Microbiota-derived short-chain fatty acids are associated with symptoms in chronic prostatitis/chronic pelvic pain syndrome through the production of proinflammatory cytokines: Results from a comparative study

In recent years we have witnessed increasing interest for the role of microbiota in the pathophysiology and management of prostatic diseases. However, there are several aspects to comprehend. Here, we aim to assess the gut microbiota composition and faecal microbiota-derived short-chain fatty acids production (SCFAs) in the pathogenesis of CP/CPPS. All patients with CP/CPPS attending our urology centre, were enrolled in this study, and underwent urological examination, microbiological evaluation, intestinal microbiota analysis and measurement of interleukins in semen. A cohort of subjects who had undergone intestinal microbiota investigation for various reasons but did not exhibit any symptoms of urological disease, was used as control group. Laboratory data from the two groups were analysed in terms of gut microbiota composition and levels of SCFAs. We enrolled 37 patients and 45 controls. In the CP/CPPS patient group, the mean levels of interleukins were: IL-8 934 pg/ml, IL-10 64 pg/ml, IL-6 871 pg/ml. In this patient group, we found higher levels of Bifidobacteriaceae and Bacteroidaceae and lower levels of Prevotella and Lactobacillus with a Firmicutes/Bacteroides mean ratio at 0.27. The control group had a normal Firmicutes/Bacteroides mean ratio (1.6). The two groups showed a significant difference in total SCFAs levels ( p  = 0.001) and in particular regarding indole-3-propionic acid ( p  = 0.003) and butyric acid ( p  < 0.001). A statistically significant correlation was found between the levels of IL-8 and a decreasing SCFAs production ( p  < 0.001). A difference in gut microbiota between patients with CP/CPPS and controls, together with a reduction in faecal levels of microbiota-derived short-chain fatty acids and decreased IL-8 levels in semen, might be part of the pathophysiological mechanism in CP/CPPS.