Effect of Antibiotic Therapy on Interleukin-6 in Fresh Semen and Postmasturbation Urine Samples of Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome - Abstract
Friday, 30 May 2008
Department of Urology, Ludwig-Boltzmann Institute for Urology and Andrology, Hospital Hietzing, Vienna, Austria.
To investigate the effect of antibiotic therapy on interleukin (IL)-6 in fresh semen and postmasturbation urine samples of patients with chronic prostatitis or chronic pelvic pain syndrome (CP/CPPS)
A total of 128 patients with CP/CPPS prospectively underwent the evaluation of IL-6 in fresh semen and postmasturbation urine samples. At 6 weeks after 4 weeks antibiotic therapy, the IL-6 levels were re-evaluated
Of the 128 patients, 109 (85.2%) were available for our analysis. Of the 109 patients, 72 (66.1%) met the criteria for National Institutes of Health (NIH) classification for inflammatory CP/CPPS (type IIIa) and 37 (33.9%) met the NIH criteria for noninflammatory CP/CPPS (type IIIb). Before antibiotic therapy, 86 patients (78.9%), irrespective of NIH classification, had an increased IL-6 level in fresh semen; 64 (88.9%) patients with CP/CPPS type IIIa and 22 (59.5%) with type IIIb CP/CPPS had increased IL-6 levels. After 4 weeks of therapy, a significant reduction was found in the IL-6 level, with only 44 (40.4%, P = .009) patients showing an increased IL-6 level: 34 patients with type IIIa (47.2%, P = .0000) and 10 with type IIIb (27.0%, P = .0033). An increased IL-6 level was found in the postmasturbation urine sample in 37 patients (33.9%), irrespective of NIH classification: 28 (38.9%) with type IIIa and 9 (24.3%) with type IIIb. At 6 weeks after therapy, only 3 patients (2.8%, P = .000) had an increased IL-6 level: 2 with type IIIa (2.8%, P = .0000) and 1 with type IIIb (2.7%, P = .02)
The IL-6 levels had decreased significantly after antibiotic therapy in patients with CP/CPPS, suggesting a bacterial inflammatory character. The determination of IL-6 in seminal plasma and postmasturbation urine samples is useful as an addition to the diagnostic test for the patient with CP/CPPS and as an efficacy marker for therapy.
Written by
Stancik I, Plas E, Juza J, Pflüger H.
Reference
Urology. 2008 May 9. Epub ahead of print.
doi:10.1016/j.urology.2008.04.005
PubMed Abstract
PMID:18468661
UroToday.com Prostatitis Section
Inflammation And Interleukin 6
Inflammation And Interleukin 6
Age:37 | Onset Age: 35 | Symptoms: pain in testicles that comes and goes that also switches sides-trying to find a pattern as to "why" this happens/Rectal Burn at the 6 O'clock position at my anus which tends to flare around the periphery of my anus typically after defication but no perineum pain-no "golf ball" pain. Pain in testicles worsens as I sit but not always...Pain is not always present but depresses me. Pain used to be at a very high level but has subsided in time to a low level but has not gone away. Pain used to flare after sex but not as much as before although it still like playing russian roulette./
/Lack of SleepHelped By: I haven't found anything that has helped to my knowledge. Tried many many sessions of PT, accupuncture and chiropractic care but still have not found steady relief that takes me back to a pre CPPS state.
/Lack of SleepHelped By: I haven't found anything that has helped to my knowledge. Tried many many sessions of PT, accupuncture and chiropractic care but still have not found steady relief that takes me back to a pre CPPS state.
Re: Inflammation And Interleukin 6
GRufus wrote:The IL-6 levels had decreased significantly after antibiotic therapy in patients with CP/CPPS, suggesting a bacterial inflammatory character.
This is in my opinion is not correct, misleading and "old school". For reasons that are still poorly understood, AB's can have an ani-inflammatory effect. Which can lower I-6 and I-8. ( but does not mean symptom improvement)I don't think I'm too far off track here. I think Webslave would have a strong opinion on this.
Regards, Carl...
I am not a medical doctor. Please fill out your signature (click here) ☼ ☼ My Starter List for new members
I encourage anxiety prone UCPPS people to consider L-Theanine
Age, 44 onset age 37 Feb 2006 Freq. need to urinate. Sensation of having to urinate soon after going. Perineum discomfort/burning/tightness, pubic area discomfort @ times,poor urine stream, post urine dripping/spray. All symptoms have improved with my protocol. At the worst I give it a 1 to 2 on irritation and discomfort and frequency. Helps: Elavil 5mg for anxiety and mast cell protection, (will only take it as needed) self internal PT as needed, stretching, walking, stairmaster cardio workout and light weights, reducing stress, moment to moment relaxation, deep breathing relaxation and using a Theracane. Makes worse: sitting for long periods, stress, over focusing on it. Currently 95%-98% recovered. Stay positive, relaxed and control your anxiety.
I encourage anxiety prone UCPPS people to consider L-Theanine
Age, 44 onset age 37 Feb 2006 Freq. need to urinate. Sensation of having to urinate soon after going. Perineum discomfort/burning/tightness, pubic area discomfort @ times,poor urine stream, post urine dripping/spray. All symptoms have improved with my protocol. At the worst I give it a 1 to 2 on irritation and discomfort and frequency. Helps: Elavil 5mg for anxiety and mast cell protection, (will only take it as needed) self internal PT as needed, stretching, walking, stairmaster cardio workout and light weights, reducing stress, moment to moment relaxation, deep breathing relaxation and using a Theracane. Makes worse: sitting for long periods, stress, over focusing on it. Currently 95%-98% recovered. Stay positive, relaxed and control your anxiety.
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webslave
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Re: Inflammation And Interleukin 6
Carl is right. I saw this abstract yesterday but didn't post it here because I believe the conclusion is wrong. There is no need to say that a bacterial factor is "suggested". I invite you all to read about interleukin-6
http://en.wikipedia.org/wiki/Interleukin_6
Notice that it is not present purely as a result of infection.
A poorly written paper that jumps to conclusions.
http://en.wikipedia.org/wiki/Interleukin_6
Notice that it is not present purely as a result of infection.
A poorly written paper that jumps to conclusions.
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dshoskes
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Re: Inflammation And Interleukin 6
I don't think they are poorly understood at all. Documented cytokine reducing effects of quinolones, macrolides and tetracyclines independent of their ability to kill bacteria have been known for years.carld wrote:GRufus wrote:The IL-6 levels had decreased significantly after antibiotic therapy in patients with CP/CPPS, suggesting a bacterial inflammatory character.
This is in my opinion is not correct, misleading and "old school". For reasons that are still poorly understood, AB's can have an ani-inflammatory effect.
Regards, Carl...
Daniel Shoskes MD
www.dshoskes.com
www.dshoskes.com
Re: Inflammation And Interleukin 6
The paper comes from the Department of Urology, Ludwig-Boltzmann Institute for Urology and Andrology, Hospital Hietzing, Vienna, Austria which should say something about those who conducted the research but hey, I'm not saying infection is the culprit. This is just food for thought.
Age:37 | Onset Age: 35 | Symptoms: pain in testicles that comes and goes that also switches sides-trying to find a pattern as to "why" this happens/Rectal Burn at the 6 O'clock position at my anus which tends to flare around the periphery of my anus typically after defication but no perineum pain-no "golf ball" pain. Pain in testicles worsens as I sit but not always...Pain is not always present but depresses me. Pain used to be at a very high level but has subsided in time to a low level but has not gone away. Pain used to flare after sex but not as much as before although it still like playing russian roulette./
/Lack of SleepHelped By: I haven't found anything that has helped to my knowledge. Tried many many sessions of PT, accupuncture and chiropractic care but still have not found steady relief that takes me back to a pre CPPS state.
/Lack of SleepHelped By: I haven't found anything that has helped to my knowledge. Tried many many sessions of PT, accupuncture and chiropractic care but still have not found steady relief that takes me back to a pre CPPS state.
Re: Inflammation And Interleukin 6
Dr. S,dshoskes wrote:I don't think they are poorly understood at all. Documented cytokine reducing effects of quinolones, macrolides and tetracyclines independent of their ability to kill bacteria have been known for years.carld wrote:GRufus wrote:The IL-6 levels had decreased significantly after antibiotic therapy in patients with CP/CPPS, suggesting a bacterial inflammatory character.
This is in my opinion is not correct, misleading and "old school". For reasons that are still poorly understood, AB's can have an ani-inflammatory effect.
Regards, Carl...
How do AB's work in lowering cytokine? This is the part that confuses me when there is no bacteria.
Does it work the same way NSAID's do?
Regards, Carl..
I am not a medical doctor. Please fill out your signature (click here) ☼ ☼ My Starter List for new members
I encourage anxiety prone UCPPS people to consider L-Theanine
Age, 44 onset age 37 Feb 2006 Freq. need to urinate. Sensation of having to urinate soon after going. Perineum discomfort/burning/tightness, pubic area discomfort @ times,poor urine stream, post urine dripping/spray. All symptoms have improved with my protocol. At the worst I give it a 1 to 2 on irritation and discomfort and frequency. Helps: Elavil 5mg for anxiety and mast cell protection, (will only take it as needed) self internal PT as needed, stretching, walking, stairmaster cardio workout and light weights, reducing stress, moment to moment relaxation, deep breathing relaxation and using a Theracane. Makes worse: sitting for long periods, stress, over focusing on it. Currently 95%-98% recovered. Stay positive, relaxed and control your anxiety.
I encourage anxiety prone UCPPS people to consider L-Theanine
Age, 44 onset age 37 Feb 2006 Freq. need to urinate. Sensation of having to urinate soon after going. Perineum discomfort/burning/tightness, pubic area discomfort @ times,poor urine stream, post urine dripping/spray. All symptoms have improved with my protocol. At the worst I give it a 1 to 2 on irritation and discomfort and frequency. Helps: Elavil 5mg for anxiety and mast cell protection, (will only take it as needed) self internal PT as needed, stretching, walking, stairmaster cardio workout and light weights, reducing stress, moment to moment relaxation, deep breathing relaxation and using a Theracane. Makes worse: sitting for long periods, stress, over focusing on it. Currently 95%-98% recovered. Stay positive, relaxed and control your anxiety.
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webslave
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Re: Inflammation And Interleukin 6
I would agree with Carl that while antibiotics are well known to have anti-inflammatory effects, the exact way these effects take place is not well understood.
https://www.ucpps.men/antibiotics-are-anti-inflammatory-agents
https://www.ucpps.men/antibiotics-are-anti-inflammatory-agents
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dshoskes
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Re: Inflammation And Interleukin 6
Antibiotics work through direct cellular transcriptional effects. No, not every binding site for every cytokine is known, but the fact that these effects are real and independent of antibacterial effects is well established.
Galley, H. F., Dhillon, J. K., Paterson, R. L. and Webster, N. R.: Effect of ciprofloxacin on the activation of the transcription factors nuclear factor kappaB, activator protein-1 and nuclear factor-interleukin-6, and interleukin-6 and interleukin-8 mRNA expression in a human endothelial cell line. Clin Sci (Lond) 99, 405, 2000 Nov.
Quinolone antibiotics such as ciprofloxacin modify immune and inflammatory responses in some cells. We have shown previously that ciprofloxacin decreases the accumulation of interleukin (IL)-6 protein from a human endothelial cell line, whilst IL-8 protein production was increased. It is not known whether this occurs through effects on transcription and mRNA expression. We therefore investigated the effect of ciprofloxacin on mRNA for IL-6 and IL-8, and on three transcription factors known to be involved in the regulation of these cytokines. We investigated the effect of ciprofloxacin on tumour necrosis factor alpha- and IL-1beta-mediated activation of the transcription factors nuclear factor kappaB (NFkappaB), activator protein-1 (AP-1) and nuclear factor IL-6 (NF-IL-6) using an electrophoretic mobility shift assay, and the effect on expression of mRNA for IL-6 and IL-8 by reverse transcriptase-PCR in the EAhy926 endothelial cell line. Ciprofloxacin decreased IL-6 mRNA (P<0.05) and increased IL-8 mRNA (P<0.05) expression. Ciprofloxacin did not modulate activation of NFkappaB or AP-1. However, NF-IL-6 binding was decreased in the presence of 100 microg/ml ciprofloxacin (P<0.05). The study shows that ciprofloxacin-mediated decreased IL-6 release by a human endothelial cell line is reflected by decreased mRNA expression and decreased NF-IL-6 but not NFkappaB or AP-1 activation. Increased IL-8 mRNA in response to ciprofloxacin was not reflected by altered transcription factor activation and may represent increased mRNA stability.
Daniel Shoskes MD
www.dshoskes.com
www.dshoskes.com
Re: Inflammation And Interleukin 6
Way over my head for a lament dude like myself.... 
Thanks though Dr. S...for your time and hard work to help us all...I've said this before...You rock!!!
All I know is I did 5 weeks of Cipro and my WBC's count in my EPS for those that care, went from 10 to 1, but did nothing for the burning discomfort in my perineum. So in the end, my belief being a former sufferer and someone that has to manage this condition for the rest of my life...If you are cleared of any serious condition and are not in the 5% that have an infection or what ever that low % group is....AB's have a useless place for CP/CPPS or LUTS related discomfort from an inflamed prostate.
I do believe that we as a patient group should first rule out other serious problems like stricture, cancer etc...do 4 to 5 weeks of Cipro to knock out any possible undetected infection and go from there.
I'm a believer that if I can drop I-8 in my case, it will help with the inflammation and discomfort I get from it. The fact that Aleve (naproxen) helps, tells me a lot( I'm still interested in elocalcitol...even though it did not help men with pain but lowered I-8)
My uro, Dr. Scott Zeitlin said...who I consider a great urologist and friend....He said something like this ( and it's not a direct quote either).... Cipro penetrates the prostate well and Cipro works the same way Motrin would for shoulder pain. Zeitlin said that to me to explain why I would take AB's even though I don't have an infection and I wasn't comfortable taking Cipro. This was before I ever heard of this site and learned about pelvic myoneuropathy and the hell many men have gone through taking long term AB's. Just my opinion and I'm not a doctor.
Kind regards, Carl...
Thanks though Dr. S...for your time and hard work to help us all...I've said this before...You rock!!!All I know is I did 5 weeks of Cipro and my WBC's count in my EPS for those that care, went from 10 to 1, but did nothing for the burning discomfort in my perineum. So in the end, my belief being a former sufferer and someone that has to manage this condition for the rest of my life...If you are cleared of any serious condition and are not in the 5% that have an infection or what ever that low % group is....AB's have a useless place for CP/CPPS or LUTS related discomfort from an inflamed prostate.
I do believe that we as a patient group should first rule out other serious problems like stricture, cancer etc...do 4 to 5 weeks of Cipro to knock out any possible undetected infection and go from there.
I'm a believer that if I can drop I-8 in my case, it will help with the inflammation and discomfort I get from it. The fact that Aleve (naproxen) helps, tells me a lot( I'm still interested in elocalcitol...even though it did not help men with pain but lowered I-8)
My uro, Dr. Scott Zeitlin said...who I consider a great urologist and friend....He said something like this ( and it's not a direct quote either).... Cipro penetrates the prostate well and Cipro works the same way Motrin would for shoulder pain. Zeitlin said that to me to explain why I would take AB's even though I don't have an infection and I wasn't comfortable taking Cipro. This was before I ever heard of this site and learned about pelvic myoneuropathy and the hell many men have gone through taking long term AB's. Just my opinion and I'm not a doctor.
Kind regards, Carl...
I am not a medical doctor. Please fill out your signature (click here) ☼ ☼ My Starter List for new members
I encourage anxiety prone UCPPS people to consider L-Theanine
Age, 44 onset age 37 Feb 2006 Freq. need to urinate. Sensation of having to urinate soon after going. Perineum discomfort/burning/tightness, pubic area discomfort @ times,poor urine stream, post urine dripping/spray. All symptoms have improved with my protocol. At the worst I give it a 1 to 2 on irritation and discomfort and frequency. Helps: Elavil 5mg for anxiety and mast cell protection, (will only take it as needed) self internal PT as needed, stretching, walking, stairmaster cardio workout and light weights, reducing stress, moment to moment relaxation, deep breathing relaxation and using a Theracane. Makes worse: sitting for long periods, stress, over focusing on it. Currently 95%-98% recovered. Stay positive, relaxed and control your anxiety.
I encourage anxiety prone UCPPS people to consider L-Theanine
Age, 44 onset age 37 Feb 2006 Freq. need to urinate. Sensation of having to urinate soon after going. Perineum discomfort/burning/tightness, pubic area discomfort @ times,poor urine stream, post urine dripping/spray. All symptoms have improved with my protocol. At the worst I give it a 1 to 2 on irritation and discomfort and frequency. Helps: Elavil 5mg for anxiety and mast cell protection, (will only take it as needed) self internal PT as needed, stretching, walking, stairmaster cardio workout and light weights, reducing stress, moment to moment relaxation, deep breathing relaxation and using a Theracane. Makes worse: sitting for long periods, stress, over focusing on it. Currently 95%-98% recovered. Stay positive, relaxed and control your anxiety.
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webslave
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Re: Inflammation And Interleukin 6
Just a note on Elocalcitol
http://www.bioxell.com/product-pipeline ... /index.lblClinical Development
We completed comprehensive preclinical testing with Elocalcitol and had planned to conduct an 80-100 patient Phase IIa trial in Europe in 2007. Following the results of the Phase IIa trial of Elocalcitol in Chronic Prostatitis, in which no reduction in pain was observed compared to placebo, it has been decided not to develop Elocalcitol further in indications where pain is a central component.
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Re: Inflammation And Interleukin 6
webslave wrote:Just a note on Elocalcitol
http://www.bioxell.com/product-pipeline ... /index.lblClinical Development
We completed comprehensive preclinical testing with Elocalcitol and had planned to conduct an 80-100 patient Phase IIa trial in Europe in 2007. Following the results of the Phase IIa trial of Elocalcitol in Chronic Prostatitis, in which no reduction in pain was observed compared to placebo, it has been decided not to develop Elocalcitol further in indications where pain is a central component.
I remember the dissapointment when this came out. At my onset, I followed bioxell's elocalcitol and even contacted them for trial here in the states, but as the above stated, it did not work, but it did lower I-8...
Cheers...
I am not a medical doctor. Please fill out your signature (click here) ☼ ☼ My Starter List for new members
I encourage anxiety prone UCPPS people to consider L-Theanine
Age, 44 onset age 37 Feb 2006 Freq. need to urinate. Sensation of having to urinate soon after going. Perineum discomfort/burning/tightness, pubic area discomfort @ times,poor urine stream, post urine dripping/spray. All symptoms have improved with my protocol. At the worst I give it a 1 to 2 on irritation and discomfort and frequency. Helps: Elavil 5mg for anxiety and mast cell protection, (will only take it as needed) self internal PT as needed, stretching, walking, stairmaster cardio workout and light weights, reducing stress, moment to moment relaxation, deep breathing relaxation and using a Theracane. Makes worse: sitting for long periods, stress, over focusing on it. Currently 95%-98% recovered. Stay positive, relaxed and control your anxiety.
I encourage anxiety prone UCPPS people to consider L-Theanine
Age, 44 onset age 37 Feb 2006 Freq. need to urinate. Sensation of having to urinate soon after going. Perineum discomfort/burning/tightness, pubic area discomfort @ times,poor urine stream, post urine dripping/spray. All symptoms have improved with my protocol. At the worst I give it a 1 to 2 on irritation and discomfort and frequency. Helps: Elavil 5mg for anxiety and mast cell protection, (will only take it as needed) self internal PT as needed, stretching, walking, stairmaster cardio workout and light weights, reducing stress, moment to moment relaxation, deep breathing relaxation and using a Theracane. Makes worse: sitting for long periods, stress, over focusing on it. Currently 95%-98% recovered. Stay positive, relaxed and control your anxiety.