Poroshina T. Local and systemic immune mechanisms in the pathogenesis of chronic prostatitis and dysfunction spermatogenesis as its complications.

The dissertation presents the theoretical general conclusion and practical solution of the actual problem - to define the peculiarities and the level of participation of local and systemic immunity indicators sIgA, SLPI, PSA and cytokine pro- and anti-inflammatory activity as markers of the pathogenesis of chronic prostatitis and the formation of excretory-toxic infertility (ETI) in patients with semen within normal limits. The active production of pro-inflammatory cytokines occurs at decreased activity of the cells that produce anti-inflammatory cytokines and the correlation does not depend on the number of leukocytes in the ejaculate. In blood of patients with the on increased concentration of SLIPI, TNF-? and IL-8, the activation occurs on a background of mononuclear cells expression of CD95 and Bcl-2, an increase of NO production and active antibody to HSP-60. It has been proved that the disturbance of the functional state of cells producing the cytokines into ejaculate is a compound in formation of excretory toxic infertility in the patients with chronic abacterial prostatitis (CAP). The formation of pathospermia is correlative with TGF-?1, IL-17 and VEGF production and depends on the sIgA, SLIPI, TNF-?, IL-6, IL-8 and IL-23 levels. The deteriorated indices of spermogramme in the CAP patients are also connected with the disturbed structural and of sperm functional state of spermatozoa with reactive oxygen species production. The research of fertile function of ejaculate in patients with chronic prostatitis is recommended for determination of CD95+ spermatozoa along with determination of TGF-?1 and the correlation does not depend on the number of leukocytes, the TNF-?, IL-6 and IL-8 levels. The presence in a man of isolated antigens HLA-A23, HLA-A24, HLA-B27, HLA-B44, HLA-B52 significantly is associated with chronic inflammation of the prostate gland. Etiological fraction is HLA-B27 and HLA-B52 antigens. In the CAP patients with ETI complication, it is advisable to determine the concentration of cytokines, the number of CD95+ spermatozoa and the lever of oxidative stress. Key words: immunity, cytokines, fertile, chronic prostatitis