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10.4103/aja202434
Chronic prostatitis/chronic pelvic pain syndrome induces metabolomic changes in expressed prostatic secretions and plasma
Zhang, Fang-Xing1,2; Chen, Xi1,2; Niu, De-Cao1,2; Cheng, Lang1,2; Huang, Cai-Sheng3; Liao, Ming4; Xue, Yu4; Shi, Xiao-Lei5; Mo, Zeng-Nan1,2
1Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University, Nanning 530021, China
2Center for Genomic and Personalized Medicine, Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, China
3Department of Urology, The Second Nanning People’s Hospital, The Third Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
4Center of Reproductive Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
5Department of Urology, Shanghai Changhai Hospital, Shanghai 200433, China
Correspondence: Dr. ZN Mo (mozengnan@gxmu.edu.cn)
Originally published: August 09, 2024 Received: November 23, 2023 Accepted: April 10, 2024
| Abstract |
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Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex disease that is often accompanied by mental health disorders. However, the potential mechanisms underlying the heterogeneous clinical presentation of CP/CPPS remain uncertain. This study analyzed widely targeted metabolomic data of expressed prostatic secretions (EPS) and plasma to reveal the underlying pathological mechanisms of CP/CPPS. A total of 24 CP/CPPS patients from The Second Nanning People’s Hospital (Nanning, China), and 35 asymptomatic control individuals from First Affiliated Hospital of Guangxi Medical University (Nanning, China) were enrolled. The indicators related to CP/CPPS and psychiatric symptoms were recorded. Differential analysis, coexpression network analysis, and correlation analysis were performed to identify metabolites that were specifically altered in patients and associated with various phenotypes of CP/CPPS. The crucial links between EPS and plasma were further investigated. The metabolomic data of EPS from CP/CPPS patients were significantly different from those from control individuals. Pathway analysis revealed dysregulation of amino acid metabolism, lipid metabolism, and the citrate cycle in EPS. The tryptophan metabolic pathway was found to be the most significantly altered pathway associated with distinct CP/CPPS phenotypes. Moreover, the dysregulation of tryptophan and tyrosine metabolism and elevation of oxidative stress-related metabolites in plasma were found to effectively elucidate the development of depression in CP/CPPS. Overall, metabolomic alterations in the EPS and plasma of patients were primarily associated with oxidative damage, energy metabolism abnormalities, neurological impairment, and immune dysregulation. These alterations may be associated with chronic pain, voiding symptoms, reduced fertility, and depression in CP/CPPS. This study provides a local-global perspective for understanding the pathological mechanisms of CP/CPPS and offers potential diagnostic and therapeutic targets.
Keywords: biomarker; chronic prostatitis/chronic pelvic pain syndrome; depression; inflammation; metabolomics
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