Імуногенез хронічного простатиту в пацієнтів із хронічною інфекцією C. trachomatis

Study of the links of prostatitis immunogenesis, including against the background of chronic infections, which is accompanied by resistance to therapy and deterioration in the quality of life of patients, is relevant for the determination of prognostic markers of the course and the development of modern effective individualized approaches to therapy. The objective: to determine the frequency of Human Leukocyte Antigen (HLA) in patients with chronic prostatitis with detected chlamydial infection, and establish their associative relationships with cytokine production and levels of antibodies to heat shock protein 60 (HSP60). Materials and methods. The distribution of HLA antigens in 89 men with chronic prostatitis (CP) and chronic genitourinary chlamydia infection (CGCh) was studied using the standard microlymphocytotoxic test (Terasaki); reference group – 350 healthy donors. Both relative (RR, if RR ≥ 2) and absolute risk of the diseases were determined by the formula: σ = x – y/1 – y, where x is the frequency of histocompatibility antigen in patients, y – in healthy subjects, the etiologic fraction of pathology was determined if σ > 0.1. In patients, the production of IL-1, IL-2, TNF-β, IFN-γ and IL-10 was studied by the ELISA, some patients were examined for IgG to recombinant HSP60 and the extinction value (Е492) was determined when the serum was diluted 1:32. For statistical processing using the SPSS for Windows software package, version 11 and MedStat using parametric statistical criteria (Student’s test) or non-parametric (Wilcoxon test), Spearman’s rank correlation; the difference was considered reliable at p < 0.05. The results. A significant increase in the phenotype of HLA-A10, -A33, -B41, -B51 and -DR4 (p ≤ 0.05), absolute risk (σ ≥ 0.1) of which is determined by A10 (25 + 26) and B51, as well as the combination of A2B21 and A36B13 (p ≤ 0.05) was found in patients with CP with chronic genitourinary chlamydia, compared to the group of healthy subjects. In the group of persons with HLA-A10, a significant decrease in the average spontaneous production of pro-inflammatory IFN-γ and TNF-α (р ≤ 0.05) and an increase in spontaneous and induced anti-inflammatory IL-10 (р = 0.011) was shown, which was confirmed by a higher % of A10 carriers in group with the highest secretion of IL-10 (р = 0.038). Average levels of antibodies to HSP60 in patients with CP with the presence of C. trachomatis exceed the norm (p = 0.003), and B51 antigen was significantly more often detected in the subgroup with their lower (by 4 times than in others) levels (p < 0.001). Conclusions. The revealed features of HLA in patients with chronic prostatitis with detected chlamydial infection of the genitourinary system and their associative relationships with cytokine production and levels of antibodies to HSP60 make it possible to indicate the defined indicators (HLA-A10 (25 + 26), -A33, -B41, -B51 and -DR4, IL-10, HSP60) as predictors and prognostic markers of the disease course for more effective prevention and treatment.