connor J.C., Andre C., Wang Y., Lawson M.A., Szegedi S.S., Lestage J., Castanon N., Kelley K.W., Dantzer R. Interferon-γ and tumor necrosis factor-α mediate the upregulation of indoleamine 2,3-dioxygenase and the induction of depressive-like behavior in mice in response to bacillus Calmette-Guerin // J. Neurosci. – 2009. – No 29. – P. 4200–4209.
O’Connor J.C., Lawson M.A., Andre C., Briley E.M., Szegedi S.S., Lestage J., Castanon N., Herkenham M., Dantzer R., Kelley K.W. Induction of IDO by bacille Calmette-Guerin is responsible for development of murine depressive-like behavior // J. Immunol. – 2009. – No 182. – P. 3202–3212.
O’Connor J.C., Lawson M.A, Andre C., Moreau M., Lestage J., Castanon N., Kelley K.W., Dantzer R. Lipopolysaccharide-induced depressive-like behavior is mediated by indoleamine 2,3-dioxygenase activation in mice // Mol. Psychiatry. – 2009. – No 14. – P. 511–522.
Yirmiya R. Endotoxin produces a depressive-like episode in rats // Brain Res. – 1996. – No 711. – P. 163–174.
Strike P.C., Wardle J., Steptoe A. Mild acute inflammatory stimulation induces transient negative mood // J. Psychosom. Res. – 2004. – No 57. – P. 189–194.
Wright C.E., Strike P.C., Brydon L., Steptoe A. Acute inflammation and negative mood: mediation by cytokine activation // Brain. Behav. Immun. – 2005. – No 19. – P. 345–350.
Harrison N.A., Brydon L., Walker C., Gray M.A., Steptoe A., Critchley H.D. Inflammation causes mood changes through alterations in subgenual cingulate activity and mesolimbic connectivity // Biol. Psychiatry. – 2009. – No 66. – P. 407–414.
Reichenberg A., Yirmiya R., Schuld A, Kraus T., Haack M., Morag A., Pollmдcher T. Cytokine-associated emotional and cognitive disturbances in humans // Arch. Gen. Psychiatry. – 2001. – No 58. – P. 445–452.
Finnerup N.B., Otto M., McQuay H.J., Jensen T.S., Sindrup S.H. Algorithm for neuropathic pain treatment: an evidence based proposal // Pain. – 2005. – No 118. – P. 289–305.
Goldstein D.J, Lu Y., Detke M.J., Lee T.C., Iyengar S. Duloxetine vs. placebo in patients with painful diabetic neuropathy // Pain. – 2005. – No 116. – P. 109–118.
Dharmshaktu P., Tayal V., Kalra B.S. Efficacy of antidepressants as analgesics: a review // J. Clin. Pharmacol. – 2012. – No 52. – P. 6–17.
Hannestad J., DellaGioia N., Bloch M. The effect of antidepressant medication treatment on serum levels of inflammatory cytokines: a meta-analysis // Neuropsychopharmacology. – 2011. – No 36. – P. 2452–2459.
Fu K.Y., Light A.R., Maixner W. Relationship between nociceptor activity, peripheral edema, spinal microglial activation and long-term hyperalgesia induced by formalin // Neuroscience. – 2000. – No 101. – P. 1127–1135.
Boyce-Rustay J.M., Honore P., Jarvis M.F. Animal models of acute and chronic inflammatory and nociceptive pain // Methods Mol. Biol. – 2010. – No 617. – P. 41–55.
Wang L.X., Wang ZJ. Animal and cellular models of chronic pain // Adv. Drug Deliv. Rev. – 2003. – No 55. – P. 949–965.
Tanga F.Y., Nutile-McMenemy N., DeLeo J.A. The CNS role of Toll-like receptor 4 in innate neuroimmunity and painful neuropathy // Proc. Natl. Acad. Sci. USA. – 2005. – No 102. – P. 5856–5861.
Oprйe A., Kress M. Involvement of the proinflammatory cytokines tumor necrosis factor-б, IL-1в, and IL-6 but not IL-8 in the development of heat hyperalgesia: effects on heat-evoked calcitonin gene-related peptide release from rat skin // J. Neurosci. – 2000. – No 20. – P. 6289–6293.
Obreja O., Rathee P.K., Lips K.S., Distler C., Kress M. IL-1 beta potentiates heat-activated currents in rat sensory neurons: involvement of IL-1R1, tyrosine kinase, and protein kinase C // FASEB J. – 2002. – No 16. – P. 1497–1503.
Parada C.A., Yeh J.J., Joseph E.K., Levine J.D. Tumor necrosis factor receptor type-1 in sensory neurons contributes to induction of chronic enhancement of inflammatory hyperalgesia in rat // Eur. J. Neurosci. – 2003. – No 17. – P. 1847–1852.
Shoskes D.A., Albakri Q., Thomas K., Cook D. Cytokine polymorphisms in men with chronic prostatitis/chronic pelvic pain syndrome: association with diagnosis and treatment response // J. Urol. – 2002. – No 168. – P. 331–335.
Uзeyler N., Valenza R., Stock M., Schedel R., Sprotte G., Sommer C. Reduced levels of antiinflammatory cytokines in patients with chronic widespread pain // Arthritis Rheum. – 2006. – No 54. – P. 2656–2664.
Miller L.J., Fischer K.A., Goralnick S.J., Litt M., Burleson J.A., Albertsen P., Kreutzer D.L. Interleukin-10 levels in seminal plasma: implications for chronic prostatitis-chronic pelvic pain syndrome // J. Urol. – 2002. – No 167. – P. 753–756.
Connor T.J., Song C., Leonard B.E., Merali Z., Anisman H. An assessment of the effects of central interleukin-1в, -2, -6, and tumor necrosis factor-б administration on some behavioural, neurochemical, endocrine and immune parameters in the rat // Neurosci. – 1998. – No 84. – P. 923–933.
Palin K., McCusker R.H., Strle K., Moos F., Dantzer R., Kelley K.W. Tumor necrosis factor-б-induced sickness behavior is impaired by central administration of an inhibitor of c-jun N-terminal kinase // Psychopharmacology. – 2008. – No 197. – P. 629–635.
Fu X., Zunich S.M., O’Connor J.C., Kavelaars A., Dantzer R., Kelley K.W. Central administration of lipopolysaccharide induces depressive-like behavior in vivo and activates brain indoleamine 2,3-dioxygenase in murine organotypic hippocampal slice cultures // J. Neuroinflammation. – 2010. – No 7. – P. 43.
Kent S., Bluthй R.M., Dantzer R., Hardwick A.J., Kelley K.W., Rothwell N.J., Vannice J.L. Different receptor mechanisms mediate the pyrogenic and behavioral effects of interleukin 1 // Proc. Natl. Acad. Sci. USA. – 1992. – No 89. – P. 9117–9120.
Kent S., Kelley K.W., Dantzer R. Effects of lipopolysaccharide on food-motivated behavior in the rat are not blocked by an interleukin(1 receptor antagonist // Neurosci. Lett. – 1992. – No 145. – P. 83–86.
Bluthй R.M., Michaud B., Poli V., Dantzer R.. Role of IL-6 in cytokineinduced sickness behavior: a study with IL-6 deficient mice // Physiol. Behav. 2000. – No 70. – P. 367–373.
Backonja M.M., Coe C..L, Muller D.A., Schell K. Altered cytokine levels in the blood and cerebrospinal fluid of chronic pain patients // J. Neuroimmunol. – 2008. – No 195. – P. 157–163.
Lu Y., Zhu L., Gao Y.J. Pain-related aversion induces astrocytic reaction and proinflammatory cytokine expression in the anterior cingulate cortex in rats // Brain Res. Bull. – 2011. – No 84. – P. 178–182.
Johansen J.P., Fields H.L., Manning B.H. The affective component of pain in rodents: direct evidence for a contribution of the anterior cingulate cortex // Proc. Natl. Acad. Sci. USA. – 2001. – No 98. – P. 8077–8082.