title: Serum antibodies against genitourinary infectious agents in prostate cancer and benign prostate hyperplasia patients: a case-control study.
abstract: BACKGROUND
  Infection plays a role in the pathogenesis of many human malignancies. Whether prostate cancer (PCa) - an important health issue in the aging male population in the Western world - belongs to these conditions has been a matter of research since the 1970 s. Persistent serum antibodies are a proof of present or past infection. The aim of this study was to compare serum antibodies against genitourinary infectious agents between PCa patients and controls with benign prostate hyperplasia (BPH). We hypothesized that elevated serum antibody levels or higher seroprevalence in PCa patients would suggest an association of genitourinary infection in patient history and elevated PCa risk.
  
  
  METHODS
  A total of 434 males who had undergone open prostate surgery in a single institution were included in the study: 329 PCa patients and 105 controls with BPH. The subjects' serum samples were analysed by means of enzyme-linked immunosorbent assay, complement fixation test and indirect immunofluorescence for the presence of antibodies against common genitourinary infectious agents: human papillomavirus (HPV) 6, 11, 16, 18, 31 and 33, herpes simplex virus (HSV) 1 and 2, human cytomegalovirus (CMV), Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Neisseria gonorrhoeae and Treponema pallidum. Antibody seroprevalence and mean serum antibody levels were compared between cases and controls. Tumour grade and stage were correlated with serological findings.
  
  
  RESULTS
  PCa patients were more likely to harbour antibodies against Ureaplasma urealyticum (odds ratio (OR) 2.06; 95% confidence interval (CI) 1.08-4.28). Men with BPH were more often seropositive for HPV 18 and Chlamydia trachomatis (OR 0.23; 95% CI 0.09-0.61 and OR 0.45; 95% CI 0.21-0.99, respectively) and had higher mean serum CMV antibody levels than PCa patients (p = 0.0004). Among PCa patients, antibodies against HPV 6 were associated with a higher Gleason score (p = 0.0305).
  
  
  CONCLUSIONS
  Antibody seropositivity against the analyzed pathogens with the exception of Ureaplasma does not seem to be a risk factor for PCa pathogenesis. The presence or higher levels of serum antibodies against the genitourinary pathogens studied were not consistently associated with PCa. Serostatus was not a predictor of disease stage in the studied population.
authors.affiliation: Charles University in Prague, 3rd Faculty of Medicine, Department of Urology, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Hrbacek
authors.forename: Michael
authors.initials: M
authors.lastname: Urban
authors.forename: Eva
authors.initials: E
authors.lastname: Hamsikova
authors.forename: Ruth
authors.initials: R
authors.lastname: Tachezy
authors.forename: Vaclav
authors.initials: V
authors.lastname: Eis
authors.forename: Marek
authors.initials: M
authors.lastname: Brabec
authors.forename: Jiri
authors.initials: J
authors.lastname: Heracek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000276:immunology; D000907:Antibodies, Bacterial / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D016022:Case-Control Studies; D002692:Chlamydia trachomatis / Q000276:immunology; D003168:Complement Fixation Tests; D003587:Cytomegalovirus / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases / Q000276:immunology* / Q000382:microbiology / Q000821:virology; D008875:Middle Aged; D019535:Mycoplasma hominis / Q000276:immunology; D009344:Neisseria gonorrhoeae / Q000276:immunology; D011467:Prostate / Q000473:pathology / Q000601:surgery; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000097:blood / Q000276:immunology*; D011471:Prostatic Neoplasms / Q000097:blood / Q000276:immunology*; D018139:Simplexvirus / Q000276:immunology; D013045:Species Specificity; D014210:Treponema pallidum / Q000276:immunology; D016990:Ureaplasma urealyticum / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral