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Abstract 32

PSA Is a Candidate Self Antigen in Autoimmune Chronic Prostatitis/ Chronic Pelvic Pain Syndrome

S Ponniah, I Arah, RB Alexander

University of Maryland, Baltimore, MD

Purpose Previous studies have demonstrated that recognition of seminal plasma antigens can occur in patients with chronic prostatitis/chronic pelvic pain syndrome (Alexander et al., Urology 50:893899, 1997). This suggests that an autoimmune component may contribute to symptoms in some men. To determine if any of the principal secretory proteins of the prostate could be candidate antigens in autoimmune prostatitis, we examined the recall proliferative response of purified CD4 T cells in patients with chronic prostatitis/chronic pelvic pain syndrome and normal volunteers, using purified prostate proteins and autologous dendritic cells.

Methods Peripheral blood mononuclear cells were harvested from 14 patients with chronic prostatitis/ chronic pelvic pain syndrome and 12 normal volunteers by density gradient centrifugation from peripheral blood samples. The stimulating cells were irradiated autologous dendritic cells produced by culture of monocyte-enriched fractions with IL4 and GMCSF. Purified CD4 T cells were the responding population. Recall proliferation assays were performed using purified seminal plasma proteins as antigens.

Results In 14 patients with chronic prostatitis/chronic pelvic pain syndrome we detected a greater than twofold increase in proliferative response to PSA compared to control in 5 patients (36%). No response to PAP or,B microseminoprotein was observed in these 14 patients. In 12 normal volunteer donors with no history of genitourinary disease or symptoms, no proliferative response above background was observed to any prostatic antigen.

Conclusions The data suggest that some men with the symptoms of chronic prostatitis/chronic pelvic pain syndrome have evidence of a proliferative CD4 T cell response to PSA. PSA is a candidate antigen in chronic prostatitis/chronic pelvic pain syndrome and may be an appropriate target for immunotherapy for prostatic cancer.