Urologische Begleiterkrankungen bei Patienten mit rheumatoider Arthritis

Lower urinary tract symptoms in rheumatoid arthritis and spondyloarthritis male patients versus controls

Background. We aimed to evaluate the severity of lower urinary tract symptoms (LUTS) in rheumatoid arthritis (RA) and spondyloarthritis (SpA) male patient versus control, then to determine the relation of LUTS with rheumatic diseases (RD) characteristics and with erectile dysfunction (ED).

Methods. We conducted a cross-sectional case control study including 50 men with RA or SpA and 50 healthy controls. LUTS were evaluated by the International Prostate Symptom Score (IPSS). LUTS bother was evaluated by the Quality of life (QoL) score, which ranges from 0 to 6. LUTS bother was considered if QoL score exceeded 2. Moreover, erectile function was assessed by the International Index of Erectile Function-5 (IIEF5) (ED if score < 21).

Results. LUTS were significantly more severe in RD patients than controls (p = 0.03). However, there was no difference between the two groups in LUTS bother (QoL) (p = 0.2). Comparing RA and SpA showed no difference as to the severity of LUTS or effect of bother on QoL (p = 0.13, p = 0.5). The prevalence of ED in RD patients was not significantly higher than controls (80% versus 70%; p = 0.2).There were also no differences either between RA and SpA groups (p = 0.74).

The severity of LUTS for patients with RD (RA and SpA) was significantly associated with age (p = 0.001), age at disease onset (p = 0.002) and ED (p = 0.008).

Conclusion. According to our study, men with RD seem to be exposed to more severe LUTS than controls. Also, the severity of LUTS was associated with ED, age of patients and the age of disease onset.

Effects of adjuvant-induced arthritis on the ventral prostate of rats treated with angiotensin AT1 receptor blocker

AIMS

To analyze the prostatic compartments, extracellular matrix, microvascularization, transforming growth factor-beta (TGF-β) and angiotensin II receptors type 1 (AT₁) levels, and histopathology of the ventral prostate in a rat model for rheumatoid arthritis, and to evaluate the effect of angiotensin II AT₁ receptor blocker (ARB) in the disease.

MAIN METHODS

Fifteen male rats (90 days old) were divided into three groups (n = 5/group): control, adjuvant-induced arthritis without (AIA) or with AT₁ receptor blocker (AIA + ARB). Animals were euthanized 60 days after immunization. The ventral prostate was collected, weighed, and processed for histological and immunohistochemical analysis.

KEY FINDINGS

Our results show that AIA increases production of the prostatic epithelium and extracellular matrix, accompanied by a reduction in the number of tissue capillaries. ARB treatment promotes decreased production of extracellular matrix and increased TGF-β and AT₁ receptor immunostaining.

SIGNIFICANCE

AIA may activate specific mechanisms that modify the prostatic environment; the use of ARB attenuates some altered prostate parameters in a rat model for arthritis.