title: Detection of Trichomonas vaginalis in prostate tissue and serostatus in patients with asymptomatic benign prostatic hyperplasia.
abstract: BACKGROUND
  Despite a worldwide common and progressive nature of benign prostate hyperplasia (BPH) in older men, no association has been observed between a causative pathogen and other etiology so far.
  
  
  METHODS
  In this study, we investigated a causative association of Trichomonas vaginalis, a flagellate protozoan parasite, in 171 BPH cases presenting without symptoms of prostatitis at a surgical outpatient clinic in Kuwait. We detected T. vaginalis DNA by polymerase chain reaction (PCR) and T. vaginalis antigen by immunocytochemistry (ICC) in the prostate tissue of these cases. A total of 171 age-matched controls with no urinary tract symptoms were also included in the study. A detailed information regarding the sexual history and sexually transmitted infections (STIs) was enquired from all the enrolled subjects.
  
  
  RESULTS
  We detected T. vaginalis DNA and T. vaginalis antigen in 42 (24.6 %) and 37 (21.6 %) of the 171 BPH cases respectively in their prostate tissue. Both these assays showed a very good agreement and statistically no significant difference in their sensitivities and specificities. A relatively higher seropositivity rate for antibodies to T. vaginalis was detected in BPH cases (53 of 171 cases, 31.0 %) than in the control group (26.9 %) [p: 0.19] and both were higher than in earlier reports but no significant association was observed between BPH and T. vaginalis serostatus. However, a greater proportion of seroreactive BPH cases had high IgG2 antibody absorbance score than in the control group (p:0.000). Furthermore, no significant association was observed between T. vaginalis seropositivity and presence of T. vaginalis DNA in the prostate tissue.
  
  
  CONCLUSIONS
  Our study documents T. vaginalis DNA and T. vaginalis antigen in 24.6 and 21.6 % respectively in the prostate tissue of the BPH cases. We also detected a relatively higher seropositivity rate for antibodies to T. vaginalis both in the BPH cases and in normal control group, 31 and 26.9 % respectively but no significant association was observed between BPH and T. vaginalis serostatus or presence of T. vaginalis DNA in the prostate tissue. Further epidemiological and case-controlled studies are needed to focus on local response to chronic asymptomatic retention of T. vaginalis in prostate tissue in the development of benign prostate hyperplasia.
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, Kuwait University, PO Box: 24923, Safat, 13110, Kuwait. iqbal@hsc.edu.kw.
authors.forename: Jamshaid
authors.identifier: http://orcid.org/0000-0002-2484-0704
authors.initials: J
authors.lastname: Iqbal
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, Kuwait University, PO Box: 24923, Safat, 13110, Kuwait.
authors.forename: Jumanah
authors.initials: J
authors.lastname: Al-Rashed
authors.affiliation: Department of Surgery (Division of Urology), Faculty of Medicine, Kuwait University, PO Box: 24923, Safat, 13110, Kuwait.
authors.forename: Elijah O
authors.initials: EO
authors.lastname: Kehinde
keywords: Benign prostate hyperplasia; Prostate tissue; Serostatus; Trichomonas vaginalis