IMMUNE STATUS OF PATIENTS WITH CHRONIC PROSTATITIS

ANOTATION.The most common urological disease among men of working age is chronic prostatitis, and its symptoms are a frequent reason for seeking urological care. PURPOSE OF THE RESEARCH. Тo assess the state of local and systemic immunity in patients with various forms of chronic prostatitis MATERIALS AND METHODS. 84 patients with chronic prostatitis, with a long recurrent course of the disease, were under observation. Among them, there were 15 (17.9%) with chronic bacterial prostatitis, 69 (82.1%) with chronic bacterial prostatitis, of which 44 patients had chronic inflammatory pelvic pain syndrome (CPPS) and 25 — non-inflammatory chronic pelvic pain syndrome (CPPS). The average age of the patients was 37.4±8.2 years, the duration of the disease from 4 to 7 years (5.7±1.3 years on average). An evaluation of symptoms and indicators of immune status was carried out in groups of patients according to the level of interferon-γ in the blood (IFN-γ), interleukins-6 and 8 (IL-6, IL-8), α-tumor necrosis factor (TNF-α) in the blood and ejaculate and also the level of secretory immunoglobulin A (sIgA) in ejaculate. RESULTS AND THEIR DISCUSSION. According to the questionnaire according to the questionnaire "Chronic Prostatitis Symptom Index" (NIH-CPSI, 1999) with an assessment of the quality of life of patients (QоL) in patients with chronic bacterial prostatitis (CBP), the total score was — 23.96±0.18, with chronic abacterial (CAP) — according to SICPP — 21.20±0.16 and SNICPP — 24.59±0.17, which corresponded to the average and severe degree (SNICPP and CBP) of the course of the disease. The results of indicators of systemic and local immunity of patients with chronic prostatitis indicated changes that depended on the form of chronic prostatitis, and were more pronounced at the local level. A more pronounced increase in pro-inflammatory cytokines (IL-6 and IL-8) both in the blood and in the ejaculate is observed in patients with the inflammatory form of chronic bacterial prostatitis (CBP), and an increase in secretory immunoglobulin A (sIgA) was observed in the ejaculate of patients with chronic bacterial prostatitis. Also, the most pronounced decrease in blood IFN-γ was also observed in patients with chronic bacterial prostatitis. An increase in the level of TNF-α, both in the blood and in the ejaculate, was observed in all patients with chronic prostatitis, but there was no significant difference in the indicators between the groups. There is no correlation between the level of cytokines and the activity of the leukocyte reaction in the secretion of the prostate gland. CONCLUSION. Changes in cytokine status are more pronounced at the local level and depend on the form of chronic prostatitis. Determination of indicators of immune status, especially in ejaculate, can increase the capabilities of the diagnostic algorithm for verifying the form of chronic prostatitis