IL-1β and TNF-α in prostatic secretions are indicators in the evaluation of men with chronic prostatitis

Purpose: Chronic Prostatitis, or Chronic Pelvic Pain Syndrome [CPPS], is a common disorder characterized by pelvic pain and varying degrees of inflammation in expressed prostatic secretions (EPS). In search of markers to more clearly define CPPS, we compared proinflammatory cytokines interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) levels in EPS from men with CPPS, to healthy men and men with Benign Prostatic Hyperplasia (BPH). Methods: 78 men: controls (n = 16), BPH (n = 14), CPPS IIIA [greater than or equal to 10 white blood cells per high power field (WBC/hpf) in EPS] (n = 18), CPPS IIIB [<10 WBC/hpf in EPS] (n = 20), and asymptomatic inflammatory prostatitis (AIP) (n = 10) were evaluated for EPS WBC, and IL-1 beta and TNF-alpha by ELISA. Results: IL-1 beta and TNF-alpha levels in EPS were usually detectable in men with CPPS IIIA (89% and 45%, respectively) or AIP (90%; 100%), but less often in controls (31%; 17%), BPH(57%; 15%), and CPPS IIIB (35%; 15%) respectively. IL-1 beta and TNF-alpha levels were higher in CPPS IIIA versus CPPS IIIB, and in AIP versus controls or BPH (p's <0.001). Cut-points for IL-1 beta and TNF-alpha discriminated AIP from controls (predictive values = 94% and 83%, respectively) and CPPS IILA from CPPS IIIB (predictive values 84% and 100%). Overall, there was a correlation between IL-1 beta and TNF-alpha (p <0.003), but no correlation between WBC and IL-1 beta (p <0.1) or TNF-alpha (p <0.50). Conclusions: Cytokines are frequently present and elevated in the EPS from men with CPPS IIIA and AIP and provide a novel means for identification, characterization and potential management of men with CPPS that differs from traditional methods based on WBC.