Elevated levels of proinflammatory cytokines in the semen of patients with chronic prostatitis chronic pelvic pain syndrome

Objectives. Chronic prostatitis/chronic pelvic pain syndrome is a common diagnosis, but the disease is poorly understood. The diagnosis is based only on symptoms, and no measurable parameter can help in defining the presence of the disease, its severity, or its cause. Cytokines are soluble proteins secreted by cells of the immune system that principally regulate inflammatory and immune responses. To provide an objective measure of inflammation in the genital tract, we measured levels of the proinflammatory cytokines, tumor necrosis factor-alpha (TNF-alpha) and interleukin-l beta (IL-l beta) in the semen of men with chronic prostatitis/chronic pelvic pain syndrome and compared these with levels in normal men. Methods. We obtained semen samples from 18 men with chronic prostatitis/chronic pelvic pain syndrome and from 8 normal male volunteers. Cytokine levels were measured in the seminal plasma by two-antibody enzyme-linked immunosorbent assay. Results. Men with prostatitis had higher mean levels of IL-l beta and TNF-alpha in seminal plasma (mean +/- SEM) than normal men: TNF-alpha 98 +/- 39 versus 17 +/- 8; IL-1 beta 246 +/- 63 versus 27 +/- 10, respectively; P <0.05. There was a strong correlation between the levels of TNF-alpha and IL-l beta in the semen of men with chronic prostatitis/chronic pelvic pain syndrome. There was no correlation between either TNF-alpha or IL-l beta levels and the number of leukocytes per high power field in expressed prostatic secretions in patients. Conclusions. Some men with chronic prostatitis/chronic pelvic pain syndrome have elevated levels of TNF-alpha and IL-l beta in the semen. This suggests that inflammation of the genital tract is a feature of this disease, irrespective of the presence or absence of leukocytes in the expressed prostatic secretions. Seminal cytokine levels may provide an objective measure of disease in these patients and suggest specific therapeutic strategies to treat chronic prostatitis/chronic pelvic pain syndrome in such patients. (C) 1998, Elsevier Science Inc. All rights reserved.