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Wang H, Ji Y, Zhang S, Yuan P, Zhao H, Guo Y, Xie X, Ding Y. Effect of acupuncture on quality of life in patients with chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial. Zhongguo Zhen Jiu 2024; 44:411-417. [PMID: 38621728 DOI: 10.13703/j.0255-2930.20230626-k0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
OBJECTIVES To observe the effect and safety of acupuncture on quality of life, pain, and prostate symptoms in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS Seventy patients with CP/CPPS were randomly divided into an acupuncture group (35 cases, 1 case was eliminated) and a sham acupuncture group (35 cases, 3 cases dropped out). The patients in the acupuncture group were treated with routine acupuncture at bilateral Zhongliao (BL 33), Huiyang (BL 35), Shenshu (BL 23) and Sanyinjiao (SP 6), while the patients in the sham acupuncture group were treated with shallow needling at non-meridian and non-acupoint points beside bilateral Zhongliao (BL 33), Huiyang (BL 35), Shenshu (BL 23) and Sanyinjiao (SP 6),without manipulation to induce arrival of qi (deqi). Both groups retained the needles for 30 min, with one session every other day, three times a week, for a total of 8 weeks (24 sessions). Before and after treatment, and at the follow-up of 24 weeks after treatment completion, the scores of MOS 36-item short-form health survey (SF-36, including 8 dimensions of physical function [PF], role physical function [RP], bodily pain [BP], general health status [GH], vitality [VT], social function [SF], role emotional [RE], and mental health [MH], which can be summarized as physical component summary [PCS] and mental component summary [MCS]), pelvic pain visual analogue scale (VAS), National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), and international prostate symptom score (IPSS) were evaluated, and safety of both groups was assessed. RESULTS After treatment and at the follow-up, the scores of each dimension and PCS, MCS scores of SF-36 in the acupuncture group were higher than those before treatment (P<0.05, P<0.01); compared before treatment, the RP, BP, and SF scores and PCS score in the sham acupuncture group were increased after treatment (P<0.05, P<0.01). After treatment, the acupuncture group had higher scores in RP, BP, GH, MH and PCS, MCS than those in the sham acupuncture group (P<0.05, P<0.01); at the follow-up, except for PF and RE dimensions, the scores in each dimension and PCS, MCS scores in the acupuncture group were higher than those in the sham acupuncture group (P<0.05, P<0.01). After treatment and at the follow-up, pelvic pain VAS, NIH-CPSI, IPSS scores in the acupuncture group were lower than those before treatment (P<0.01); in the sham acupuncture group, pelvic pain VAS, NIH-CPSI scores were lower after treatment, and NIH-CPSI score at the follow-up was lower compared with those before treatment (P<0.01). After treatment and at the follow-up, pelvic pain VAS, NIH-CPSI, IPSS scores in the acupuncture group were lower than those in the sham acupuncture group (P<0.01, P<0.05). No significant adverse reactions were observed in both groups, and the incidence rates of adverse reactions had no significant difference (P>0.05). CONCLUSIONS Acupuncture could effectively improve the quality of life, reduce pain levels, alleviate prostate symptoms, and shows favorable long-term efficacy in patients with CP/CPPS.
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Affiliation(s)
- Huaiyu Wang
- Department of Acupuncture-Moxibustion, Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100072, China
| | - Yuan Ji
- Department of Acupuncture-Moxibustion, Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100072, China
| | - Shuo Zhang
- Department of Acupuncture-Moxibustion, Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100072, China
| | - Pengfei Yuan
- Department of Acupuncture-Moxibustion, Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100072, China
| | - Hongchao Zhao
- Department of Acupuncture-Moxibustion, Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100072, China
| | - Yan Guo
- Department of Acupuncture-Moxibustion, Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100072, China
| | - Xiaodi Xie
- Department of Acupuncture-Moxibustion, Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100072, China
| | - Yulong Ding
- Department of Acupuncture-Moxibustion, Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100072, China.
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Hua X, Zhang J, Ge S, Liu H, Du H, Niu Q, Chen X, Yang C, Zhang L, Liang C. CXCR3 antagonist AMG487 ameliorates experimental autoimmune prostatitis by diminishing Th1 cell differentiation and inhibiting macrophage M1 phenotypic activation. Prostate 2022; 82:1223-1236. [PMID: 35700340 DOI: 10.1002/pros.24395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/16/2022] [Accepted: 05/16/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS) is an inflammatory immune disease that is characterized by infiltrating inflammatory cells in the prostate and pelvic or by perineal pain. Receptor CXCR3modulates immune and inflammatory responses; however, the effects of CXCR3 antagonist AMG487 in the context of CP/CPPS are unknown. Therefore, we investigated the effect of AMG487 in experimental autoimmune prostatitis (EAP) mice and explored the potential functional mechanisms. METHODS The EAP model was induced by intradermally injecting a mixture of prostate antigens and complete Freund's adjuvant on Days 0 and 28. To evaluate the effect of AMG487 on EAP mice, treatment with AMG487 and vehicle solution was conducted for the indicated period. Then, procedures were performed, including behavioral test, to evaluate the pain response to stimulation before the mice were killed and a histological assessment to evaluate the inflammation after the mice were killed. Immunofluorescence, flow cytometry, and Western blot assay were used to analyze the functional phenotype and regulation mechanism of AMG487 on T helper type 1 (Th1) cells and macrophages. RESULTS We found high expression of CXCR3 in human benign prostate tissues with inflammation and EAP mice. The elevated CXCR3 in prostate tissues correlates with the severity of inflammation. CXCR3 antagonist AMG487 treatment ameliorated the inflammatory changes and the pelvic pain of EAP mice. AMG487 inhibits Th1 cell differentiation through the IL-12/STAT4pathway and inhibits pro-inflammatory M1 macrophages through the lipopolysaccharide/NF-κB p65signaling. AMG487 could inhibit the secretion of inflammatory mediators in EAP mice. CONCLUSION CXCR3 antagonist AMG487 could ameliorate the inflammatory changes and the pelvic pain of EAP mice by diminishing Th1 cell differentiation and inhibiting macrophage M1 phenotypic activation. Thus, the results imply that AMG487 has the potential as an effective therapeutic agent in the prevention and treatment of EAP.
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Affiliation(s)
- Xiaoliang Hua
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
- The Institute of Urology, Anhui Medical University, Hefei, China
| | - Jiong Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
- The Institute of Urology, Anhui Medical University, Hefei, China
| | - Shengdong Ge
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
- The Institute of Urology, Anhui Medical University, Hefei, China
| | - Haoran Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
- The Institute of Urology, Anhui Medical University, Hefei, China
| | - Hexi Du
- The Institute of Urology, Anhui Medical University, Hefei, China
| | - Qingsong Niu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- The Institute of Urology, Anhui Medical University, Hefei, China
| | - Xianguo Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
- The Institute of Urology, Anhui Medical University, Hefei, China
| | - Cheng Yang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
- The Institute of Urology, Anhui Medical University, Hefei, China
| | - Li Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
- The Institute of Urology, Anhui Medical University, Hefei, China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
- The Institute of Urology, Anhui Medical University, Hefei, China
- Anhui Institute of Translational Medicine, Hefei, China
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Liu Y, Zhang Y, Zhang M, Meng J, Ma Q, Hao Z, Zheng M, Zhang L, Chen X, Liang C. Activated autophagy restored the impaired frequency and function of regulatory T cells in chronic prostatitis. Prostate 2021; 81:29-40. [PMID: 33085775 DOI: 10.1002/pros.24073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 08/04/2020] [Accepted: 09/02/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Chronic prostatitis or chronic pelvic pain syndrome (CP/CPPS) is a disease with an unclear pathogenesis. Recent studies have reported that regulatory T (Treg) cells might be involved in the development of CP/CPPS. In this study we aimed to examine the functional role of Treg cells and explore the possible regulatory mechanism of Treg cells in CP/CPPS. METHODS An experimental autoimmune prostatitis (EAP) mouse model was constructed; the numbers and functions of Treg cells in the EAP and control groups were tested. Then, cell differentiation experiments were conducted to evaluate the regulatory effect of autophagy on Treg cell differentiation. Furthermore, autologous CD4+ CD25- cells and CD4+ CD25+ cells from the two groups were magnetically sorted and cocultured to observe differences in cellular inhibitory functions. Finally, in an in vivo experiment, rapamycin was intraperitoneally injected into EAP mice for 4 weeks to observe the therapeutic effects. RESULTS We found that the number and function of Treg cells in the EAP group were diminished compared to those in the control group. Meanwhile, the tolerance of pain in EAP mice had also decreased. Moreover, after using the autophagy activator rapamycin, the expression of the inflammatory cytokines interleukin-1β was decreased and the pain symptoms were alleviated. A mechanistic study found that autophagy activation promoted the differentiation of Treg and increased the suppressive functions of Treg cells, along with the elevated expression of GATA-3 and cytotoxic T lymphocyte antigen 4 (CTLA-4). Furthermore, in vivo administration of the autophagy activator rapamycin had similar effects on recovering the frequency and function of Treg cells as well as the expression of GATA-3 and CTLA-4. CONCLUSION The impaired frequency and function of Treg cells may contribute to the progression of CP/CPPS, and autophagy is a protective mechanism that promotes the differentiation of Treg cells and restores the suppressive functions of Treg cells. Autophagy may be a novel therapeutic option for patients with CP/CPPS.
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Affiliation(s)
- Yi Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Urology, Institute of Urology, Anhui Medical University, Hefei, Anhui, China
| | - Yong Zhang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Meng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Urology, Institute of Urology, Anhui Medical University, Hefei, Anhui, China
| | - Jialin Meng
- Department of Urology, Institute of Urology, Anhui Medical University, Hefei, Anhui, China
| | - Qingqing Ma
- Department of Urology, Medical Research Center, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Zongyao Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Urology, Institute of Urology, Anhui Medical University, Hefei, Anhui, China
| | - Meijuan Zheng
- Department of Urology, Medical Research Center, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Li Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Urology, Institute of Urology, Anhui Medical University, Hefei, Anhui, China
| | - Xianguo Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Urology, Institute of Urology, Anhui Medical University, Hefei, Anhui, China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Urology, Institute of Urology, Anhui Medical University, Hefei, Anhui, China
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Zhang W, Fang Y, Shi M, Zhang M, Chen Y, Zhou T. Optimal acupoint and session of acupuncture for patients with chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis. Transl Androl Urol 2021; 10:143-153. [PMID: 33532304 PMCID: PMC7844493 DOI: 10.21037/tau-20-913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background The study aims to perform a meta-analysis of published trials and evaluate the efficacy of acupuncture on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) by symptom score reduction, optimal acupuncture session, and most frequently used acupoints. Methods A literature search was performed for randomized controlled trials (RCTs) comparing efficacy of acupuncture with sham acupuncture or standard medication on CP/CPPS. The primary outcome was the reduction of National Institute of Health-Chronic Prostatitis Index (NIH-CPSI) total score and its subscales. The optimal acupuncture session to reach its clinical efficacy and most common compatibility rule of acupoints were also evaluated. Results Ten trials involving 770 participants were included. Meta-analysis showed compared with sham acupuncture, acupuncture yielded significant reduction in NIH-CPSI total score [weighted mean difference (WMD): 7.28, 95% confidence interval (95% CI): 5.69-8.86), and provided better pain relief (WMD: 3.57, 95% CI: 2.07-5.08), urinary symptoms improvement (WMD: 1.68, 95% CI: 1.13-2.22), and quality of life (QOL) (WMD: 2.38, 95% CI: 1.41-3.36). Compared with standard medication, acupuncture were more efficacious in reducing NIH-CPSI total score (WMD: 3.36, 95% CI: 1.27-5.45), also showed significant greater pain relief (WMD: 2.36, 95% CI: 1.67-3.06), marginal advantage in improving QOL (WMD: 0.98, 95% CI: 0.12-1.83) but no difference in reducing urinary symptom (WMD: -0.03, 95% CI: -1.30 to 1.24). Four acupuncture sessions were the minimum "dose" to reach clinical efficacy, and prolonged acupuncture sessions continuously improved urinary symptoms and QOL. The majority of acupoint selection strategies were based on the combination of any three acupoints from CV3, CV4, BL32, SP6, and SP9. Conclusions Acupuncture has promising efficacy for patients with CP/CPPS, especially category IIIB, in aspects of relieving pain and urinary symptoms and improving the QOL. Acupuncture may serve as a standard treatment option when available, and a tailored comprehensive treatment strategy for CP/CPPS is the future trend.
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Affiliation(s)
- Wei Zhang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yu Fang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Minfeng Shi
- Reproductive Center, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Mingzhen Zhang
- Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China.,WMU-Monash University BDI Alliance in Clinical & Experimental Biomedicine, Wenzhou Medical University, Wenzhou, China
| | - Yuangui Chen
- Hongkou Branch, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Tie Zhou
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
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Qin Z, Wu J, Xu C, Liu Z. Using meta-regression approach to explore the dose-response association between acupuncture sessions and acupuncture effects on chronic prostatitis/chronic pelvic pain syndrome. Ann Transl Med 2019; 7:116. [PMID: 31032271 DOI: 10.21037/atm.2018.11.45] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background The benefits of acupuncture on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been well established according to previous studies. However, uncertainty exists regarding the dose-response relationship between acupuncture sessions and acupuncture effects for CP/CPPS. The objective of this study is to explore the association between the acupuncture sessions and its effects based on previously published data. Methods A non-linear meta-regression approach with restricted cubic spline (RCS) was used to investigate the dose-response relationship between acupuncture sessions and its effects on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). PubMed, EMBASE, and Cochrane CENTRAL were searched up to May 20, 2018. Randomized controlled trials (RCTs) and case series studies (CSSs) reported the treatment sessions of acupuncture for CP/CPPS with at least two categories were eligible for inclusion. Results Ten studies involving 329 participants were included, the results showed a J-shaped dose-response association between acupuncture sessions and NIH-CPSI score (range 0 to 43, with higher score indicating greater CP/CPPS symptoms). Overall, more acupuncture sessions received for CP/CPPS patients is associated with increased symptom relieving. After 6 acupuncture sessions, the NIH-CPSI decreased from 26.1 (95% CI: 25.3-27.0) to 18.5 (95% CI: 11.6-25.4), with a between-session difference of -7.6 (95% CI: -14.6 to -0.7). Considering the 95%CI, both robust-error meta-regression modeling [MD: -8.3 (95% CI: -10.4 to -6.3)] and sensitivity analysis without CSSs [MD: -8.1 (95% CI: -9.5 to -6.7)] demonstrated that 18 acupuncture sessions could reach a clinically meaningful improvement regarding NIH-CPSI score. Conclusions There appear to be dose-response relationship between acupuncture sessions and CP/CPPS outcome. Prolonged acupuncture sessions were associated with less NIH-CPSI score. According to current evidence, six acupuncture sessions might be the minimal required 'dose' to reach its clinical effects.
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Affiliation(s)
- Zongshi Qin
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.,School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jiani Wu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Chang Xu
- Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhishun Liu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
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Qin Z, Wu J, Xu C, Sang X, Li X, Huang G, Liu Z. Long-term effects of acupuncture for chronic prostatitis/chronic pelvic pain syndrome: systematic review and single-arm meta-analyses. Ann Transl Med 2019; 7:113. [PMID: 31032268 PMCID: PMC6465443 DOI: 10.21037/atm.2018.06.44] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 06/19/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cumulative evidences indicate that acupuncture may ameliorate the symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, the long-lasting effects of acupuncture on CP/CPPS has not been fully evaluated. The objective of this study is to assess the sustained effects of acupuncture on CP/CPPS. METHODS We searched PubMed, EMBASE, and CENTRAL databases for studies on the use of acupuncture in patients with CP/CPPS. Studies with long-term follow-up periods were included. Single-arm meta-analyses were performed using random-effects model. The primary outcome was the response rate at the end of follow-up period; the secondary outcomes were changes of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores at the end of follow-up, including total score and 3 sub-scores (pain, urinary, and quality of life). RESULTS Six studies with 310 patients were performed in data synthesis, among which four studies were randomized controlled trials (RCT) and two were case series studies. At the end of follow-up, the weighted "average" response rate was 68.4% (95% CI: 42.1% to 89.5%, n=226; I2=93.5%); the change of NIH-CPSI total score were -14.8 (95% CI: -17.0 to -12.6, n=310; I2=92.1%); the change of pain, urinary, and quality of life sub-scores were -6.0 (95% CI: -6.9 to -5.2, n=266; I2=83.6%), -2.6 (95% CI: -3.2 to -2.0, n=266; I2=87.9%), and -4.4 (95% CI: -6.2 to -2.6, n=266; I2=98.7%), respectively. The source of heterogeneity could not be identified owing to insufficient studies. CONCLUSIONS Acupuncture may have clinically long-lasting benefits for CP/CPPS. However, current evidence is limited owing to insufficient data and significant heterogeneity. Further studies with larger sample size and long-term follow-up periods are warranted.
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Affiliation(s)
- Zongshi Qin
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, China
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Jiani Wu
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Chang Xu
- Chinese Evidence-Based Medicine Center and Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiaopu Sang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xiao Li
- Department of Urology, Jiangsu Cancer Hospital& Jiangsu Institute of Cancer Research& Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210000, China
| | - Guangrui Huang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Zhishun Liu
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
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Chen G, Xiang J, Ouyang L, Wang X, Zhang S, Chen H, Chen J, Li T. [Acupuncture combined with western medicine for CP/CPPS:a randomized controlled trial]. Zhongguo Zhen Jiu 2018; 36:1247-1251. [PMID: 29231360 DOI: 10.13703/j.0255-2930.2016.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare the clinical efficacy differences among acupuncture combined with western medicine, acupuncture alone and western medicine alone for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS Ninety patients were randomly assigned into a needle-medicine group, an acupuncture group and a western medicine group, 30 patients in each group. The patients in the needle-medicine group were treated with acupuncture combined with western medicine; the scalp points included Shenting (GV 24), Xinhui (GV 22), Qianding (GV 21), Baihui (GV 20), Chengguang (BL 6), Tongtian (BL 7), etc. The body points were Zhongji (CV 3), Guanyuan (CV 4), Pangguangshu (BL 28), Ciliao (BL 32), etc. The acupuncture was given 30 min per treatment, once a day. Besides, oral administration of 0.2g levofloxacin (twice per day) and 0.2 mg tamsulosin (once a day) was applied. The patients in the acupuncture group and western medicine group were treated by acupuncture and western medicine respectively. 12-d treatment was taken as one session, and totally 2 sessions were given. The clinical efficacy of the three groups after treatment was compared as well as the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) total score and pain score, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) before and after treatment. RESULTS During the trial two patients dropped out, as a result, 30 patients in the needle-medicine group, 29 patients in the acupuncture group and 29 patients in the western medicine group were included in the analysis. After treatment, 21 patients were cured, 6 patients were markedly effective, 2 patients were effective and 1 patient failed in the needle-medicine group;12 patients were cured, 10 patients were markedly effective, 5 patients were effective and 2 patients failed in the acupuncture group; 11 patients were cured, 12 patients were markedly effective, 4 patients were effective and 2 patients failed in the medicine group; the efficacy in the needle-medicine group was superior to those in the acupuncture group and medicine group (both P<0.05). Each score was improved after treatment in each group (all P<0.01); the total score of NIH-CPSI as well as SAS and SDS scores in the needle-medicine group were superior to those in the acupuncture group and medicine group (P<0.05, P<0.01); the pain scores of NIH-CPSI in needle-medicine group and acupuncture group were superior to that in the medicine group (P<0.05, P<0.01), but the difference between the needle-medicine group and acupuncture group was not significant (P>0.05). CONCLUSIONS The efficacy of acupuncture combined with western medicine for CP/CPPS is superior to that of acupuncture alone and western medicine alone, which could improve the symptom of prostatitis as well as status of anxiety and depression.
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Affiliation(s)
- Guo Chen
- College of Acupuncture-Moxibustion and Tuina, Hunan University of CM, Changsha 410208, Hunan Province, China
| | - Juan Xiang
- College of Acupuncture-Moxibustion and Tuina, Hunan University of CM, Changsha 410208, Hunan Province, China
| | - Lizhi Ouyang
- College of Acupuncture-Moxibustion and Tuina, Hunan University of CM, Changsha 410208, Hunan Province, China
| | - Xuzhe Wang
- College of Acupuncture-Moxibustion and Tuina, Hunan University of CM, Changsha 410208, Hunan Province, China
| | - Sainan Zhang
- College of Acupuncture-Moxibustion and Tuina, Hunan University of CM, Changsha 410208, Hunan Province, China
| | - Haijiao Chen
- College of Acupuncture-Moxibustion and Tuina, Hunan University of CM, Changsha 410208, Hunan Province, China
| | - Junjun Chen
- The First Affiliated Hospital of Hunan University of CM
| | - Tielang Li
- College of Acupuncture-Moxibustion and Tuina, Hunan University of CM, Changsha 410208, Hunan Province, China
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Nesheim N, Ellem S, Dansranjavin T, Hagenkötter C, Berg E, Schambeck R, Schuppe HC, Pilatz A, Risbridger G, Weidner W, Wagenlehner F, Schagdarsurengin U. Elevated seminal plasma estradiol and epigenetic inactivation of ESR1 and ESR2 is associated with CP/CPPS. Oncotarget 2018; 9:19623-19639. [PMID: 29731970 PMCID: PMC5929413 DOI: 10.18632/oncotarget.24714] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 02/24/2018] [Indexed: 12/15/2022] Open
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is associated with urinary tract symptoms and hormonal imbalances amongst others. The heterogeneous clinical presentation, unexplored molecular background and lack of prostate biopsies complicate therapy. Here, using liquid biopsies, we performed a comprehensive translational study on men diagnosed with CP/CPPS type III (n= 50; median age 39.8, range 23-65) and age-matched controls (n= 61; median age 36.8, range 20-69), considering biochemical parameters of blood and ejaculates, and epigenetic regulation of the estrogen receptor genes (ESR1 and ESR2) in leukocytes isolated from blood (systemic regulation) and in somatic cells isolated from ejaculates (local regulation). We found elevated 17β-estradiol (E2) levels in seminal plasma, but not in blood plasma, that was significantly associated with CP/CPPS and impaired urinary tract symptoms. In ejaculated somatic cells of CP/CPPS patients we found that ESR1 and ESR2 were both significantly higher methylated in CpG-promoters and expressionally down-regulated in comparison to controls. Mast cells are reported to contribute to CP/CPPS and are estrogen responsive. Consistent with this, we found that E2 -treatment of human mast cell lines (HMC-1 and LAD2) resulted in altered cytokine and chemokine expression. Interestingly, in HMC-1 cells, possessing epigenetically inactivated ESR1 and ESR2, E2 -treatment led to a reduced transcription of a number of inflammatory genes. Overall, these data suggest that elevated local E2 levels associate with an epigenetic down-regulation of the estrogen receptors and have a prominent role in CP/CPPS. Investigating E2 levels in semen could therefore serve as a promising biomarker to select patients for estrogen targeted therapy.
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Affiliation(s)
- Nils Nesheim
- Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
- Working Group Epigenetics of the Urogenital System, Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Stuart Ellem
- Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Temuujin Dansranjavin
- Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Christina Hagenkötter
- Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
- Working Group Epigenetics of the Urogenital System, Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Elena Berg
- Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
- Working Group Epigenetics of the Urogenital System, Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Rupert Schambeck
- Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
- Working Group Epigenetics of the Urogenital System, Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Hans-Christian Schuppe
- Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Adrian Pilatz
- Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Gail Risbridger
- Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
| | - Wolfgang Weidner
- Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Florian Wagenlehner
- Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
| | - Undraga Schagdarsurengin
- Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
- Working Group Epigenetics of the Urogenital System, Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany
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