Low levels of IL-1ra versus IL-1 levels in prostatic fluid are not a cause of prolongation of prostatitis.

We have investigated the significance of leukocytosis1,2) and its prolongation3) in prostatic fluid (PF) from prostatitis patients. In a previous paper we reported an increase in the survival rate of peripheral blood monocytes (PBMC) when cultured with macrophages in PF from nonbacterial prostatitis (NBP) patients, possibly due to cytokines secreted from the macrophages, because elevated interleukin (IL-1)f3 levels in culture medium were observed4) Recent papers have reported that the balance between the production of IL-1 and IL-1 receptor antagonist (ra) probably influences the regulation of the host response and the severity and prolongation of inflammatory reactions in some diseases5), and that the balance is necessary for homeostasis of the mononuclear phagocytosis system6), because IL-1ra limits the extent of the potentially deleterious effects of IL-1'). The inhibitory action of IL-lra results from binding of IL-lra to the IL-1 receptor Type I with an affinity comparable to that of IL-la or IL-1fl, thus competing with IL-la or IL-1/3 for binding this receptor. This binding, however, does not result in signal transductions). An excess of 10 to 100 times more IL-lra than IL-1 is needed to abrogate the biologic effects of IL-1 on target cells by 50%7). High dose administration of IL-lra to affect cartilageproteoglycan synthesis disturbance caused by IL1 is considered for clinical application8). Herein we have attempted to clarify whether low levels of IL-lra vs. IL-1 are a cause of prolongation of prostatitis, especially NBP and prostatodynia. Generally prostatitis is classified into four groups: acute bacterial prostatitis (ABP), chronic bacterial prostatitis, NBP and prostatodynia. The latter two are most common in prostatitis and usually take a long course. In prostatodynia, patients have similar complaints as in NBP, but there is no leukocytosis in prostatic fluid. Because of a shortage of cases of prostatitis, female acute bacterial cystitis (ABC), which is the most common disease in out-patient urology clinics, was also studied for the understanding of data obtained in the present study of prostatitis. No studies of the relation between IL-1 and IL-lra in the urological field are to be found in the literature. IL-ig and IL-lra concentrations in urine after prostatic massage (VB3: Voided bladder 3) in prostatitis and catheterized urine from female ABC patients were determined by using enzyme-linked immunosorbent assay kits (R & D Systems INC. Minneapolis, MN, USA)