Failure of a Monotherapy Strategy for Difficult Chronic Prostatitis/Chronic Pelvic Pain Syndrome

Nickel, J. Curtis; Downey, Joe; Ardern, Dale; Clark, Janet; Nickel, Kyle

doi:10.1097/01.ju.0000131592.98562.16

Cited by 93 publications

(50 citation statements)

References 14 publications

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“…While the authors note that the NIH-CPSI was not designed as a diagnostic tool to evaluate treatment response, they do conclude that a step-wise, multimodal approach to therapy for long-standing CP/CPPS may be more effective than monotherapy protocols (48). A subsequent study involving the use of step-wise monotherapy strategy confirmed that patients with refractory CP/CPPS did show modest benefit as compared to monotherapy alone, but that the responses to this approach were still suboptimal, and instead multimodal, concurrent therapy would potentially be more appropriate (49).…”

Section: Treatment Approaches To Cp/cppsmentioning

confidence: 88%

Gut microbiome and chronic prostatitis/chronic pelvic pain syndrome

Arora¹,

Eng²,

Shoskes³

2017

Ann. Transl. Med.

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Section: Treatment Approaches To Cp/cppsmentioning

confidence: 88%

Gut microbiome and chronic prostatitis/chronic pelvic pain syndrome

Arora¹,

Eng²,

Shoskes³

2017

Ann. Transl. Med.

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“…Studies addressing the capacity of Elocalcitol to induce CD4 ϩ CD25 ϩ regulatory T cells in EAP are currently in progress. The optimal medical treatment of CP/CPPS is not known (65), and effective therapies for CP/CPPS patients are warranted. Our results, showing that Elocalcitol interferes with key pathogenic events in already established autoimmune prostatitis, reducing by ϳ70% intraprostatic lymphomononuclear cell infiltration, indicate that treatment with this compound may inhibit prostatic inflammation in CP/CPPS patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Experimental Autoimmune Prostatitis in Nonobese Diabetic Mice by the Vitamin D Receptor Agonist Elocalcitol

Penna

Amuchastegui

Cossetti

et al. 2006

The Journal of Immunology

119

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On the basis of on the marked inhibitory activity of the vitamin D receptor agonist Elocalcitol on basal and growth factor-induced proliferation of human prostate cells and on its potent anti-inflammatory properties, we have tested its capacity to treat experimental autoimmune prostatitis (EAP) induced by injection of prostate homogenate-CFA in nonobese diabetic (NOD) mice. Administration of Elocalcitol, at normocalcemic doses, for 2 wk in already established EAP significantly inhibits the intraprostatic cell infiltrate, leading to a profound reduction in the number of CD4+ and CD8+ T cells, B cells, macrophages, dendritic cells, and I-Ag7-positive cells. Immunohistological analysis demonstrates reduced cell proliferation and increased apoptosis of resident and infiltrating cells. Significantly decreased production of the proinflammatory cytokines IFN-γ and IL-17 is observed in prostate-draining lymph node T cells from Elocalcitol-treated NOD mice stimulated by TCR ligation. In addition, Elocalcitol treatment reduces IFN-γ production by prostate-infiltrating CD4+ T cells and draining lymph node T cells specific for an immunodominant peptide naturally processed from prostate steroid-binding protein, a prostate-specific autoantigen. Finally, CD4+ splenic T cells from Elocalcitol-treated NOD mice show decreased ability, upon adoptive transfer into NOD.SCID recipients, to induce autoimmune prostatitis, paralleled by a reduced capacity to produce IFN-γ in response to prostate steroid-binding protein. The results indicate that Elocalcitol is able to interfere with key pathogenic events in already established EAP in the NOD mouse. These data show a novel indication for vitamin D receptor agonists and indicate that treatment with Elocalcitol may inhibit the intraprostatic inflammatory response in chronic prostatitis/chronic pelvic pain syndrome patients.

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“…In addition, other evidence suggests that pro-fibrotic effects of TGF-β may be partly mediated by CTGF [24]. As another potent profibrotic factor, CTGF is implicated in fibroblast proliferation, cellular adhesion, angiogenesis, and extracellular matrix (ECM) synthesis [25].…”

Section: Discussionmentioning

confidence: 99%