AUA 2004 - Quercetin Reduces signs of Inflammation

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Program#/Poster#: 113

Presentation Title:
CORRELATION OF SYSTEMIC CYTOKINE PRODUCTION WITH SEMINAL OXIDATIVE STRESS AND TREATMENT RESPONSE IN CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME

Presentation Time: 5/8/2004 1:00:00 PM

Author Block: Daniel Shoskes, Chantale Lapierre. Cleveland Clinic Florida, Weston, FL

Introduction and Objective: Systemic and local cytokine level abnormalities have been reported in men with chronic pelvic pain syndrome (CPPS) suggesting an inflammatory or autoimmune etiology in some patients. Furthermore, PSA has been identified as a possible antigen target for this autoimmunity. While cytokine levels can be highly variable, the ELISPOT assay allows direct identification of the number of cytokine producing cells in the peripheral blood (PBMC). We measured cytokine producing cells in the periphery of men with CPPS, both with and without PSA antigen stimulation and correlated the results with seminal inflammation, clinical presentation and treatment outcome.

Methods: Samples were collected from 35 patients who fulfilled the NIDDK criteria for chronic prostatitis / chronic pelvic pain syndrome as well as controls. PBMC were extracted from peripheral blood and ELISPOT assays performed for IL-1, IL-2, IFN-gamma, IL-10 and TNF, both with and without PSA antigen. Results were reported as cytokine producing cells per 10e5 PBMC. EPS was analyzed by ELISA for isoprostanes (measure of oxidative stress). A subset of patients treated with quercetin for at least 4 weeks had assays repeated following therapy. Statistical analysis was by paired t test or Mann Whitney as appropriate.

Results: Compared to controls, chronic prostatitis / chronic pelvic pain syndrome patients had significantly different cytokine production for IL-1 (3970 vs 6710), IL-2 (2230 vs 312) and IL-10 (102 vs 225)(all p<0.05). Stimulation with PSA antigen did not significantly increase cytokine production except in one patient who was later found to have an E. coli infection. There was no correlation between production of any cytokine with symptom severity (NIH-CPSI), or EPS levels of isoprostane. Patients with low levels of systemic IL-10 production were more likely to be category IIIa and to have symptoms for more than 3 years. Men treated with quercetin had a significant reduction in seminal isoprostanes (23892 vs 172 pg/ml, p=0.0001) as well as peripheral production of IL-1 (5036 vs 2384 p=0.004) and increased IL-10 (2.6 vs 36.2, p=0.07)

Conclusions: Men with chronic prostatitis / chronic pelvic pain syndrome have a higher proportion of IL-2 and a lower proportion of IL-10 producing PBMC's than controls. PSA antigen does not stimulate cytokine production in these men. Treatment with quercetin affects both systemic and local inflammation, regardless of symptomatic response. Lack of production of the anti-inflammatory cytokine IL-10 may be associated with CPPS, particularly in those with longstanding symptoms.