K. Ausmees

Prevalence of asymptomatic inflammatory (National Institutes of Health Category IV) prostatitis in young men according to semen analysis.

OBJECTIVES To determine the prevalence of asymptomatic inflammatory (National Institutes of Health category IV) prostatitis in a cross-sectional community sample of young men. METHODS The study group consisted of 565 men aged 18.9 +/- 1.8 years (mean +/- standard deviation). Cytologic examination of all ejaculates (using Bryan-Leishman stained slides), as well as analysis for basic semen parameters (volume, concentration, and motility) and clinical examination for possible pathologies in the genital region, were performed. Subjects with any clinical symptoms of inflammation were excluded. Levels of prostate-specific antigen in blood serum and interleukin-6 in seminal plasma were determined as well. RESULTS The prevalence of asymptomatic inflammatory prostatitis (greater than 1 x 10(6) white blood cells [WBC]/mL in semen, according to World Health Organization guidelines) was 6.0%, but when we used a lower threshold suggested by our previous studies (greater than 0.2 x 10(6) WBC/mL), the prevalence was 19.0%. In this study the analysis did not show any significant effect of leukocytospermia on sperm quality, except higher sperm concentration in subjects with moderate leukocytospermia (0.2-1 x 10(6) WBC/mL). We did not detect any seasonal differences in the prevalence of asymptomatic inflammatory prostatitis. Interleukin-6 and prostate-specific antigen levels were significantly higher in leukocytospermic subjects than in those without leukocytospermia. CONCLUSIONS Asymptomatic inflammatory prostatitis has a notable prevalence among healthy young men, suggesting the need for further studies to investigate pathogenetic mechanisms of the disease. Lack of negative effect of leukocytospermia on basic semen parameters may indicate higher functional reserve of accessory sex glands in this age group.

Influence of sexual intercourse on genital tract microbiota in infertile couples

Several studies have suggested the association of disturbed genital tract microbiota with infertility. Our aim was to clarify the influence of sexual intercourse on partners genital tract microbiota in infertile couples. Seventeen couples were studied, and in 5 men inflammatory prostatitis (IP) was diagnosed. Semen samples were collected during menstruation of the female counterpart, two self-collected vaginal samples were taken 3-5 days later - before intercourse and 8-12 h after intercourse. Ureaplasma parvum was found in 59% of women, its prevalence was higher in women whose partner had IP, as well as in half of their male partners. Sexual intercourse caused significant shifts in vaginal microbiota - increase of Nugent score and shifts in cultured microbiota (emergence and disappearance of several species). These changes were less expressed in the presence of normal vaginal microbiota but more prominent in the partners of IP men. These changes may interfere with fertilization.

Seminal Interleukin-6 and Serum Prostate-specific Antigen as Possible Predictive Biomarkers in Asymptomatic Inflammatory Prostatitis

OBJECTIVES To determine the possible predictive values of seminal interleukin-6 (IL-6) and serum prostate-specific antigen (PSA), as well as their combined values, in differentiating between subjects with or without asymptomatic inflammatory prostatitis. METHODS The study group consisted of 490 men (mean age 18.9 ± 1.8 years, range 16-25). Cytologic examination of all ejaculates (using Bryan-Leishman-stained slides) and clinical examination for possible pathologic findings in the genital region were performed. The subjects with any clinical symptoms of inflammation were excluded. The levels of PSA in the blood serum and IL-6 in the seminal plasma were also determined. The IL-6 and PSA levels for different leukocytospermia status were statistically compared, and receiver operating characteristic curves were designed to determine the sensitivity versus specificity and the positive and negative predictive values of IL-6 and PSA levels against different thresholds of leukocytospermia (0.2, 0.5, and >1.0 × 10(6) leukocytes/mL). RESULTS The levels of both IL-6 in the seminal plasma and PSA in the blood serum were significantly greater in National Institutes of Health prostatitis IV than in the controls. The receiver operating characteristic curves for seminal IL-6 and serum PSA showed high negative prognostic values for all 3 leukocytospermic subgroups, and positive prognostic values were seen only with IL-6 in the lower leukocytospermic range. CONCLUSIONS Both seminal IL-6 and serum PSA are excellent negative predictive markers for asymptomatic inflammatory prostatitis in young men, although positive predictive values of these biomarkers remain less indicative in this age group.

Seminal microbiome in men with and without prostatitis.

To profile the seminal microbiome applying next generation sequencing.

Alpha-1 antitrypsin phenotypes in patients with Klinefelter’s syndrome

Klinefelter’s syndrome (KS) is the most common human sex chromosome disorder, with a prevalence of 1 in 660 men. The phenotype is variable, but the most constant findings are small and firm testes, decreased testosterone level, infertility, eunuchoid body proportion, increased height, and learning disabilities, due to the presence of extra X chromosome(s) (Smyth and Bremner 1998). KS patients have frequently other diseases of lung, skin, liver and kidney (Morales et al. 1992; Swerdlow et al. 2005). Restrictive lung defects have been attributed to chest wall abnormalities, decreased respiratory muscle strength and increased chest wall compliance (Huseby and Petersen 1981). The likely cause is, decrease of lung compliance due to diminished elasticity of the lung matrix, but its biochemical cause is unknown (Morales et al. 1992). One of the causes could be the mutations in the alpha-1 antitrypsin (AAT) gene (SERPINE1), which is highly polymorphic, with more than 100 alleles identified so far. The alleles are categorized into normal, deficient and null variants on the basis of the plasma level and function of AAT. The protein phenotype is classified according to the ‘Pi’ (protease inhibitor) system, as defined by plasma isoelectric focusing. Normal Pi M types account for 95% of alleles in Caucasian individuals and are characterized by normal plasma levels. Pi X is a rare normal allele variant. Pi Z, S and null types are the most frequent AAT deficiency variants described in lung pathology, but Pi ZZ is associated with both pulmonary and liver diseases (Kaczor et al. 2007; Greene et al. 2008). AAT gene is located on chromosome 14q32.1 (Schroeder et al. 1985).

N51 Prevalence of asymptomatic inflammatory prostatitis in ageing male with lower urinary tract symptoms

OAB walls revealed increased severity of inflammatory cells infiltration of bladder wall (neutrophils and mononuclear cells). Compared to the control group, a single dose of CYP caused increased activity of mast cells. However, chronic administration of CYP suppressed the activity of mast cells within bladder wall. Furthermore, CYP-treated rats showed clear signs of inflammation; however the alteration of bladder histological structure depends on the mode of CYP administration. Acute model caused more severe mucosal abrasion compared to chronic one which revealed more developed haemorrhage changes within bladder wall. Additionally, in acute and chronic OAB we observed similar tissue oedema changes. Optional comparison bladder histological architecture and hyperemia degree between rats after (group I) and without (group IV) bladder catheter implantation showed no significant changes. Conclusions: CYP induces chemical cystitis with alteration in histological structure and inflammatory cells activity. The suppression of mast cells in chronic OAB seems to be a result of direct cytotoxic effect of CYP, as well as stems from a decrease of peripherally (within bladder) substance P release by afferent C fibres endings. Our results prove that acute model of CYPinduced cystitis in rats is more credible for further evaluation of neurogenic inflammation response in overactive bladder.