RESUMO
This literature review of recent clinical and experimental studies describes the role of oxidative stress in the multifactorial and interdisciplinary pathogenesis of non-inflammatory chronic pelvic pain syndrome IIIB (CPPS-IIIB) in men. The authors outline general biological nature of oxidative stress and its mechanisms. More detailed information is presented on cytokine-mediated chronic subclinical inflammation, one of the key mechanisms of oxidative stress, which is currently being actively studied. It is shown that the imbalance between pro- and anti-inflammatory cytokines observed in patients with CPPS-IIIB can explain some features of the clinical course (in particular, the characteristics of the pain syndrome) and the progression of this disease. In this regard, cytokine profiling of prostatic secretion can provide valuable diagnostic, prognostic and monitoring information in the management of this category of patients. Recently published evidence has demonstrated the essential role of the cytokine-mediated chronic inflammatory response as a mechanism of oxidative stress in the pathogenesis of CPPS-IIIB. Further studies in this area are warranted and in the long term may become a basis for the development of new effective pathogenetic pharmacotherapy of CPPS-IIIB.
Assuntos
Dor Crônica , Dor Pélvica , Prostatite , Estresse Fisiológico , Dor Crônica/diagnóstico , Dor Crônica/etiologia , Dor Crônica/terapia , Humanos , Inflamação/diagnóstico , Inflamação/etiologia , Inflamação/terapia , Masculino , Dor Pélvica/diagnóstico , Dor Pélvica/etiologia , Dor Pélvica/terapia , Próstata/patologia , Prostatite/diagnóstico , Prostatite/etiologia , Prostatite/terapia , SíndromeRESUMO
Hyperbaric oxygenation (HBO) was used in combined treatment of 66 patients with acute pyelonephritis. In 29 of them with primary pyelonephritis it was a part of conservative treatment. In 37 patients with secondary pyelonephritis HBO was applied postoperatively. A HBO course comprised 8-10 sessions under pressure 2.0-2.4 atm for 60 min. It was found that frequency of surgical interventions in HBO administration reduced by 36.2%. Postoperative HBO administration decreased hospital stay by 16.9%. Mechanisms of HBO positive action operate through attenuation of systemic inflammatory reaction and polyorganic insufficiency 1.62 and 2.9-fold, respectively, decline of intoxication in growing glomerular filtration rate and improvement of renal hemodynamics. Moreover, HBO promotes recovery of the immune status. In experiment on 40 white rats with acute pyelonephritis HBO decreased inflammation in renal tissue.