Chronic Prostate Inflammation
Chronic Prostate Inflammation is an unpleasant, painful state. Bacteria to explain the symptoms can usually not be found. In an acute infection, if fluid from the prostate is cultured, many bacteria are usually found. But this is not an acute prostate inflammation that would be comparable with e.g. acute bladder infection.
Due to the presence of bacteria, acute infections are treated with antibiotics. But if the inflammation becomes chronic, something very different is happening in the body. In that case, the immune system does not function normally. Then, inflammatory processes are initiated by the body in healthy tissue, without the involvement of bacteria.
This ‘self-aggressive’ behaviour of the immune system is found in many different diseases, therefore commonly known as auto-immune diseases. An example is rheumatoid arthritis of the joints. Other examples are the intestinal inflammatory diseases colitis ulcerosa and Crohn’s disease. Chronic prostatitis also belongs to this group.
Chronic prostatitis is not an isolated case; chronic bladder inflammation is also quite common and likely has the same cause (or causes). Both are inflammations with an unknown cause that do not resolve naturally, and have no demonstrable involvement of bacteria.
What happens during prostate infection
To explain chronic bladder- and prostate infections, 3 main mechanisms have been identified.
Firstly, damage occurs to the cells separating the bladder- or prostate tissue from the fluids. These cells are called the urothelium. The urothelium becomes damaged and permeable for all kinds of substances that normally should not pass these cells into the tissues beneath. It is as if this protective layer has stopped doing its job. The substances passing into the tissue cause irritation of small fibre nerve endings in the prostate or bladder wall.
Secondly, a process called ‘neurogenic upregulation’ plays a role. Due to the irritation caused by inflammatory substances that permeate into the prostate tissue, nerve ends are stimulated. These nerve ends then react by giving off continuous pain signals.
Thirdly, one type of inflammatory cell, the mast cell, becomes overactive. The mast cell penetrates into the prostatic tissue and, when activated, secretes multiple substances that promote inflammation. Examples of such substances are histamine and TNF-alpha.
These three mechanisms lead to a pathological cycle of events that lead to increasing damage to prostate tissue and increasing pain. This is clearly shown in the diagram accompanying this text.
If we start for example from the activated mast cells, we see that the infective factors that these cells secrete irritate and damage the prostate tissue. This in turn triggers pathological processes that irritate nerve fibers that will become activated and initiate pain signals. The prostate also forms substance P in reaction, which causes pain as well.
The activation of nerve fibers and the increased amount of pain signals then stimulate the mast cells that react with secretion of increased amounts of inflammatory substances such as histamine. These inflammatory substances lead to increased irritation of prostate tissue, leading to more damage.
This is how the vicious circle of prostatic pain works.
Treatment of chronic prostate pain with palmitoylethanolamide (PeaPure)
No products are available that treat the mechanisms causing chronic prostatic pain, expect the naturally occurring compound palmitoylethanolamide (PEA). PEA occurs naturally in the human body and has anti-inflammatory and painkilling properties.
It inhibits the activation of the mast cells and the secretion of inflammation promoting substances by multiple cells in the prostate. It is our natural ‘brake’ on inflammatory processes that have run out of hand. PEA is produced by the prostatic cells in chronic prostatic pain, but not in adequate amounts to break the circle.
PEA has been available since many years as a food supplement to counteract the processes described above. However, it has mainly been used by Italian and Spanish doctors. This is due to the fact that the effects of PEA were discovered in 1993 by Italian Nobel laureate prof. Levi-Montalcini. Since then, lots has been said and written in Italy about this compound. But as Italian language publications do not spread readily to non-Italian (or Spanish) speakers, little was known about PEA elsewhere.
Now, through the work of two small organisations, an Italian and a Dutch one, PEA is becoming more and more known in Northern Europe and the rest of the world as a food supplement. Particularly since two key clinical review articles were published in English, more and more doctors and patients start to use PEA to treat chronic pain- and inflammatory syndromes.
The dosage schedule for chronic pain and infections is 400mg PEA, three times daily as PeaPure or 2 times daily for Normast 600 mg. It has been shown that this compound that is naturally present in the human body is safe to use and can be used easily in combination with all kinds of other drugs and painkillers without negative effects.
PeaPure is a product containing the highest pure concentration of PEA in each dose-unit (capsule), without any chemical or pharmaceutical excipients. Both PeaPure as well as Normast are products containing finely milled PEA, micronized PEA. PeaPure and Normast are both GMP produced products; Normast is produced in Italy and PeaPure in the Netherlands.