Urine chemokine levels correlate with treatment response to phosphodiesterase 4 inhibitor in prostatitis

Figure 3 Significant improvement in clinical outcome measures was noted post treatment in adherent chronic prostatitis/chronic pelvic pain syndrome patients. A-E: The disease heterogeneity and variability in response to treatment in CP/CPPS patients is highlighted by different urinary chemokines correlating with the clinical outcome scores measured at each visit (VAS and CPSI) in different treatment adherent Patients 6, 9, 10, 16 and 17 at baseline and week 4, 8, 12 and 16 after starting treatment. Lower VAS in Patient 10 strongly correlated with reduced urine levels of CXCL-10 (triangle; Pearson r = 0.97; P = 0.003), CCL2 (Inverted triangle; r = 0.97; P = 0.005), CCL5 (diamond; r = 0.99; P < 0.0001), VEGF (square; r = 0.98; P = 0.003) and PDGF (circular; r = 0.99; P < 0.0001) at various time points and CPSI scores correlated with CXCL-10 (triangle; Pearson r = 0.96; P = 0.009), CCL2 (Inverted triangle; r = 0.86; P = 0.05), CCL 5 (diamond; r = 0.91; P = 0.03), VEGF (square; r = 0.80; P = 0.1), PDGF (circular; r = 0.86; P = 0.06) and CXCL-1 (r_s = 0.9; P = 0.08) (A). In contrast, in Patient 17, only VAS scores showed strong correlation with CXCL-10 (triangle) (Pearson r = 0.84; P = 0.07), IL-8 (triangle) (r = 0.94; P = 0.01) and sIL-1RA (square) (r = 82; P = 0.08) (B) and CPSI showed Spearman r_s coefficient of 0.4-0.5 for PDGF, CXCL-10 and CXCL-8 without any significance. In Patient 6 (C), reduced CXCL-10 (triangle) linearly correlated with lower VAS (r = 0.89; P = 0.04) and CPSI (r = 0.82; P = 0.08) wheera PDGF (circular) was non-linearly correlated with VAS (r_s = 0.89; P = 0.08) and CPSI (r_s = 0.9; P = 0.08). In Patient 9 (D), lower CCL5 (diamond) strongly correlated with VAS (r = 0.80; P = 0.09) and CPSI (r = 0.86; P = 0.05) whereas CCL2 (inverted triangle) shown non-linear correlation withVAS (r_s = 0.9; P = 0.08). In Patient 16 (E), PDGF (circular) correlated with VAS (r = 0.95; P = 0.01) and CPSI correlated with CXCL-10 (triangle) (r_s = 0.82; P = 0.13) Notice the log-scale on the y-axis in all the panels. The units of pg/mL only apply to chemokines and not to VAS and CPSI scores. PDGF: Platelet derived growth factor; VAS: Visual analog scale; CPSI: Chronic Prostatitis Symptom Index; IL: Interleukin; VEGF: Vascular endothelial growth factor.