title: Monocyte chemoattractant protein-1 and macrophage inflammatory protein-1alpha as possible biomarkers for the chronic pelvic pain syndrome.
abstract: OBJECTIVE
  The chronic pelvic pain syndrome is characterized by pelvic pain, voiding symptoms and varying degrees of inflammation within expressed prostatic secretions. We evaluated the chemokines monocyte chemoattractant protein 1 (CCL2) and macrophage inflammatory protein-1alpha (CCL3) in expressed prostatic secretions to identify marker increases associated with inflammatory (IIIA) and noninflammatory (IIIB) chronic pelvic pain syndrome. In addition, chemokine levels were correlated with clinical pain as determined by the National Institutes of Health chronic prostatitis symptom index.
  
  
  METHODS
  Expressed prostatic secretions were collected by digital rectal examination, and evaluated by enzyme linked immunosorbent assays for monocyte chemoattractant protein 1 and macrophage inflammatory protein-1alpha in 154 patients including controls (13), those with benign prostatic hyperplasia (54), chronic pelvic pain syndrome IIIA (37) and IIIB (50). Monocyte chemoattractant protein 1 and macrophage inflammatory protein-1alpha levels were compared between IIIA, IIIB and the control subgroups, and correlated against the chronic prostatitis symptom index and pain subscore using a Spearman test.
  
  
  RESULTS
  Mean levels of monocyte chemoattractant protein 1 in the control, inflammatory benign prostatic hyperplasia, noninflammatory benign prostatic hyperplasia, inflammatory chronic pelvic pain syndrome and noninflammatory chronic pelvic pain syndrome were 599.4, 886.0, 1,636.5, 3,261.2 and 2,272.7 pg/ml, respectively. Mean levels of macrophage inflammatory protein-1alpha in the control, inflammatory benign prostatic hyperplasia, noninflammatory benign prostatic hyperplasia, IIIA chronic pelvic pain syndrome and IIIB chronic pelvic pain syndrome were 140.1, 299.4, 238.7, 1,057.8 and 978.4 pg/ml, respectively. For each cytokine both chronic pelvic pain syndrome subtypes had statistically higher levels than the control group and patients with benign prostatic hyperplasia (p = 0.0002). Receiver operating curves using monocyte chemoattractant protein 1 levels greater than 704 pg/ml and macrophage inflammatory protein-1alpha greater than 146 pg/ml identified patients with chronic pelvic pain syndrome with an accuracy of 90% from control patients. Macrophage inflammatory protein-1alpha levels (p = 0.0007) correlated with the pain subscore of the chronic prostatitis symptom index while monocyte chemoattractant protein 1 (p = 0.71) did not.
  
  
  CONCLUSIONS
  Monocyte chemoattractant protein 1 and macrophage inflammatory protein-1alpha within the prostatic fluid in both chronic pelvic pain syndrome subtypes provide candidate future biomarkers for chronic pelvic pain syndrome. In addition, macrophage inflammatory protein-1alpha increase in expressed prostatic secretions provides a new marker for clinical pain in chronic pelvic pain syndrome patients. Given these findings prostatic dysfunction likely has a role in the pathophysiology of this syndrome. These chemokines may serve as effective diagnostic markers and modulators against the chemokines could provide an attractive treatment strategy in individuals with chronic pelvic pain syndrome.
authors: Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
authors: Naresh V
authors: NV
authors: Desireddi
authors: Phillip L
authors: PL
authors: Campbell
authors: Jeffrey A
authors: JA
authors: Stern
authors: Rudina
authors: R
authors: Sobkoviak
authors: Shannon
authors: S
authors: Chuai
authors: Shiva
authors: S
authors: Shahrara
authors: Praveen
authors: P
authors: Thumbikat
authors: Richard M
authors: RM
authors: Pope
authors: J Richard
authors: JR
authors: Landis
authors: Alisa E
authors: AE
authors: Koch
authors: Anthony J
authors: AJ
authors: Schaeffer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D018932:Chemokine CCL2 / Q000032:analysis*; D054405:Chemokine CCL3 / Q000032:analysis*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D017699:Pelvic Pain / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011467:Prostate / Q000378:metabolism; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D054405:Chemokine CCL3