PATHOGENESIS OF NON BACTERIAL CHRONIC PROSTATITIS

淋巴细胞和淋巴细胞衍生的细胞因子被认为是通过调节多种细胞（包括炎症细胞、免疫细胞和组织细胞（如肥大细胞））的功能来控制慢性炎症过程的关键。目前，人们对T淋巴细胞、肥大细胞、神经及其产物在非细菌性慢性前列腺炎（NBCP）及其相关慢性疼痛中的存在及其作用知之甚少。基于越来越多的关于淋巴细胞-肥大细胞-神经相互作用在疼痛中的作用的文献，我们提出了以下假设：非细菌性慢性前列腺炎（NBCP）、前列腺痛和慢性非细菌性炎症（CNBI）是由特异性T淋巴细胞亚群（T1与T2）失衡引起的前列腺炎性疾病，T淋巴细胞亚群通过其细胞因子的表达，直接或间接地调节前列腺微环境中炎症、免疫和组织细胞（肥大细胞和神经）的功能。从而控制慢性炎症前列腺组织的炎症和疼痛。为了验证这一假设，我们提出了以下目标：1)从NBCP、前列腺痛、CNBI和对照患者群体中分离、表征和关联体液（血液、尿液、前列腺液）和组织中的T细胞。2)表征和关联NBCP、前列腺痛、CNBI和对照患者体液和组织中T1和T2细胞因子的分布。3)探讨NBCP、前列腺痛、CNBI及对照患者肥大细胞及肥大细胞相关因子的分布特征及相关性。4)明确NBCP、前列腺痛、CNBI及对照组患者淋巴细胞、肥大细胞与神经的关系。5)量化慢性前列腺炎（NBCP、前列腺痛和CNBI）患者的疼痛，使用已建立的验证仪器将其临床病程与细胞和细胞因子结果相关联。

Lymphocytes and lymphocyte-derived cytokines are thought to be critical in controlling chronic inflammatory processes by regulating the function of a wide variety of cells including inflammatory, immunologic and tissue cells (e.g. mast cells). Currently, little is known about the existence and role of T lymphocytes, mast cells, nerves and their products in non-bacterial chronic prostatitis (NBCP) and its associated chronic pain. Based on the growing body of literature on the role of lymphocyte-mast cell-nerve interactions in pain we have developed the following hypothesis: Hypothesis: Non-bacterial chronic prostatitis (NBCP), prostatodynia and chronic nonbacterial inflammation (CNBI) are inflammatory diseases of the prostate that result from an imbalance of specific T lymphocyte subpopulations (T1 vs. T2), which via their cytokine expression, regulate directly and indirectly the function of inflammatory, immunology and tissue cells (mast cells and nerves) within the prostate microenvironment, and thereby control both inflammation and pain within chronically inflamed prostate tissue. To test this hypothesis we propose the following goals: 1) to isolate, characterize and correlate T cells in fluids (blood, urine, prostate fluids) and tissue from NBCP, prostatodynia, CNBI and control patient populations. 2) to characterize and correlate the distribution of T1 and T2 cytokines in fluids and tissue from NBCP, prostatodynia, CNBI and control patients. 3) to characterize and correlate the distribution of mast cells and mast cell-related factors in NBCP, prostatodynia, CNBI and control patients. 4) to define the relationships between lymphocytes, mast cells and nerves in NBCP, prostatodynia, CNBI and control patients. 5) to quantify pain in patients with chronic prostatitis (NBCP, prostatodynia, and CNBI) using established validated instruments to correlate their clinical course with cell and cytokine results.