The Prostatitis Foundation
 

Advance word on cytokine reserch
...from Dr. Shoskes

The results of my genetic polymorphism study are now complete and submitted for publication and meeting presentation. Until it is accepted I will not provide specific details of the findings but I can summarize them here:

The genes that produce cytokines in humans are polymorphic; there are differences between individuals that control how much is produced for a given stimulus. For instance, different people may produce different amounts of IL-6 in response to identical types of bacterial infections. High or low levels of pro- and anti-inflammatory cytokines can confer high or low susceptibility to infectious and autoimmune diseases. A current comprehensive database of polymorphisms and their association with human disease (or lack thereof) can be found at http://bris.ac.uk/pathandmicro/services/GAI/cytokine4.htm.

We looked at genetic polymorphisms in men with CPPS and compared them to a control population of 252 people without CPPS and to published expected frequencies. In each case, the interesting numbers came from the gene type associated with the "low expression" for the given cytokine.

As a whole, CPPS patients had a significantly higher proportion expressing the "low IL-10" gene. IL-10 is protective against autoimmune disease, therefore having low IL-10 expression would predispose to autoimmune disease. Interestingly, none of the patients with positive cultures had the low IL-6 gene but the numbers in this subgroup was too small for statistical significance.

Groups were analyzed according to many pretreatment and posttreatment factors. The most interesting finding was that all patients who failed therapy with Prosta-Q had the low TNF-alpha gene and a significantly lower proportion had the low IL-10 gene. One would expect an inflammatory/autoimmune condition to be associated with high TNF-alpha and low IL-10 expression so the Prosta-Q appears to not be effective in those patients with the opposite condition (low TNF and high IL-10). There were no differences seen for any of the cytokines based on treatment response to antibiotics, other anti-inflammatories, alpha-blockers or neuromuscular agents.

Thanks to all the patients who agreed to participate in these studies, which is the only way we will advance understanding of CPPS and hopefully learn how to treat it more effectively.

Daniel Shoskes MD
Cleveland Clinic Florida
http://www.dshoskes.com

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