UroToday - The association of infection and chronic disorders including neoplasia is not new to the urogenital tract and the frequent presence of histologic inflammation within prostatic tissues requires further investigation. This manuscript extends the hypothesis that infectious agents, in particular Propionibacterium acnes, may be responsible for this inflammatory reaction. We used an indirect method of estimating the severity of infection by utilising the titre of serum antibodies specific to P. acnes. At the time of writing this manuscript no direct method was available for identifying or quantifying these organisms in prostatic tissue. However, recently direct FISH analysis(1) has confirmed intracellular P. acnes in prostatic sections taken from radical prostatectomy specimens.

It is important to note that our ELISA is not specific for P. acnes types IB and II which are common in the urinary tract. It will also detect antibodies against type IA which predominates on the skin, therefore a high antibody titre does not necessarily indicate infection of the prostate gland. However a high antibody titre may identify histologic inflammation and/or subclinical BPH in the specific subgroup of men who present with elevated serum PSA levels and biopsy results negative for cancer. Further, we wish to clarify that the lack of association between a high antibody titre and a diagnosis of prostate cancer reported in our study may simply reflect the small sample size. We noted that all four patients with antibody titres of 1:4000 or higher were diagnosed with prostate cancer and it is possible that analysis of a larger patient group could show a statistically significant association between these factors.

Beverley A Shannon, Ronald J Cohen and Kerryn L Garrett, as part of Beyond the Abstract on UroToday. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

References

(1). Alexeyev OA, Marklund I, Shannon B, Golovleva I, Olsson J, Andersson C, Eriksson I, Cohen R and Elgh F. Direct visualization of Propionibacterium acnes in prostate tissue by multicolor fluorescent in situ hybridization assay. J. Clin. Microbiol. 2007: doi:10.1128/JCM.01543-07

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