Inflammatory Prostatitis Plus IBS-D Subtype and Correlation with Immunomodulating Agent Imbalance in Seminal Plasma: Novel Combined Treatment

We recently demonstrated the effectiveness of long-term treatment with rifaximin and the probiotic DSF (De Simone formulation) in improving urogenital and gastrointestinal symptoms in patients with both chronic inflammatory prostatitis (IIIa prostatitis) and diarrhea-predominant irritable bowel synd...

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Main Authors: Roberto Castiglione, Gaetano Bertino, Beatrice Ornella Vicari, Agostino Rizzotto, Giuseppe Sidoti, Placido D’Agati, Michele Salemi, Giulia Malaguarnera, Enzo Vicari
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Diseases
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Online Access:https://www.mdpi.com/2079-9721/12/10/260
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author Roberto Castiglione
Gaetano Bertino
Beatrice Ornella Vicari
Agostino Rizzotto
Giuseppe Sidoti
Placido D’Agati
Michele Salemi
Giulia Malaguarnera
Enzo Vicari
author_facet Roberto Castiglione
Gaetano Bertino
Beatrice Ornella Vicari
Agostino Rizzotto
Giuseppe Sidoti
Placido D’Agati
Michele Salemi
Giulia Malaguarnera
Enzo Vicari
author_sort Roberto Castiglione
collection DOAJ
description We recently demonstrated the effectiveness of long-term treatment with rifaximin and the probiotic DSF (De Simone formulation) in improving urogenital and gastrointestinal symptoms in patients with both chronic inflammatory prostatitis (IIIa prostatitis) and diarrhea-predominant irritable bowel syndrome (IBS-D), relative to patients with IBS-D alone. Because the low-grade inflammation of the intestine and prostate may be one of the reasons for co-developing both IIIa prostatitis and IBS-D, we designed the present study to once again evaluate the efficacy of combined rifaximin and DSF treatment in patients affected by IIIa prostatitis plus IBS-D, but we also measured seminal plasma pro-inflammatory (IL-6) and anti-inflammatory (IL-10) cytokines before and after treatment. Methods: We consecutively enrolled 124 patients with IIIa prostatitis and IBS-D (diagnosed using the Rome III criteria). Patients were randomized into two groups: group A (n = 64) was treated with rifaximin (seven days per month for three months) followed by DSF, and group B (n = 60) was treated with a placebo. By the end of the intervention, 68.7% and 62.5% of patients from group A reported improved NIH-CPSI (National Institute of Health’s Chronic Prostatitis Symptom Index) and IBS-SSS (Irritable Bowel Syndrome Severity Scoring System) scores, respectively, compared to only 3.3% and 5% of the placebo group. Group A patients also had significantly lower mean seminal plasma levels of IL-6 (11.3 vs. 32.4 pg/mL) and significantly higher mean levels of IL-10 (7.9 vs. 4.4 pg/mL) relative to baseline, whereas the levels of IL-6 and IL-10 did not change in the placebo group. Conclusions: The combined treatment with rifaximin and DSF appears to represent the optimal approach for addressing a syndrome such as irritable bowel syndrome (IBS-D plus), which frequently co-occurs with prostatitis (IIIa prostatitis). This approach is particularly beneficial in cases where the symptoms are not always clearly delineated, the etiology is multifactorial, and the diagnosis is multilevel.
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spelling doaj-art-52fa53765078455f96936d050894e8f82025-08-20T02:11:15ZengMDPI AGDiseases2079-97212024-10-01121026010.3390/diseases12100260Inflammatory Prostatitis Plus IBS-D Subtype and Correlation with Immunomodulating Agent Imbalance in Seminal Plasma: Novel Combined TreatmentRoberto Castiglione0Gaetano Bertino1Beatrice Ornella Vicari2Agostino Rizzotto3Giuseppe Sidoti4Placido D’Agati5Michele Salemi6Giulia Malaguarnera7Enzo Vicari8Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, ItalyDepartment of Clinical and Experimental Medicine, University of Catania, 95123 Catania, ItalyResearch Center “The Great Senescence”, University of Catania, 95100 Catania, ItalyCenter of Rare Diseases, Policlinico Catania, University of Catania, 95100 Catania, ItalySimple Departmental Operating Unit, Internal Medicine Ambulatory Andrology & Endocrinology, ARNAS-Garibaldi, 95123 Catania, ItalyDepartment “GF Ingrassia” Hygiene and Public Health, University of Catania, 95123 Catania, ItalyOasi Research Institute—IRCCS, 94018 Troina, ItalyResearch Center “The Great Senescence”, University of Catania, 95100 Catania, ItalyDepartment of Clinical and Experimental Medicine, University of Catania, 95123 Catania, ItalyWe recently demonstrated the effectiveness of long-term treatment with rifaximin and the probiotic DSF (De Simone formulation) in improving urogenital and gastrointestinal symptoms in patients with both chronic inflammatory prostatitis (IIIa prostatitis) and diarrhea-predominant irritable bowel syndrome (IBS-D), relative to patients with IBS-D alone. Because the low-grade inflammation of the intestine and prostate may be one of the reasons for co-developing both IIIa prostatitis and IBS-D, we designed the present study to once again evaluate the efficacy of combined rifaximin and DSF treatment in patients affected by IIIa prostatitis plus IBS-D, but we also measured seminal plasma pro-inflammatory (IL-6) and anti-inflammatory (IL-10) cytokines before and after treatment. Methods: We consecutively enrolled 124 patients with IIIa prostatitis and IBS-D (diagnosed using the Rome III criteria). Patients were randomized into two groups: group A (n = 64) was treated with rifaximin (seven days per month for three months) followed by DSF, and group B (n = 60) was treated with a placebo. By the end of the intervention, 68.7% and 62.5% of patients from group A reported improved NIH-CPSI (National Institute of Health’s Chronic Prostatitis Symptom Index) and IBS-SSS (Irritable Bowel Syndrome Severity Scoring System) scores, respectively, compared to only 3.3% and 5% of the placebo group. Group A patients also had significantly lower mean seminal plasma levels of IL-6 (11.3 vs. 32.4 pg/mL) and significantly higher mean levels of IL-10 (7.9 vs. 4.4 pg/mL) relative to baseline, whereas the levels of IL-6 and IL-10 did not change in the placebo group. Conclusions: The combined treatment with rifaximin and DSF appears to represent the optimal approach for addressing a syndrome such as irritable bowel syndrome (IBS-D plus), which frequently co-occurs with prostatitis (IIIa prostatitis). This approach is particularly beneficial in cases where the symptoms are not always clearly delineated, the etiology is multifactorial, and the diagnosis is multilevel.https://www.mdpi.com/2079-9721/12/10/260irritable bowel syndromeinflammatory prostatitisIBS severity scoring systemrifaximinDSF probioticsinterleukins
spellingShingle Roberto Castiglione
Gaetano Bertino
Beatrice Ornella Vicari
Agostino Rizzotto
Giuseppe Sidoti
Placido D’Agati
Michele Salemi
Giulia Malaguarnera
Enzo Vicari
Inflammatory Prostatitis Plus IBS-D Subtype and Correlation with Immunomodulating Agent Imbalance in Seminal Plasma: Novel Combined Treatment
Diseases
irritable bowel syndrome
inflammatory prostatitis
IBS severity scoring system
rifaximin
DSF probiotics
interleukins
title Inflammatory Prostatitis Plus IBS-D Subtype and Correlation with Immunomodulating Agent Imbalance in Seminal Plasma: Novel Combined Treatment
title_full Inflammatory Prostatitis Plus IBS-D Subtype and Correlation with Immunomodulating Agent Imbalance in Seminal Plasma: Novel Combined Treatment
title_fullStr Inflammatory Prostatitis Plus IBS-D Subtype and Correlation with Immunomodulating Agent Imbalance in Seminal Plasma: Novel Combined Treatment
title_full_unstemmed Inflammatory Prostatitis Plus IBS-D Subtype and Correlation with Immunomodulating Agent Imbalance in Seminal Plasma: Novel Combined Treatment
title_short Inflammatory Prostatitis Plus IBS-D Subtype and Correlation with Immunomodulating Agent Imbalance in Seminal Plasma: Novel Combined Treatment
title_sort inflammatory prostatitis plus ibs d subtype and correlation with immunomodulating agent imbalance in seminal plasma novel combined treatment
topic irritable bowel syndrome
inflammatory prostatitis
IBS severity scoring system
rifaximin
DSF probiotics
interleukins
url https://www.mdpi.com/2079-9721/12/10/260
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