Inflammatory mechanisms and oxidative stress in prostatitis: the possible role of antioxidant therapy

Gianni Paulis, Gianni Paulis

Abstract

This article focuses on the role that oxidative stress plays in chronic prostatitis, not only with respect to the known impact on symptoms and fertility but also especially in relation to possible prostate cancer development. Prostatitis is the most common urologic disease in adult males younger than 50 years and the third most common urologic diagnosis in males older than 50 years. If the germ-causing acute prostatitis is not eliminated, the inflammatory process becomes chronic. Persistent inflammation causes ongoing production of large quantities of pro-inflammatory cytokines and both oxygen and nitrogen reactive species, with consequent activation of transcription factor nuclear factor-kappa B (NF-κB) and genes encoding for further production of pro-inflammatory cytokines, chemotactic factors, and growth factors. Confirming the role of oxidative stress in chronic prostatitis, several studies have demonstrated the presence of oxidative stress markers in the genital secretions of patients suffering from the disease. Antioxidants can therefore play an essential role in the treatment of chronic bacterial and non-bacterial prostatitis; in the case of bacterial inflammation, they can be associated with antibiotic therapy. Moreover, due to their anti-inflammatory properties, antioxidants hinder the progression of inflammation and the possible development of prostate cancer.

Keywords: antioxidant therapy; chronic prostatitis; chronic prostatitis treatment; nitrosative stress; radical oxygen species.

Conflict of interest statement

Disclosure The author reports no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Schematic illustration of the fundamentals involved in the mechanisms of acute prostatitis. Abbreviations: IL, interleukin; iNOS, inducible nitric oxide synthase; MCP, monocyte chemoattractant protein; MIP, macrophage inflammatory protein; NF-kB, nuclear factor-kappa B; PRR, pattern-recognition receptor; RNS, reactive nitrogen species; ROS, reactive oxygen species; Th, T helper; TNF-α, tumor necrosis factor alpha.
Figure 2
Figure 2
Schematic illustration of the fundamentals involved in the mechanisms of chronic prostatitis. Abbreviations: EGF, epidermal growth factor; IFN, interferon; IL, interleukin; iNOS, inducible nitric oxide synthase; MCP, monocyte chemoattractant protein; NF-kB, nuclear factor-kappa B; RNS, reactive nitrogen species; ROS, reactive oxygen species; TGF, transforming growth factor; Th, T helper; TNF-α, tumor necrosis factor alpha; VEGF, vascular endothelial growth factor.

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