The Clinical and Immunologic Effects of Acetylcysteine in the Treatment of Chronic Abacterial Prostatitis

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a chronic inflammatory disease of the prostate. The effectiveness of acetylcysteine in CP/CPPS patients was assessed including the dynamics of levels of pro-inflammatory TNF-α, and anti-inflammatory IL-10 in the ejaculate. 60 patients with CP/CPPS were studied including: Group 1 treated with quercetin (n=30) orally 1 g per day for 1 month; and Group 2 treated with acetylcysteine (n=30) orally 600 mg daily for 1 month. All participants had a standard ejaculate analysis. Cytokines were determined by ELISA in seminal plasma. Treatment results were evaluated by assessing the Chronic Prostatitis Symptoms Index (NIH-CPSI), sperm count, and cytokine dynamics in the ejaculate. Both groups significantly (p<0.05) improved according to the NIH-CPSI scale, with increased sperm concentration and motility, and decreased in number of pathological sperm and leukocytes in the ejaculate. The ejaculate viscosity decreased significantly only in Group 2 (р<0.05) with significant improvement in sperm motility and the decrease in leukocyte counts compared to Group 1. After treatment both groups showed a decrease in the concentration of the pro-inflammatory TNF-α (р<0.05), significantly more notable in Group 2. Both groups had a significant increase in the concentration of the anti-inflammatory IL-10 (р<0.05). The dynamics of cytokine changes corresponded to the development of remission in patients with chronic abacterial prostatitis. Acetylcysteine showed a clinical efficacy of 63.3% based on a 25% decrease in NIH-CPSI scores.