DF/HCC Program Affiliation

Prostate Cancer

Research Abstract

The object of our research in progress is to elucidate the connection between prostatic inflammation, chronic prostatitis and prostate cancer. The etiology and pathogenesis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has remained elusive. This has hampered development of mechanistic treatment strategies for this common, chronic and distressing medical condition. We believe that CP/CPPS is part of a spectrum of complex but inter-related genetic and acquired diseases resulting from the interaction of several genes regulating immune/inflammatory and neurogenic parameters and environmental factors/circumstances or exposure, culminating in the combination of pain, frequency, urgency and sexual specific symptoms. New research has delineated the dynamic and powerful association of the immune and neurogenic system in pain activation. An immune-modulated neurogenic model of CP/CPPS illuminating the action of immune derived substances and pain related substances might be important in discovering the determinants of pain, voiding dysfunction and gender specific sexual problems. This inter-related dynamic model of CP/CPPS disease pathogenesis could be explored for potential avenues leading to novel diagnostic and treatment strategies. We plan to identify and evaluate the sensitivity and specificity of several novel nerve and inflammation related markers in the diagnosis and follow up of CP/CPPS. By correlating the levels of urine immune and pain related substances to disease mechanisms, severity and progression, we may be able to create a human disease specific model for diagnosis and treatment.This could provide a potential link to prostate cancer pathogenesis and new insights into the relationship between prostatitis and prostate cancer.

Publications

• Farokhzad OC, Dimitrakov JD, Karp JM, Khademhosseini A, Freeman MR, Langer R.Drug delivery systems in urology--getting "smarter".Urology 2006 Sep;68(3):463-9.
  17010721
• Dimitrakov JD, Kaplan SA, Kroenke K, Jackson JL, Freeman MR.Management of chronic prostatitis/chronic pelvic pain syndrome: an evidence-based approach.Urology 2006 May;67(5):881-8.
  16698346
• Dimitrakov JD.Saw palmetto for benign prostatic hyperplasia.N Engl J Med 2006 May 4;354(18):1950-1; author reply 1950.
  16673527
• Dikov D, Vassilev I, Dimitrakov J.Nonspecific granulomatous prostatitis with calculous ductal ectasia and extensive Paneth cell-like epithelial metaplasia. Case report.APMIS 2005 Jul-Aug;113(7-8):564-7.
  16086829
• Dikov D, Chatelet FP, Dimitrakov J.Pathologic features of necrotizing adenoviral prostatitis in an AIDS patient.Int J Surg Pathol 2005 Apr;13(2):227-31.
  15864391
• Dimitrakov JD.A case of familial clustering of interstitial cystitis and chronic pelvic pain syndrome.Urology 2001 Aug;58(2):281.
  11489726