Treatment Of Chronic Nonbacterial Prostatitis Research Articles

Thermosensitive hydrogel with emodin-loaded triple-targeted nanoparticles for a rectal drug delivery system in the treatment of chronic non-bacterial prostatitis

BackgroundThe complex etiology and pathogenesis underlying Chronic Non-Bacterial Prostatitis (CNP), coupled with the existence of a Blood Prostate Barrier (BPB), contribute to a lack of specificity and poor penetration of most drugs. Emodin (EMO), a potential natural compound for CNP treatment, exhibits commendable anti-inflammatory, anti-oxidant, and anti-fibrosis properties but suffers from the same problems as other drugs.MethodsBy exploiting the recognition properties of lactoferrin (LF) receptors that target intestinal epithelial cells (NCM-460) and prostate epithelial cells (RWPE-1), a pathway is established for the transrectal absorption of EMO to effectively reach the prostate. Additionally, hyaluronic acid (HA) is employed, recognizing CD44 receptors which target macrophages within the inflamed prostate. This interaction facilitates the intraprostatic delivery of EMO, leading to its pronounced anti-inflammatory effects. A thermosensitive hydrogel (CS-Gel) prepared from chitosan (CS) and β-glycerophosphate disodium salt (β-GP) was used for rectal drug delivery with strong adhesion to achieve effective drug retention and sustained slow release. Thus, we developed a triple-targeted nanoparticle (NPs)/thermosensitive hydrogel (Gel) rectal drug delivery system. In this process, LF, with its positive charge, was utilized to load EMO through dialysis, producing LF@EMO-NPs. Subsequently, HA was employed to encapsulate EMO-loaded LF nanoparticles via electrostatic adsorption, yielding HA/LF@EMO-NPs. Finally, HA/LF@EMO-NPs lyophilized powder was added to CS-Gel (HA/LF@EMO-NPs Gel).ResultsCellular assays indicated that NCM-460 and RWPE-1 cells showed high uptake of both LF@EMO-NPs and HA/LF@EMO-NPs, while Raw 264.7 cells exhibited substantial uptake of HA/LF@EMO-NPs. For LPS-induced Raw 264.7 cells, HA/LF@EMO-NPs can reduce the inflammatory responses by modulating TLR4/NF-κB signaling pathways. Tissue imaging corroborated the capacity of HA/LF-modified formulations to breach the BPB, accumulating within the gland's lumen. Animal experiments showed that rectal administration of HA/LF@EMO-NPs Gel significantly reduced inflammatory cytokine expression, oxidative stress levels and fibrosis in the CNP rats, in addition to exerting anti-inflammatory effects by inhibiting the NF-κB signaling pathway without obvious toxicity.ConclusionThis triple-targeted NPs/Gel rectal delivery system with slow-release anti-inflammatory, anti-oxidant, and anti-fibrosis properties shows great potential for the effective treatment of CNP.Graphical

The Protective Effects of Bushen Daozhuo Granule on Chronic Non-bacterial Prostatitis.

Background: Chronic non-bacterial prostatitis (CNP), one of the most common chronic diseases in urology, leads to pain in the prostate and dysuria, critically affecting the physical or mental health of patients. However, there are no standard treatment approaches for the treatment of CNP in the clinic. Although the clinical application of Bushen Daozhuo granule (BSDZG) offers hope to CNP patients in China, the mechanisms of BSDZG in treating CNP are still not entirely clear. Hence, we aimed to investigate the novel therapeutic mechanisms of BSDZG on CNP. Methods: In this study, we first assayed the prostate index of rats and then determined the anti-inflammatory and anti-apoptotic effects of BSDZG on CNP in vivo and in vitro by employing ELISA kits and TUNEL staining. Next, we investigated whether the anti-inflammatory and anti-apoptotic mechanisms of BSDZG on prostate protein-induced rats and lipopolysaccharide (LPS) induced RWPE-1 cells were related to the AKT, p38 MAPK, and NF-κB pathways with the help of Western blot. Finally, the influence of BSDZG on the interaction between the p38 MAPK and NF-κB pathway in LPS-induced RWPE-1 cells was explored by adopting dehydrocorydaline (DHC, p38 MAPK activator) with the help of ELISA kits and Western blot. Results: In vivo, BSDZG effectively reduced the prostate index. In vivo and in vitro, BSDZG dramatically declined the level of two pro-inflammatory cytokines, TNF-α and IL-1β, as well as the apoptosis rate. Moreover, in vivo and in vitro, BSDZG memorably upregulated the expression level of p-AKT, and substantially downregulated the expression level of p-p38 MAPK and NF-κB2. The activation of p38 MAPK significantly reversed the moderation effects of BSDZG on the level of TNF-α and IL-1β, as well as the expression level of p-p38 MAPK and NF-κB2 in vitro. Conclusion: To sum up, the in vivo and in vitro therapeutic mechanisms of BSDZG on CNP were reflected as the anti-inflammation and anti-apoptosis that was formed by inhibiting the level of pro-inflammatory cytokines, TNF-α and IL-1β, to regulate the AKT, p38 MAPK, and NF-κB pathways, and the anti-inflammatory effect of BSDZG was realized by suppressing the p38 MAPK pathway to inhibit the downstream NF-κB pathway.

Dihydroartemisinin ameliorated the inflammatory response and regulated miRNA-mRNA expression profile of chronic nonbacterial prostatitis.

Chronic nonbacterial prostatitis (CNP) is a chronic inflammatory disease. Patients often have trouble urinating, experience painful and frequent urination, and pelvic floor pain, which seriously affects their quality of life. Dihydroartemisinin (DHA) is the most important artemisinin derivative with good anti-inflammatory effects. However, the mechanism of DHA for CNP has not been fully elucidated. To examine the protective effect of DHA on CNP in mice model and to explore the potential mechanisms from the perspective of microRNAs (miRNAs). The CNP mouse model was induced using a prostate protein extract solution and complete Freund's adjuvant. The pain threshold was determined using von Frey filaments. Hematoxylin and eosin (H&E) staining, TUNEL staining, western blot, real-time polymerase chain reaction (PCR), and small RNA sequencing were used to evaluate the effect of DHA on CNP. Dihydroartemisinin significantly alleviated prostate tissue damage in CNP mice, reduced the pain threshold, improved the prostate index, and reduced cell apoptosis. It also reduced the expressions of interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and macrophage chemoattractant protein-1 (MCP-1). Furthermore, after screening 48 differentially expressed genes, we found 4 miRNAs significantly downregulated and 2 miRNAs upregulated in the model group, which were later significantly reversed by DHA treatment. These results indicate that DHA treatment of CNP involves several signaling pathways. Dihydroartemisinin can improve the pathological state and inflammatory response in a CNP mouse model, which may be related to the regulation of miRNAs.

Radial Extracorporeal Shock Wave Therapy Combined with Resveratrol Derivative Alleviates Chronic Nonbacterial Prostatitis in Rats.

Resveratrol (Res) is a non-flavonoid polyphenol compound with biological pleiotropic properties, but low bioavailability limits its application value. Here, we synthesized a new Res derivative ((E)-5-(dimethylamino)-2-(4-methoxystyryl)phenol), and attempted to determine the function of Res derivative combined with radial extracorporeal shock wave therapy (rESWT) in chronic nonbacterial prostatitis (CNP). CNP model rats were constructed by subcutaneous administration of prostatein suspension (15mg/ml), followed by rESWT treatment alone or in associated with Res or Res derivatives. In this study, inflammatory cell infiltration and tissue fibrosis in the prostate tissues of CNP rats were significantly deteriorated, which was effectively abolished by rESWT treatment alone or in combination with Res or Res derivative. The expression of interleukin 1β (IL-1β), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF), and nuclear factor kappa-B (NF-κB) were increased, while silent information regulator 1 (SIRT1) expression was suppressed in the prostate tissues of CNP rats, which were then rescued by rESWT treatment alone or in associated with Res or Res derivative. Importantly, compared with Res derivative treatment alone or rESWT combined with Res treatment, combination treatment with rESWT and Res derivative was more effective in alleviating inflammation and fibrosis, in reducing IL-1β, TNF-α, NGF, and SIRT1 expression, and in facilitating SIRT1 expression. Overall, rESWT combined with Res derivative treatment improved CNP in rat by reducing inflammation and fibrosis, which attributed to regulate the expression of SIRT1 and NF-κB. Thus, this work provides a theoretical basis for rESWT combined with Res derivative in the clinical treatment of CNP.

Improvement of chronic non-bacterial prostatitis by Jiedu Huoxue decoction through inhibiting TGF-β/SMAD signaling pathway.

Chronic non-bacterial prostatitis (CNBP) accounts for more than 90 % of clinical prostatitis cases, and there is no specific and effective treatment for CNBP. The regulatory role of Jiedu Huoxue decoction (JDHXD)in CNBP remains unclear. We investigated if JDHXD could improve CNBP METHODS: The animal model of CNBP was established by carrageenan injection with 1 % carrageenan (50μL). The prostate index, epithelial thickness, lumen area, and pain response time were investigated. The apoptosis levels were measured with TUNEL staining and flow cytometry, respectively. Inflammatory factors in the serum were measured with ELISA method. Treatment with JDHXD significantly improve prostate tissues injury in CNBP rats. Some parameters, such as prostate index, and pain response time, reflecting the prostate function were improved by JDHXD. Inhibition of apoptosis, reactive oxygen species (ROS), and inflammatory response were achieved by JDHXD in vivo. JDHXD markedly suppressed the TGF-β/SMAD signaling pathway, and activation of TGF-β/SMAD signaling pathway could reverse the improvement of CNBP injury by JDHXD. The anti-inflammatory, anti-oxidative and anti-apoptotic effects of JDHXD were proved. JDHXD might improve CNBP injury through suppressing inflammation response, ROS, and apoptosis by targeting TGF-β/SMAD signaling pathway. This research might provide a new thought for the prevention and treatment of CNBP through inhibiting TGF-β/SMAD signaling pathway.

Dihydroartemisinin ameliorates chronic nonbacterial prostatitis and epithelial cellular inflammation by blocking the E2F7/HIF1α pathway.

Chronic nonbacterial prostatitis (CNP) has remained one of the most prevalent urological diseases, particularly in older men. Dihydroartemisinin (DHA) has been identified as a semi-synthetic derivative of artemisinin that exhibits broad protective effects. However, the role of DHA in inhibiting CNP inflammation and prostatic epithelial cell proliferation remains largely unknown. CNP animal model was induced by carrageenan in C57BL/6 mouse. Enzyme linked immunosorbent assay (ELISA), Real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot were used to examine inflammatory cytokines and proliferation genes expression. Immunofluorescence and immunochemistry staining were used to detect and E2F7 expression. Human prostatic epithelial cells (HPECs) and RWPE-1 was induced by lipopolysaccharide (LPS) to mimic CNP model in vitro. Cell proliferation was determined using MTS assay. DHA significantly alleviated the rough epithelium and inhibited multilamellar cell formation in the prostatic gland cavity and prostatic index induced by carrageenan. In addition, DHA decreased the expression of TNF-α and IL-6 inflammatory factors in prostatitis tissues and in LPS-induced epithelial cells. Upregulation of transcription factor E2F7, which expression was inhibited by DHA, was found in CNP tissues, human BPH tissues and LPS-induced epithelial cells inflammatory response. Mechanically, we found that depletion of E2F7 by shRNA inhibited epithelial cell proliferation and LPS-induced inflammation while DHA further enhance these effects. Furthermore, HIF1α was transcriptional regulated by E2F7 and involved in E2F7-inhibited CNP and cellular inflammatory response. Interestingly, we found that inhibition of HIF1α blocks E2F7-induced cell inflammatory response but does not obstruct E2F7-promoted cell growth. The results revealed that DHA inhibits the CNP and inflammation by blocking the E2F7/HIF1α pathway. Our findings provide new evidence for the mechanism of DHA and its key role in CNP, which may provide an alternative solution for the prevention and treatment of CNP.

Intraprostatic injection of exosomes isolated from adipose-derived mesenchymal stem cells for the treatment of chronic non-bacterial prostatitis.

Mesenchymal stem cells (MSCs) own the capacity to secrete trophic factors as exosomes which play significant roles in regulating the functions of other cells and preventing inflammation. Due to the inflammatory process in chronic non-bacterial prostatitis (CNP) and the ambiguity in the treatment of this disease, the present study was aimed to investigate the therapeutic use of adipose-derived MSC exosomes in an animal model of CNP. MSCs were first isolated from rat subcutaneous adipose tissue, and exosomes were extracted from them. Specific features of exosomes were characterized by a scanning electron microscope, western blot technique, and Dynamic Light Scattering methods. To establish CNP in rats, intraprostatic injection of Freund's complete adjuvant was done. After confirmation of prostatitis, intraprostatic injections of exosomes were performed for treatment. Histological evaluation revealed that treatment with exosomes resulted in a relative improvement of lesions caused by CNP. The expression of p-NF-κB and p-IκBα proteins along with inflammatory markers was significantly increased in the CNP group, which treatment with exosomes significantly reduced their expression as well as IL-1β and TNF-α proteins. The antioxidant effects of exosomes were also determined by significantly regulating glutathione peroxidase and superoxide dismutase activity and malondialdehyde levels in these animals. Our results cautiously suggest the therapeutic effects of MSC-derived exosomes against CNP-induced prostatitis through their antioxidant and anti-inflammatory activities, which should be further considered in the future.

IL-6/STAT3 pathway is involved in the regulation of autophagy in chronic non-bacterial prostatitis cells, and may be affected by the NLRP3 inflammasome

ABSTRACT Studies have shown that the cytokine IL-6 plays an important role in the occurrence and development of chronic non-bacterial prostatitis (CNP), but the specific mechanism by which this cytokine regulates CNP is still unclear. At the same time, relevant research have also shown that autophagy is involved in regulating the occurrence and development of inflammation. The possible mechanisms are IL-6/STAT3 signaling pathway and NLRP3 inflammasome. On the basis of establishing the CNP model in rats, we found that IL-6 can regulate autophagy of CNP cells and is associated with the STAT3 pathway and NLRP3 inflammasome. Our results indicate that IL-6 is involved in the regulation of autophagy signaling pathways in CNP. IL-6/STAT3 signaling pathway can suppress cell autophagy pathway in CNP; And the NLRP3 inflammasome may regulate CNP cell autophagy by regulating the IL-6/STAT3 pathway. These findings may provide a new theoretical basis for the pathogenesis of CNP, as well as new ideas and new targets for the treatment and prevention of CNP.

Poria cocos polysaccharides attenuate chronic nonbacterial prostatitis by targeting the gut microbiota: Comparative study of Poria cocos polysaccharides and finasteride in treating chronic prostatitis

Finasteride is an antiandrogenic drug used for the clinical treatment of chronic nonbacterial prostatitis (CNP). Recently, we reported the anti-CNP activity of Poria cocos polysaccharides (PPs) in a rat model. In this study, we compared the differences between PPs and finasteride in treating CNP, especially their effects on the gut microbiota. Results showed that both PPs and finasteride significantly reduced the prostate weight and prostate index of CNP rats, and improved the histological damages in the inflamed prostate. Moreover, PPs and finasteride inhibited the production of pro-inflammatory cytokines (TNF-α, IL-2 and IL-8) and androgens (dihydrotestosterone and testosterone). By 16S rDNA sequencing, PPs and finasteride were found to reprogram the gut microbiota into distinct profiles. Further analysis presented that PPs but not finasteride recovered CNP-induced changes in the gut microbiota, including Ruminococcaceae NK4A214 group, uncultured bacterium f Ruminococcaceae, Ruminiclostridium 9, Phascolarctobacterium, Coriobacteriaceae UCG-002 and Oribacterium. LDA effect size (LEfSe) analysis revealed that PPs recovered the gut microbiota by targeting Ruminococcaceae NK4A214 group. Our results suggested that PPs alleviated CNP via different mechanisms from finasteride, especially by regulating the gut microbiota, which offers therapeutic target for the treatment of CNP.

MiR-181c inhibits prostatic epithelial cell proliferation caused by chronic non-bacterial prostatitis through downregulating COX-2

Background: Chronic non-bacterial prostatitis (CNP) is a widespread disease of the male reproductive system. MiR-181c can be expressed in prostate tissue, but it has not been reported in CNP. This study aims to investigate the role of miR-181c in CNP and its mechanism of action on CNP, providing new ideas for the treatment and diagnosis of CNP. Methods: Quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting were applied to determine miR-181c expression in clinical CP patients, CNP rats, and LPS-induced human prostaglandin epithelial cell RWPE-1. Then, luciferase reporter assay was performed to verify the targeting relation between miR-181c and COX-2. Through cell transfection experiments, the effect of mi-181c on the expression of COX2 and PGE2 was studied, and the effect of miR-181c/COX-2 on the proliferation of prostate epithelial cells was also explored. Results: qRT-PCR and Western blotting analysis revealed that miR-181c was low expressed in prostate tissue of CP patients and CNP rats and human prostaglandin epithelial cell RWPE-1. The luciferase reporter assay confirmed the targeting relation between miR-181c and COX-2. And miR-181c overexpression reduced the expression of COX-2 and PGE2 and suppressed the proliferation of prostate epithelial cells. COX-2 up-regulation reversed these effects caused by overexpression of miR-181c. Conclusions: miR-181c inhibited the proliferation of prostate epithelial cells through negatively regulating COX-2 to alleviate chronic non-bacterial prostatitis. Keywords: Chronic non-bacterial prostatitis, miR-181c, COX-2, prostatic epithelial cell, proliferation

Efficacy and safety of extracorporeal shockwave therapy for the treatment of chronic non-bacterial prostatitis: A systematic review and meta-analysis.

Chronic pelvic pain syndrome (CPPS) is one of the most common outpatient urological diagnoses, and its incidence is increasing. Extracorporeal shockwave therapy (ESWT) has been suggested for relieving local perineal symptoms associated with chronic prostatitis/CPPS. Despite several treatment methods, no causal or standardized treatment is available for CPPS. This study aimed to investigate the efficacy and safety profile of ESWT for the treatment of chronic non-bacterial prostatitis. Studies were collected using four search engines (Pubmed, Cochrane, ScienceDirect, and EBSCOHost), on May 16, 2020; and assessed based on predetermined inclusion and exclusion criteria. Two reviewers performed study selection. Studies were then analyzed using Review Manager 5.3 for the meta-analysis. Seventy-four publications were initially retrieved, and three studies were considered for both qualitative and quantitative analyses. From these studies, we found that the use of ESWT was significantly associated with decreased pain domain (mean difference: -3.93; 95% confidence interval [CI] -5.13, -2.73; p<0.001), improved urinary score (mean difference: -1.79; 95% CI -2.38, -1.21; p<0.001), improved quality of life (mean difference: -1.71; 95% CI -2.12, -1.31; p<0.001), and improved National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) score (mean difference: -5.45; 95% CI -5.74, -5.16; p<0.001) after 12 weeks of treatment. ESWT is efficacious and safe in reducing pain and improving urinary condition, NIH-CPSI score, and quality of life in patients with chronic non-bacterial prostatitis.

Features Treatment of Chronic Nonbacterial Prostatitis/chronic Pelvic Pain Syndrome (Category IIIB) due to Herpetic Infection

The objective: to evaluate the effectiveness of the improved treatment of chronic nonbacterial prostatitis CNP/CPPS (category IIIB) of herpetic etiology, by including antiviral and immunomodulating therapy in standard therapy.Materials and methods. 71 people with chronic nonbacterial prostatitis (category IIIB) were examined. The comparison group (group I) consisted of 46 men aged 35,2±4,6 with CNP/CPPS of herpetic etiology, whose patients were divided into two subgroups, 23 people each, who subsequently underwent various types of treatment: traditional treatment of CNP/CPPS according according to the protocol and, accordingly, traditional treatment and additionally 500 mg valaciclovir 2 times a day for 10 days with the transition to maintenance therapy 500 mg 1 time per day for another 20 days and in parallel sodium oxodihydroacridinyl acetate (intramuscular 2,0 ml (250 mg) once a day every 48 hours 10 injections. The control group (group II) consisted of 25 men aged 35,5±2,8 CNP/CPPS without viral infection. The state of local and systemic immunity before and after treatment was assessed by the level of indicators: IFN-γ in blood serum and the content of secretory immunoglobulin A (sIgA) in the ejaculate of patients, the level of pro-inflammatory interleukin 6 (IL-6) and anti-inflammatory interleukin 10 (IL-10) in ejaculate. To assess the symptoms of prostatitis, the NIH-CPSI Chronic Prostatitis Symptom Index Scale was used, with an assessment of the quality of life, an assessment of the general condition by the total score (S+L).Results. According to the study, a positive dynamics of prostatitis symptoms was recorded in both subgroups (p&lt;0,05). However, when comparing the results between the subgroups, a significant difference was found in favor of improved treatment (p&lt;0,05). The levels of IFN-γ in the blood serum of patients after both types of treatment significantly improved (р&lt;0,05). When comparing between subgroups, the level of IFN-γ is higher after improved treatment (p&lt;0,001). The results of both types of treatment compared with the control group: after the traditional one, the level of IFN- γ is lower (p&lt;0,05). After improved treatment, the level of IFN-γ in serum did not statistically differ (p&gt;0,05). Dynamics of secretory immunoglobulin A (sІgА) in the ejaculate of patients: in the subgroup of patients after traditional treatment – 20,90±2,09 (p&lt;0,001). In the subgroup of patients after improved treatment, it increased by 20% (p&lt;0,001). Between comparison subgroups, the level of immunoglobulin became significantly higher precisely after improved treatment. The results of both types of treatment compared with the control group: after the traditional level of sІgA – no significant difference was recorded (p&gt;0,05). After improved treatment, sIgA levels are higher than in the comparison group (p&lt;0,05). When assessing the level of IL-6 in the ejaculate, there was a significant decrease after improved treatment, compared with traditional (p&lt;0,05). After the traditional one, the level was high compared with the control group, in patients of the subgroup after advanced treatment, lower than in patients of the control group (p&lt;0,05), which shows the effectiveness of the proposed treatment and the presence of the viral etiology of chronic prostatitis. The level of anti inflammatory interleukin 10 (IL-10) after treatment was: after traditional treatment, 11,36±1,31 (p&lt;0,001), in patients after advanced treatment, according to 12,45±1,24 (p&lt;0,001). When comparing with each other, significantly higher levels of IL-10 were in patients after improved treatment. It should be noted that in patients of both subgroups, the indices after treatment (both traditional and advanced) were significantly higher than the indicators of IL-10 in the ejaculate in patients of the control group.Conclusion. The proposed therapy with the inclusion in treatment, along with the traditional, chronic nonbacterial prostatitis of the herpetic etiology of valaciclovir and sodium oxodihydroacridinyl acetate is significantly more effective than traditional monotherapy according to the protocol.

Clinical treatment of chronic nonbacterial prostatitis of kidney-yang deficiency type by acupuncture of Sanhuang points

To observe the clinical effect of acupuncture stimulation of Sanhuang points in the treatment of chronic nonbacterial prostatitis (CNP) of kidney-yang deficiency type. A total of 60 CNP outpatients were equally randomized into medication(control) group and acupuncture plus medication (acupuncture) group. Patients of the control group were ordered to take Tamsulosin (0.2 mg/d) for successive 8 weeks. On the basis of medication treatment, for patients of the acupuncture group, bilateral Sanhuang points including Tianhuang-fu Point (Shenguan), Dihuang Point and Renhuang Point (at the lower leg) were needled with filiform needles which were manipulated for a while till Deqi, followed by retaining the needles for 30 min. The treatment was conducted once daily for successive 8 weeks. The therapeutic effect was evaluated in reference to the "Criteria for Diagnosis and Therapeutic Effect Evaluation of Syndromes/Diseases of Traditional Chinese Medicine". The National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores were used to assess the severity of chronic prostatitis. Routine examination of the leukocyte count in the prostatic fluid was performed before and after the treatment. Of the two 30 cases of the control and acupuncture groups, 9 and 19 were cured, 14 and 10 experienced improvement, and 7 and 1 failed in the treatment, with the effective rates being 76.67% and 96.67%, respectively. The effective rate of the acupuncture plus medication was significantly higher than that of the medication (P<0.05). After the treatment, the scores of NIH-CPSI and white blood cell counts in the prostatic fluid in both groups were significantly decreased in comparison with their own pre-treatment (P<0.05). The therapeutic effect of acupuncture plus medication was significantly superior to that of the medication alone in reducing the NIH-CPSI symptom score and the number of leukocytes in the prostatic fluid (P<0.05). Acupuncture at Sanhuang points is effective in improving symptoms of CNP patients of kidney-yang deficiency type, and the therapeutic effect of acupuncture plus medication is superior to that of medication alone.

The effect of sensation of transmission along meridian acupuncture for chronic nonbacterial prostatitis

ObjectiveTo investigate the short-term efficacy difference between sensation of transmission along meridian acupuncture and non- sensation of transmission along meridian acupuncture in the treatment of chronic nonbacterial prostatitis. MethodsA randomized, controlled, and single-blind clinical study was performed to collect 63 patients with chronic nonbacterial prostatitis who met the inclusion criteria and were randomly assigned to a transmission sensation group (31 patients) and a non-transmission sensation group (32 patients). The two groups of patients took the same acupuncture points. When they were lying down on their backs, Guānyuán (关元 CV4), Zhōngjí (中极 CV3) and Dàhè (大赫 KI12) were taken. When they were lying down on their stomachs, Shènshū (肾俞 BL 23), Cìliáo (次髎 BL32) and Huìyáng (会阳 BL35) were taken. Among them, the transmission sensation group was treated with transmission sensation along meridian to apply deep needling to the lower abdomen and lumbosacral acupuncture points with lifting, thrusting, and twirling method, so that the needling sensation was transmitted to the bladder, perineum and urethra. The non-transmission sensation group was treated with non-transmission sensation along meridian, and the acupuncture points were treated with conventional acupuncture until the patient felt soreness and distending etc. and the arrival of qi. Both groups of patients were treated with electro-acupuncture during acupuncture, and the sparse-dense wave (sparse wave 4 Hz, dense wave 20 Hz), and the needle retention continued for 20 min. All patients were treated for 3 times with once every other day, and the treatment lasted for one week. The CV4, CV3 and KI12 were used in the first and third treatments, and the BL23, BL32 and BL35 were used in the second treatment. The National Institute of Health chronic prostatitis syndrome index (NIH-CPSI) and Hamilton Anxiety Rating Scale (HAMA) were observed, and the clinical efficacies of the patient were observed. ResultsAfter treatment, the NIHCPSI scores (18.29±1.25, 21.56±1.28) and HAMA scores (10.29±1.16, 11.25±1.14) in the transmission sensation group and non-transmission sensation group were all lower than the pre-treatment NIHCPSI score (24.90±1.45, 24.94±1.25) and HAMA (14.10 ± 1.53, 14.47 ± 1.22) in the transmission sensation group and non-transmission sensation group, the differences were statistically significant (all P < 0.05). The difference value between the pre-treatment and post-treatment NIHCPSI scores of the transmission sensation group (6.61±0.97) was higher than that of the non-transmission sensation group (3.48±0.59), and the difference was statistically significant (P<0.05). The difference value between the pre-treatment and post-treatment HAMA scores of the transmission sensation group (3.81±0.81) was higher than that of the non-transmission sensation group (2.77±0.54). The total effective rate of the transmission sensation group (35.48%) was higher than that of the non-transmission sensation group (12.50%), and the difference was statistically significant (P<0.05). ConclusionsBoth the method of transmission sensation along meridian and the method of non-transmission sensation along meridian can effectively relieve the clinical symptoms and anxiety symptoms of patients with chronic nonbacterial prostatitis, improve the quality of life, and the method of transmission sensation along meridian had a more advantageous effect.

Clinical efficacy of Qianlie Shutong capsule combined with tamsulosin hydrochloride capsule on inflammatory factors in patients with chronic nonbacterial prostatitis

Objective To explore the clinical efficacy of Qianlie Shutong capsule combined with tamsulosin hydrochloride capsule on inflammatory factors in patients with chronic non-bacterial prostatitis. Methods A total of 130 patients with chronic non-bacterial prostatitis were selected from June 2014 to June 2016 in our hospital. A randomized, controlled, double-blind clinical trial was performed according to clinical epidemiological and statistical studies. All patients were randomly divided into two groups: the experimental group (65 cases) and the control group(65 cases). The basic clinical data were recorded (age, BMI, course of disease, etc). The patients in experimental group were treated with Qianlie Shutong capsule and tamsulosin hydrochloride capsule and the patients in control group were treated with tamsulosin hydrochloride capsule. One month as a course of treatment and all patients were treated two courses continuously. Whether there were significant differences in efficiency and incidence of adverse reactions, NIH-CPSI score and IIEF-5 score, maximum urinary flow rate, EPS-WBC, PH value and inflammatory factor were observed between the two groups before and after treatment. Results There were no significant differences between the two groups in the basic clinical data, NIH-CPSI and IIEF-5 scores, maximum urinary flow rate and inflammatory factor levels before treatment (P>0.05). The levels of NIH-CPSI, EPS-WBC, PH value and inflammatory factors in the two groups were significantly lower than those before treatment (P<0.05), and the difference between the two groups was significant (P<0.05 ). The scores of IIEF-5 and the maximum urinary flow rate of the two groups were significantly higher than those before treatment (P<0.05), and the experimental group was more significant than the control group (P<0.05). The total effective rate was 90.80% in the experimental group, 17 cases were cured, 23 cases were markedly effective, 19 cases were effective, 6 cases ineffective. The total effective rate was 73.85% in the control group, 10 cases were cured, 21 cases were markedly effective, 17 cases were effective, 17 cases ineffective, the difference was significant (P<0.05). There was no adverse reaction in the two groups during the course of treatment. Conclusions The clinical effect of Qianlie Shutong capsules combined with tamsulosin hydrochloride capsule in the treatment of chronic non-bacterial prostatitis is more obvious than that of the simple use of tamsulosin hydrochloride capsule, and can effectively reduce the level of inflammatory factors in prostatic fluid. Therefore, the combination procedure should be promoted in clinic. Key words: Prostatitis; Capsules

EFFECT OF PROSTATILEN® AC ON SPERM DNA FRAGMENTATION DURING TREATMENT OF PATIENTS WITH CHRONIC NONBACTERIAL PROSTATITIS AND CONCOMITANT DISORDERS OF THE REPRODUCTIVE FUNCTION

The study objective is to analyze the effect of Prostatilen® AC on sperm DNA fragmentation during treatment of patients with chronic nonbacterial prostatitis and concomitant disorders of the reproductive function. Materials and methods . The study is based on the results of treatment of 25 men aged 24 to 45 years (mean age 35.3 ± 4.4 years) with a verified diagnosis of chronic nonbacterial prostatitis and complaints of early-stage missed miscarriage in a spouse/sexual partner. All patients received Prostatilen® AC daily in rectal suppositories formulation. The duration of treatment was 10 days with retreatment after 20 days. In all patients before treatment and 20 days after it, spermiogram parameters (5th ed., WHO, 2010) and sperm DNA fragmentation level using SCSA (sperm chromatin structure assay) by FACSCantoll with monoclonal antibodies (Roche, Germany) were determined, and all patients underwent the MAR (mixed antiglobulin reaction) test with normal value considered to be 10 % or less. The normal value of sperm DNA fragmentation was considered to be 15 % or less (low risk of fertility impairment). The analysis of the obtained data was carried out using the IBM SPSS Statistics program 22. Results . Before the treatment, pathologic level of sperm DNA fragmentation was observed in 6 (43 %) of 14 patients with normozoospermia and in 7 (63 %) of 11 patients with pathozoospermia (χ² = 1.06; p <0.3). Thus, there weren’t any significant difference between the rates of occurrence of increased sperm DNA fragmentation in patients with normo- and pathozoospermia. A correlation was found between the level of sperm DNA fragmentation and the results of MAR test before treatment (r = 0.8, p <0.05), which varied between 0 and 99 % (mean 16.48 ± 31.64 %). Meanwhile, increased sperm DNA fragmentation was observed in 7 (53 %) of 13 patients with pathological MAR test results, and in 2 (40 %) of 5 patients with normal MAR test results (χ² = 0.67; p <0.01). The level of sperm DNA fragmentation prior to treatment varied between 1 and 55 % (mean 18.99 ± 6.87 %), and after treatment it varied between 1 and 26 % (mean 9.76 ± 4.32 %). Increased level of sperm DNA fragmentation was observed in 13 (52 %) of 25 patients before treatment with Prostatilen® AC and only in 3 (12 %) patients after the treatment (χ² = 0.86; p < 0.001). Conclusion . Prostatilen® AC as treatment of chronic nonbacterial prostatitis promotes a decrease in the level of sperm DNA fragmentation.

The anti-inflammatory effect of montelukast, a cysteinyl leukotriene receptor-1 antagonist, against estradiol-induced nonbacterial inflammation in the rat prostate.

There is no standard treatment of chronic nonbacterial prostatitis in humans. The current study was aimed to investigate the effect of montelukast, an antagonist of cysteinyl leukotriene receptor-1, against estrogen-induced, nonbacterial lateral lobe-specific prostate inflammation in rats. Male Wistar rats were randomized into five groups of six rats, including sham controls (group 1) and castrated rats (group 2), whereas nonbacterial prostatitis (NBP) was induced in groups 3-5 by castration followed by a daily subcutaneous injection of estradiol (0.25mg/kg body weight) for 30days. The rats were left otherwise untreated (group 3) or received a daily oral administration of montelukast (1 and 10mg/kg body weight for groups 4 and 5, respectively) from the 17th day after castration for two consecutive weeks. Compared with sham controls, induction of NBP led to a significant increase in serum leukotriene B4 (LTB4), tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6) levels, along with a significant upregulation in the transcript level of proinflammatory molecules (nuclear factor kappa beta [NF-κβ] and inducible nitric oxide synthase [iNOS]), chemokines (monocyte chemoattractant protein-1 [MCP-1] and eotaxin), and E-selectin in the lateral prostate. Histological examination revealed intense inflammation in the prostate with leukocyte infiltration and acinar degeneration following estradiol treatment of castrated rats. Montelukast significantly suppressed the increase in serum and prostate proinflammatory mediators/chemokines expression and abolished the histologically inflammatory changes in the lateral prostate. These findings indicate that montelukast inhibits estradiol-induced NBP in a rat model through anti-inflammatory mechanisms, suggesting its future beneficial effect for the treatment of clinical chronic NBP.

Clinical application of terazosin combined with Qianlielongbitong in the treatment of chronic non-bacterial prostatitis

Objective To investigate the effect and mechanism of terazosin combined with Qianlielongbitong in the treatment of non-bacterial prostatitis.Methods One hundred and two patients with non-bacterial prostatitis were divided into two groups:one group was treated with terazosin 4 mg qn and Qianlielongbitong,while the other group was treated with terazosin and Levoofloxacin.We compared three indices of chronic prostatitis symptom index (NIH-CPSI),prostatic secretion examination(EPS) and urodynamic data in three different steps:before treatment,after 4-week treatment and after 8-week treatment.Results The NIH-CPSI of both groups was greatly improved after treatment( all P ＜0.01 ).Inside the treatment group,the NIH-C-PSI after 8-week treatment was better than that after 4- week treatment ( all P ＜ 0.01 ).However,in both groups,there was no significant difference between the index after 8-week treatment and the one after 4 week.EPS,AFR and MFR were greatly improved in both groups( all P ＜0.01 ).Conclusion Terazosin can relieve the clinical symptom,and improve the life quality. Key words: Prostatitis; Terazosin; Qianlielongbitong

Study strategies for acupuncture treatment of chronic nonbacterial prostatitis

By retrospectively reviewing the current status of traditional Chinese medicine (TCM) and Western medicine treatments of chronic nonbacterial prostatitis (CNP), the TCM understanding of its etiologies and pathogenesis, the therapeutic principles and the mechanisms of acupuncture treatment of CNP, the clinical study strategies of acupuncture treatment for CNP were further proposed, which could provide more scientific basis and support for the definite longer-term therapeutic efficacy of acupuncture treatment of CNP. Breakthrough in the treatment of CNP will be achieved with the application of acupuncture therapy both in clinical practice and experimental research.

Na-tartrate in the treatment of chronic nonbacterial prostatitis.

In an open investigation 20 patients with a history of chronic abacterial prostatitis (24 month duration) and of multiple therapies were treated by 0.07-0.15/kg Na-tartrate. Na-tartrate, a known inhibitor of the prostatic fraction of acid phosphatase in laboratory studies, was given orally for 12 weeks after dissolution in fluids and well tolerated. 13 patients completed the study and 3 spermiograms at 6 weeks interval were performed. 11/13 patients demonstrated increased sperm count (44.5 +/- 26.4 leads to 55.06 +/- 34.7) elevated seminal prostatic phosphatase (727 +/- 114.7 leads to 810.8 +/- 55.7) and improved seminal testosterone (2.86 +/- 1.6 leads to 4 +/- 1.4) while seminal y-GT was not significantly changed. Polyamine excretion showed a distinct elevation for putrescine 17.7 +/- 5.3 leads to 28.5 +/- 6.8. Clinically the 11 from 13 patients presented with marked improvement in a 4 months follow-up.