Abstract

BackgroundProstatodynia is the main symptom of chronic prostatitis and the main reason that patients go to the hospital for treatment. Although a variety of factors, including inflammatory immune response, nervous system sensitization, and psychological factors, have been shown to play important roles in the induction and development of chronic pain in prostatitis, the underlying cause of chronic prostatodynia maintenance in prostatitis patients remains unclear.MethodsA mouse model of chronic prostatitis induced by carrageenan injection was used. The von Frey test was used to measure pain behavior. The microglial and astrocyte activations were immunohistochemically demonstrated with antibodies against Iba1 and GFAP. The expression of cytokine or signaling pathway was detected by enzyme-linked immunosorbent assay (ELISA) and Western blotting.ResultsIn this study, we provide several lines of evidence to demonstrate that activated spinal astrocytes contribute to the later phase (5 weeks after carrageenan injection) of carrageenan-induced prostatitis pain. First, activation of spinal astrocytes but not microglia was found in the spinal cord dorsal horn at 5 weeks. Second, intrathecal injection of the astroglial toxin L-2-Aminoadipate acid (L-AA) but not microglial inhibitor minocycline reduced mechanical allodynia at 5 weeks. Third, chronic prostatitis induced a profound and persistent upregulation of connexin-43 hemichannels in spinal astrocytes, and spinal injection of the connexin-43 inhibitor carbenoxolone (CBX) effectively reduced pain symptoms. Fourth, increased expression and release of chemokine C-X-C motif ligand 1 (CXCL1) in the spinal dorsal horn and intrathecal injection of a CXCL1 neutralizing antibody or the CXCR2 (a major receptor of CXCL1) antagonist SB225002 significantly reduced mechanical allodynia at 5 weeks.ConclusionsIn this study, we found that a novel mechanism of activated spinal astrocytes plays a crucial role in maintaining chronic prostatitis-induced persistent pain via connexin-43-regulated CXCL1 production and secretion.

Highlights

  • Prostatodynia is the main symptom of chronic prostatitis and the main reason that patients go to the hospital for treatment

  • Quantitation of the degree of inflammation in prostate is shown in Additional file 1: Table S2. These results indicated that a mouse model of Chronic prostatitis (CP/CPPS) was successfully established after carrageenan injection into the prostate

  • Comparison of the CP/CPPS model mice and control mice injected with saline revealed that mechanical allodynia was fully developed at 2 weeks and persisted for at least 5 weeks after carrageenan injection into the prostate of the mice (Fig. 2c, P < 0.05 versus BL, two-way ANOVA, followed by post hoc Bonferroni test), indicating that persistent prostate pain was induced after carrageenan injection

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Summary

Introduction

Prostatodynia is the main symptom of chronic prostatitis and the main reason that patients go to the hospital for treatment. A variety of factors, including inflammatory immune response, nervous system sensitization, and psychological factors, have been shown to play important roles in the induction and development of chronic pain in prostatitis, the underlying cause of chronic prostatodynia maintenance in prostatitis patients remains unclear. Deng et al Journal of Neuroinflammation (2019) 16:189 development of chronic pain in prostatitis, the underlying cause of chronic prostatodynia maintenance in prostatitis patients remains unclear [6]. Previous studies have shown that the persistence of prostate pain may be related to the conduction pathway and abnormal neuromodulation in the L6~S2 spinal segment, which dominates the prostate [9]. There is increasing evidence that spinal microglia and astrocytes play important roles in chronic pain sensitization by releasing cellular mediators such as cytokines, chemokines, and growth factors [13,14,15]. Previous studies of prostate pain maintenance have focused on early phases that occur in the first 1–4 weeks after injury [9, 11, 19], and the specific role of glial cells in maintaining late-phase (> 5 weeks) prostate pain remains unclear

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