Kronik pelvik ağrı sendrom'lu erkeklerdeki seminal plazma tümör nekrozis faktör alfa ve interlökin 1 Beta düzeylerinin, tanı ve tedavi yanıtıyla ilişkisi
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Date
2006
Authors
Kekilli, Onur
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Amaç: Kronik pelvik ağrı sendromu (KPAS) sık konulan bir tanı olup tam olarak anlaşılamamış bir durumdur. Tanı genellikle semptomlara dayalı olup, başlıca tedavi ise hastaya güven verme ve kanıtlanmış bir enfeksiyon olmamasına karşın antibiyotik ve antiinflamatuar ilaçlardan oluşur. Biz bu çalışmada, KPAS’lı hastaların seminal plazmalarındaki tümör nekrozis faktör alfa (TNF-alfa) ve interlökin 1 beta (IL-1 beta) düzeylerinin, tanı ve tedavideki önemini belirlemeyi amaçladık. Gereç ve yöntem: KPAS’lı 25 erkek ve gönüllü 8 normal erkekden semen örnekleri alındı. Seminal plazma TNF-alfa ve IL-1 beta düzeyleri ELISA yöntemi ile ölçüldü. Siprofloksasin tedavisinden sonra KPAS’lı hastalarda bu semen sitokin düzeyleri, tekrar ölçüldü. Hastalar tedavi öncesi ve sonrası kronik prostatit semptom indeksi (KPSİ) ile değerlendirildi. Hastalar, tedavi öncesi sitokin düzeylerine göre beş gruba ayrıldı. Bu gruplar, tedavi sonrası KPSİ ve sitokin düzeylerine göre karşılaştırıldı. Bulgular: KPAS’lı hastaların TNF alfa ve IL-1 beta düzeyleri, kontrol grubuyla karşılaştırıldığında belirgin olarak yüksekti (p<0,05). KPAS’lı erkeklerin, KPSİ ile semen TNF alfa ve IL-1 beta düzeyleri arasında güçlü bir korelasyon saptandı. Tedavi sonrasında, tüm grupların KPSİ ve sitokin düzeylerinde azalma saptandı ancak bu azalma yalnızca tedavi öncesi sitokin düzeyleri en yüksek olan iki grupta anlamlıydı (p<0,05). Sonuç: Seminal plazma TNF alfa ve IL-1 beta düzeyi ölçümleri, hangi KPAS’lı hastaların antibiyotik tedavisinden fayda görebileceğinin belirlenmesinde yardımcı olabilir ve gereksiz antibiyotik kullanımını önleyebilir.
Purpose: Chronic pelvic pain syndrome (CPPS) is a common diagnosis, but the condition is poorly understood. Diagnosis usually depends on the symptoms and treatment mainly consists of reassurance and antiinflammatory medications and antibiotics in the abcence of a documented infection. In this study, we aimed to asses the importance of seminal plasma tumor necrosis factor alpha (TNF-alpha) and interleukin 1 beta (IL-1 beta) levels in the diagnosis and treatment of CPPS patients. Materials and methods: Semen samples from 25 men with CPPS and 8 normal male volunteers were obtained. TNF-alpha and IL-1 beta levels were measured in the seminal plasma by ELISA method. After treatment with ciprofloxacin, the levels of these cytokines were measured again in the semen of men with CPPS. The patients are evaluated with chronic prostatic symptom index (CPSI) before and after treatment. The patients are divided in five groups according to pretreatment cytokine levels. After the treatment these groups were compared according to CPSI and cytokine levels. Results: TNF-alpha and IL-1 beta levels were elevated significantly in the men with CPPS compared with the control group (p<0,05). A strong correlation between the CPSI and the seminal levels of TNF alpha and IL-1 beta of men with CPPS was determined. After the treatment, a decrease was determined in CPSI and cytokine levels in all groups but it was significant only in two groups which had highest pretreatment cytokine levels (p<0,05). Conclusions: Seminal plasma TNF alpha and IL-1 beta level measurements may help to determine which CPPS patients would benefit from the antibiotic therapy and may prevent unnecessary antibiotic use.
Purpose: Chronic pelvic pain syndrome (CPPS) is a common diagnosis, but the condition is poorly understood. Diagnosis usually depends on the symptoms and treatment mainly consists of reassurance and antiinflammatory medications and antibiotics in the abcence of a documented infection. In this study, we aimed to asses the importance of seminal plasma tumor necrosis factor alpha (TNF-alpha) and interleukin 1 beta (IL-1 beta) levels in the diagnosis and treatment of CPPS patients. Materials and methods: Semen samples from 25 men with CPPS and 8 normal male volunteers were obtained. TNF-alpha and IL-1 beta levels were measured in the seminal plasma by ELISA method. After treatment with ciprofloxacin, the levels of these cytokines were measured again in the semen of men with CPPS. The patients are evaluated with chronic prostatic symptom index (CPSI) before and after treatment. The patients are divided in five groups according to pretreatment cytokine levels. After the treatment these groups were compared according to CPSI and cytokine levels. Results: TNF-alpha and IL-1 beta levels were elevated significantly in the men with CPPS compared with the control group (p<0,05). A strong correlation between the CPSI and the seminal levels of TNF alpha and IL-1 beta of men with CPPS was determined. After the treatment, a decrease was determined in CPSI and cytokine levels in all groups but it was significant only in two groups which had highest pretreatment cytokine levels (p<0,05). Conclusions: Seminal plasma TNF alpha and IL-1 beta level measurements may help to determine which CPPS patients would benefit from the antibiotic therapy and may prevent unnecessary antibiotic use.
Description
Keywords
Kronik pelvik ağrı sendromu, TNF alfa, IL-1 beta, Siprofloksasin, Chronic pelvic pain syndrome, TNF alpha, Ciprofloxacin
Citation
Kekilli, O. (2006). Kronik pelvik ağrı sendrom'lu erkeklerdeki seminal plazma tümör nekrozis faktör alfa ve interlökin 1 Beta düzeylerinin, tanı ve tedavi yanıtıyla ilişkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.