慢性前立腺炎におけるChlamydia trachomatisの検討

Abstract

NBPにおけるC. trachomatisの関連を, ELISA法による抗体測定と, 前立腺の吸引生検における抗原検索により検討した.1) IgA抗体陽性率は, 血清25.6%, 前立腺分泌液31.5%, マッサージ後尿29.4%でcontrol群に比し有意(p<0.05)であった.2)前立腺分泌液とマッサージ後尿中のC. trahomatis IgA抗体価は, 相関係数0.78 (p<0.01)と相関を認めた.3)夫婦間における感染では, C. trachomatis抗体陽性のNBP 9名の患者の配偶者の5名が血清抗体陽性であった.4)血清, 前立腺分泌中のC. trachomatis抗体高値のNBPの患者に対し有効な抗菌剤の投与により抗体価の低下がみられた.5)前立腺液中抗体価高値の患者7名に前立腺吸引生検を行い, 検体にin situ hybridizationを行い内2名にC. trachomatisのhybridを同定した.前立腺癌の患者10名ではhybridは観察されなかった

To assess the pathogenetic role of Chlamydia trachomatis in non-bacterial prostatitis (NBP), aspiration biopsied specimens were examined for C. trachomatis by using in situ DNA hybridization and antibody titer to C. trachomatis was measured. An enzyme-linked immunosorbent assay (ELISA) for C. trachomatis specific IgA was employed using purified C. trachomatis type L2 EBs. The positive rates of IgA antibodies to C. trachomatis in serum, EPS and VB3 were 25.6%, 31.5% and 29.4%, respectively. They were significantly higher (p less than 0.05) in the control groups. A good correlation (0.78) of IgA antibody titer to C. trachomatis was found between EPS and VB3. In 9 husbands with positive antibodies to C. trachomatis, 5 wives showed positive serum antibodies. In the NBP patients with a high positive antibody titer, the decrease of titers was shown after treatment with drugs effective against C. trachomatis. Transrectal aspiration biopsies were performed on 7 patients with high positive IgA antibody titers to C. trachomatis, and 2 specimens showed hybrids in the cells by using in situ DNA hybridization. These findings indicate that C. trachomatis is a predominant pathogen for NBP.