title: Infectious mononucleosis, other infections and prostate-specific antigen concentration as a marker of prostate involvement during infection.
abstract: Although Epstein-Barr virus has been detected in prostate tissue, no associations have been observed with prostate cancer in the few studies conducted to date. One possible reason for these null findings may be use of cumulative exposure measures that do not inform the timing of infection, i.e., childhood versus adolescence/early adulthood when infection is more likely to manifest as infectious mononucleosis (IM). We sought to determine the influence of young adult-onset IM on the prostate by measuring prostate-specific antigen (PSA) as a marker of prostate inflammation/damage among U.S. military members. We defined IM cases as men diagnosed with IM from 1998 to 2003 (n = 55) and controls as men without an IM diagnosis (n = 255). We selected two archived serum specimens for each participant, the first collected after diagnosis for cases and one randomly selected from 1998 to 2003 for controls (index), as well as the preceding specimen (preindex). PSA was measured in each specimen. To explore the specificity of our findings for prostate as opposed to systemic inflammation, we performed a post hoc comparison of other infectious disease cases without genitourinary involvement (n = 90) and controls (n = 220). We found that IM cases were more likely to have a large PSA rise than controls (≥ 20 ng/mL: 19.7% versus 8.8%, p = 0.027; ≥ 40% rise: 25.7% versus 9.4%, p = 0.0021), as were other infectious disease cases (25.7% versus 14.0%, p = 0.020; 27.7% versus 18.0%, p = 0.092). These findings suggest that, in addition to rising because of prostate infection, PSA may also rise because of systemic inflammation, which could have implications for PSA interpretation in older men.
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO.|Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, MO.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Sutcliffe
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Remington L
authors.initials: RL
authors.lastname: Nevin
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO.
authors.forename: Ratna
authors.initials: R
authors.lastname: Pakpahan
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Elliott
authors.affiliation: Division of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ.
authors.forename: Marvin E
authors.initials: ME
authors.lastname: Langston
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.|Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.|Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD.
authors.forename: Angelo M
authors.initials: AM
authors.lastname: De Marzo
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
authors.affiliation: Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.|Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD.
authors.forename: William B
authors.initials: WB
authors.lastname: Isaacs
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.|Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.|Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD.|Department of Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: William G
authors.initials: WG
authors.lastname: Nelson
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.|Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.|Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD.
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Sokoll
authors.affiliation: Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Walsh
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Zenilman
authors.affiliation: U.S. Army Public Health Command (Provisional), Aberdeen Proving Ground, Aberdeen, MD.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Cersovsky
authors.affiliation: Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.|Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD.|Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Platz
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D006801:Humans; D007239:Infections / Q000097:blood / Q000150:complications / Q000382:microbiology*; D007244:Infectious Mononucleosis / Q000097:blood* / Q000473:pathology; D007249:Inflammation / Q000097:blood / Q000821:virology; D008297:Male; D011467:Prostate / Q000821:virology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D017430:Prostate-Specific Antigen
keywords: epidemiology; infection; infectious mononucleosis; prostate cancer; prostate-specific antigen