The etiology of the so-called chronic prostatitis is uncertain in over 90% of men diagnosed, and therapy is largely empirical and ineffective. The long-term objectives of this proposal are to determine the causes, consequences, and optimal therapy for chronic prostatitis syndromes (CPS).
The specific aims are: (1) Test the hypothesis that genitourinary tract infection is important using clinical, microbiological, and molecular approaches. Preliminary studies used polymerase chain reaction (PCR) methods to identify microbial DNAs in patients with CPS (25% by one and 77% by another assay) and found that such patients were more likely to have inflammation in their expressed prostatic secretions (EPS). These observations will be extended and it will be determined if the spectrum of organisms associated with chronic inflammatory prostatitis differs from the spectrum of organisms associated with non-inflammatory prostatitis. (2) Test the hypothesis that multiple EPS evaluations are needed for accurate patient classification. The new NIH classification distinguishes patients with EPS inflammation from those without inflammation. Preliminary data suggest that some patients have intermittent EPS inflammation. This study will establish if patients need multiple evaluations of their EPS and provide insight into the sources and characteristics of leukocytes in the prostatic secretions. (3) Test the hypothesis that men with CPS and EPS or seminal inflammation are more likely to have abnormal prostatic blood flow than patients without inflammation. Preliminary studies established methods to evaluate leukocytes in EPS, seminal fluid and prostatic parenchyma, and to measure the amount and distribution of blood flow within the prostate. This study will provide insight into the pathophysiology of chronic prostatitis and establish the clinical utility of these evaluations. (4) Test the hypothesis that patients with EPS inflammation are more likely to exhibit bladder stigmata associated with interstitial cystitis than patients with EPS inflammation. Preliminary data suggest that some patients exhibit petechial bladder hemorrhages and glomerulations after hydrodistension. This study will provide insight into the pathophysiology of chronic prostatitis and the clinical utility of cystoscopy under anaesthesia for evaluating patients.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK038955-13
Application #
6176453
Study Section
Special Emphasis Panel (ZRG4-GMB (05))
Program Officer
Mullins, Christopher V
Project Start
1991-08-01
Project End
2001-07-31
Budget Start
2000-08-01
Budget End
2001-07-31
Support Year
13
Fiscal Year
2000
Total Cost
$407,225
Indirect Cost
Name
University of Washington
Department
Urology
Type
Schools of Medicine
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay et al. (2014) Acupuncture and immune function in chronic prostatitis/chronic pelvic pain syndrome: a randomized, controlled study. Complement Ther Med 22:965-9
Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay et al. (2011) Validation of a sham acupuncture procedure in a randomised, controlled clinical trial of chronic pelvic pain treatment. Acupunct Med 29:40-6
Riley, Donald E; Krieger, John N (2009) UTR dinucleotide simple sequence repeat evolution exhibits recurring patterns including regulatory sequence motif replacements. Gene 429:80-6
Riley, Donald E; Krieger, John N (2009) Embryonic nervous system genes predominate in searches for dinucleotide simple sequence repeats flanked by conserved sequences. Gene 429:74-9
Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay et al. (2008) Adverse impact of sexual dysfunction in chronic prostatitis/chronic pelvic pain syndrome. Urology 71:79-84
Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay et al. (2008) Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Am J Med 121:79.e1-7
Riley, Donald E; Jeon, Joon Seong; Krieger, John N (2007) Simple repeat evolution includes dramatic primary sequence changes that conserve folding potential. Biochem Biophys Res Commun 355:619-25
Riley, Donald E; Krieger, John N (2005) Short tandem repeat (STR) replacements in UTRs and introns suggest an important role for certain STRs in gene expression and disease. Gene 344:203-11
Krieger, John N; Ross, Susan O; Limaye, Ajit P et al. (2005) Inconsistent localization of gram-positive bacteria to prostate-specific specimens from patients with chronic prostatitis. Urology 66:721-5
Riley, Donald E; Krieger, John N (2004) Short tandem repeats are associated with diverse mRNAs encoding membrane-targeted proteins. Bioessays 26:434-44

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