The Gut-Prostate axis in chronic Prostatitis/Chronic Pelvic pain syndrome: Mechanisms, evidence gaps, and biomarker-stratified translation.

Authors

Shuo Pang, Yuxin Liu, Kaixin Shi, BaiLin Yi, Shiming Wang, Yingwei Bi, Jianbo Wang

Published in

iScience. Volume 29. Issue 8. Pages 116935. Aug 21, 2026. Epub Jul 29, 2026.

Abstract

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a heterogeneous disorder traditionally framed around local prostate, pelvic-floor, neurological, and psychosocial factors. Emerging evidence suggests that gut dysbiosis may contribute to CP/CPPS in a subset of patients through barrier dysfunction, immune priming, microbial metabolites, and neuroimmune modulation. We propose a Dual-Hit Permissive Model in which gut-derived systemic immunometabolic priming must converge with prostate-local or pelvic permissive cues before organ-localized inflammation and chronic pain can be sustained. We distinguish direct human CP/CPPS evidence from animal prostatitis models, contextual prostate-disease evidence, and hypothesis-generating mechanisms. Ectopic mucosal addressins, prostate-specific vascular "address codes," and microbial-prostate molecular mimicry remain testable hypotheses rather than established mechanisms. Future work should prioritize biomarker-stratified, target-engagement studies to validate immunometabolic, tissue-localization, and neuroimmune checkpoints before gut-directed interventions are broadly translated into CP/CPPS care.

PMID:
42571299
Bibliographic data and abstract were imported from PubMed on 09 Aug 2026.

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