Abstract
PurposeTo assess the expression of selected cytokines in penile lichen sclerosus (PLS) and associate them with the occurrence of micro-incontinence (MI) in different stages of PLS.MethodsThe skin biopsies from 49 PLS affected, and 13 from nonlesional foreskins (healthy control adult males undergoing circumcision due to phimosis caused by short frenulum) were obtained. All specimens were used for RNA extraction and RT-qPCR. Quantitative assessment of the gene expression of interleukin 1-A (IL-1A), interleukin 1-B (IL-1B), interleukin 1 receptor antagonist (IL-1RN), interleukin 6 (IL-6), transforming growth factor β1 (TGF-β1), and interferon-gamma (INF-γ) was performed. To determinate the presence of MI, the patients were asked about voiding patterns, especially leaking tiny drops of urine from the urethral meatus after urination.ResultsIL-1A, IL-6, and INF-γ mRNA levels were approximately 150, 16, and 59 times higher in PLS than in control samples, respectively. The highest IL-1A mRNA levels were observed in early PLS (n = 13), INF-γ in moderate PLS (n = 32), while IL-6 in severe PLS (n = 4). MI was noted in 45 PLS patients vs. 0 in control (p < 0.0001). IL-1A and IL-6 vs control ratios were concentration (ca.) 400 and 30 times higher, respectively, in MI PLS samples than in PLS without MI.ConclusionOcclusion and irritating urine effect are associated with the clinical progression of penile LS with increased mRNA expression of IL-1A, INF-γ, and IL-6 pro-inflammatory cytokines in the foreskin.
Highlights
Penile lichen sclerosus (PLS) is a kind of chronic and fibrotic dermatosis
To determinate the presence of microincontinence, the patients were asked about voiding patterns before phimosis formation, especially leaking tiny drops of urine from the urethral meatus after urination
We found the highest level of interleukin 1-A (IL-1A) gene expression in PLS, with concentration 150 times higher than in control foreskin samples (p < 0.05)
Summary
Penile lichen sclerosus (PLS) is a kind of chronic and fibrotic dermatosis. The typical clinical manifestations are white plaques and induration which can appear at every part of penile skin or mucosa. Less common symptoms are telangiectasias, purpura, and nonspecific hypopigmented or erythematous macules. The most often localization is prepuce, frenulum, penile glans, and urethral meatus. Sclerosis seems to be the main factor that provides to PLS complications such as phimosis, paraphimosis, painful erections, dyspareunia, and urethral strictures [1].
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