Insight into infection-mediated prostate damage: Contrasting patterns of C-reactive protein and prostate-specific antigen levels during infection.

Abstract

BACKGROUND:

To investigate mechanisms underlying our previous observation of a large rise in serum prostate-specific antigen, a marker of prostate pathology, during both sexually transmitted and systemic infections, we measured serum high-sensitivity C-reactive protein (hsCRP), a marker of systemic inflammation, in our previous case-control study of young, male US military members and compared our findings to those for PSA.

METHODS:

We measured hsCRP before and during infection for 299 chlamydia, 112 gonorrhea, and 59 non-chlamydial, non-gonococcal urethritis (NCNGU) cases; before and after infection for 55 infectious mononucleosis (IM) and 90 other systemic/non-genitourinary cases; and for 220-256 controls.

RESULTS:

Only gonorrhea cases were significantly more likely to have a large hsCRP rise (≥1.40 mg/L or ≥239%) during infection than controls (P < 0.01). However, gonorrhea, IM, and other systemic/non-genitourinary cases were more likely to have a rise of any magnitude up to one year post-diagnosis than controls (p = 0.038-0.077).

CONCLUSIONS:

These findings, which differ from those for PSA, suggest distinct mechanisms of elevation for hsCRP and PSA, and support both direct (eg, prostate infection) and indirect (eg, systemic inflammation-mediated prostate cell damage) mechanisms for PSA elevation. Future studies should explore our PSA findings further for their relevance to both prostate cancer screening and risk.

• Authors: Melissa Milbrandt, Anke C Winter, Remington L Nevin, Ratna Pakpahan, Gary Bradwin, Angelo M De Marzo, Debra J Elliott, Charlotte A Gaydos, William B Isaacs, William G Nelson, Nader Rifai, Lori J Sokoll, Jonathan M Zenilman, Elizabeth A Platz, Siobhan Sutcliffe
• Journal: The Prostate (Prostate) Vol. 77 Issue 13 Pg. 1325-1334 (May 2017) ISSN: 1097-0045 [Electronic] United States
• PMID: 28703328 (Publication Type: Journal Article)
• Copyright: © 2017 Wiley Periodicals, Inc.

Chemical References

• C-Reactive Protein
• Prostate-Specific Antigen

Topics

• Adult
• C-Reactive Protein (analysis)
• Chlamydia Infections (blood)
• Gonorrhea (blood)
• Humans
• Infectious Mononucleosis (blood)
• Male
• Middle Aged
• Prostate-Specific Antigen (analysis)
• Prostatitis (blood, diagnosis, etiology)
• Statistics as Topic
• Urethritis (blood, diagnosis, etiology)