Clinical and experimental rationale for antioxidant therapy of chronic bacterial prostatitis

Zinc metabolism in healthy men and in patients with chronic bacterial prostatitis

Introduction: Zinc is a vital trace element, which regulates metabolism of a prostate gland. It has been established that a low plasma zinc level in men increases the risk of chronic prostatitis and vice versa, chronic prostatitis is often accompanied by zinc deficiency in the prostate gland. The purpose of this study is to research the features and possible correlations of zinc metabolism disorders at systemic (in blood) and local (in prostatic fluid) levels in healthy men and patients with chronic bacterial prostatitis (CBP).

Materials and methods: Ninety patients with CBP (main group) and thirty healthy men (control group) were randomized by age (mean age 38.5±2.9 years) and examined. In addition to standard examinations, the zinc levels in blood serum and prostatic fluid were determined, and the oxidative status of the prostate gland was assessed (the level of reactive oxygen species (ROS), conjugated dienes, malondialdehyde, superoxide dismutase (SOD) activity in the prostatic fluid) according to standard methods.

Results and discussion: In patients with CBP, the absolute deficiency of plasma and prostatic zinc was detected 2.89 and 2.5 times more often, respectively, than in healthy men (p < 0.05). At the same time, both the patients with CBP and healthy men had significant correlations between plasma zinc and zinc in prostatic fluid (r = 0.345; n = 37; p = 0.001 and r = 0.156; n = 30; p = 0.001; respectively). A significant positive correlation between the zinc level and the activity of SOD in prostatic fluid was revealed only in the patients with CBP (r = 0.389; n = 90; p = 0.001).

Conclusion: Zinc concentration in blood plasma does not objectively reflect zinc metabolism disorders in the prostate gland, and therefore the determination of zinc in prostatic fluid is the most reliable and sensitive method for assessing zink disorders in patients with CBP.

Immune-Metabolic Therapy of Purulent Inflammatory Diseases

Introduction: Inflammatory diseases of the female genital organs rank among the leading ones in the total number of women of reproductive age. This results from a decrease in immunity, early sexual activity, neglect of personal hygiene, abortions, birth complications, etc.

Materials and Methods: The study included 100 patients suffering from exacerbated chronic salpingo-oophoritis and its combination with bacterial vaginosis. In the study, all the patients were randomly divided into five groups, with 20 patients each. The patients were treated in the prescribed regimens and doses, according to the standards of specialized medical care. An immunomodulator immunomax and an antioxidant hypoxene were chosen as additional treatment options. Clinical and laboratory parameters were measured in all the patients before and after the treatment. The effectiveness of the treatment was evaluated 10-14 days later. In 18 people, the procedure was repeated after 2-3 months.

Results and Discussion: It was found that the standard therapy to treat exacerbated chronic salpingo-oophoritis reduced inflammatory manifestations after 10-14 days; however, the risk of complications and relapse of the disease remained. Immunomax provided satisfactory second-order normalization of the immunological and metabolic parameters, ultimate normalization of pro-inflammatory parameters and absolutely no positive effect on the clinical parameters in patients with chronic salpingo-oophoritis in the acute stage, when compared with the standard treatment. A complex therapy of salpingo-oophoritis with bacterial vaginosis by means of immunomax and hypoxene aimed to normalize most clinical and laboratory parameters was absolutely positive; a moderate level of parameters was revealed only in cellular-humoral immunity.

Conclusion: After 10-14 days, the standard treatment of patients resulted in normalization of the pro-inflammatory and immunological parameters, rather than the clinical and metabolic parameters. The administration of immunomax contributed to the correction of metabolic, immunological and pro-inflammatory markers, and the complex administration of an immunomodulator with an antioxidant favorably affected all the laboratory parameters.