Smoking Is Associated with Acute and Chronic Prostatic Inflammation: Results from the REDUCE Study.

Daniel M Moreira,J Curtis Nickel,Gerald L Andriole,Ramiro Castro-Santamaria,Stephen J Freedland,Leah Gerber,Roberto L Muller

doi:10.1158/1940-6207.capr-14-0260

Abstract

Both anti- and proinflammatory effects of cigarette smoking have been described. As prostate inflammation is common, we hypothesized smoking could contribute to prostate inflammation. Thus, we evaluated the association of smoking status with acute and chronic inflammation within the prostate of men undergoing prostate biopsy. We retrospectively analyzed 8,190 men ages 50 to 75 years with PSA levels between 2.5 and 10 ng/mL enrolled in the Reduction by Dutasteride of Prostate Cancer Events study. Smoking status was self-defined as never, former, or current. Prostate inflammation was assessed by systematic central review blinded to smoking status. The association of smoking with inflammation in the baseline, 2-year, and 4-year biopsies was evaluated with univariable and multivariable logistic regressions. At study enrollment, 1,233 (15%), 3,203 (39%), and 3,754 (46%) men were current, former, and never smokers, respectively. Current smokers were significantly younger and had smaller prostates than former and never smokers (all P < 0.05). Former smokers were significantly heavier than current and never smokers (P < 0.001). Acute and chronic prostate inflammations were identified in 1,261 (15%) and 6,352 (78%) baseline biopsies, respectively. In univariable analysis, current smokers were more likely to have acute inflammation than former (OR, 1.35; P, 0.001) and never smokers (OR, 1.36; P, 0.001). The results were unchanged at 2- and 4-year biopsies. In contrast, current smoking was linked with chronic inflammation in the baseline biopsy, but not at 2- and 4-year biopsies. In conclusion, among men undergoing prostate biopsy, current smoking was independently associated with acute and possibly chronic prostate inflammations.

Highlights

Cigarette smoking has been associated with higher prostate cancer mortality in all comers and more disease recurrence, metastasis, and cancer-specific mortality after surgery and radiotherapy for prostate cancer [1,2,3,4,5]
Men were excluded if they had history of prostate cancer, high-grade intraepithelial neoplasia, atypical small acinar proliferation, prostate volume (PV) >80 mL, had undergone previous prostate surgery or had International Prostate Symptom Score 25 or 20 on alpha-blockers, or were previously on finasteride or dutasteride
Cigarette smoking has a major impact on health issues worldwide

Summary

Introduction

Cigarette smoking has been associated with higher prostate cancer mortality in all comers and more disease recurrence, metastasis, and cancer-specific mortality after surgery and radiotherapy for prostate cancer [1,2,3,4,5]. The pathways by which smoking affects prostate carcinogenesis and prostate cancer progression are largely unknown, several potential mechanisms have been proposed, including genetic and epigenetic changes, enhanced angiogenesis, life style factors, and inflammation. The effects of cigarette smoking on the immune system are far-reaching and may affect the prostate. Inflammatory changes in distant organs, such as eyes, arteries, and pancreas, have been described among active smokers [7,8,9]. The direct inflammatory effects of cigarette smoking on several organs, including the prostate, remain to be determined

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Results

Conclusion