Allopurinol treatment results in elevated prostate-specific antigen levels in prostatic fluid and serum of patients with non-bacterial prostatitis.
Non-bacterial prostatitis is a common problem in young men. It is a disease which is often recurrent and each episode lasts for several months. Different causative mechanisms of the disease have been discussed including identified and non-identified microorganisms, stone formation and psychological factors. It was shown in an earlier study that urinary reflux (as shown by a high creatinine concentration in prostatic fluid) took place to a varying extent in the prostatic ducts and this reflux was related to prostatic pain and urate concentration in expressed prostatic secretion (EPS). Allopurinol treatment lowered the urate concentration in EPS and relieved the subjective discomfort. This study reports serum (S) levels of prostate-specific antigen (PSA) in patients with non-bacterial prostatitis and the way in which S-PSA was affected by allopurinol treatment. It is also shown that the S-PSA level is age dependent. A correlation existed between the S-PSA concentration and EPS content of white blood cells. Patients with high EPS urate concentrations corresponded to low S-PSA levels and allopurinol treatment resulted in elevated S-PSA levels. PSA in EPS was also increased by allopurinol treatment. Hence, an increased release of PSA from the prostate gland was noted upon allopurinol treatment. The mechanism of the allopurinol-induced release is obscure. It might be explained by an induction of PSA synthesis via an allopurinol effect on the genome but an increased leakage of the prostatic cells elicited by allopurinol could no be ruled out.
Persson
B E
BE
Department of Urology, University Hospital, Uppsala, Sweden.
Ronquist
G
G
D000328:Adult; D000367:Age Factors; D000493:Allopurinol / Q000627:therapeutic use*; D001826:Body Fluids / Q000378:metabolism*; D004311:Double-Blind Method; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood* / Q000187:drug effects; D011472:Prostatitis / Q000097:blood* / Q000188:drug therapy*; D014527:Uric Acid / Q000378:metabolism
D004791:Enzyme Inhibitors; D014527:Uric Acid; D000493:Allopurinol; D017430:Prostate-Specific Antigen