A new antioxidant nutraceutical compound is able to reduce the level of prostate pro-inflammatory mediators: results from a phase III, placebo controlled trial
Abstract
Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is still a challenging disease for all urologists. Several therapeutic approaches haven been purposed for symptoms relief and quality of life improvement. Here, we aim to evaluate the efficacy of a new nutraceutical compound in patients affected by CP/CPPS and perform a detailed evaluation of pro-inflammatory mediators [interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10)] in order to establish the treatment mechanism of action and evaluate its clinical efficacy.
Methods: All patients with a diagnosis of CP/CPPS attending the same urologic centre between January and December 2024 were enrolled in this randomised controlled phase III study. Participants were randomised to receive oral capsules of a dietary supplement containing solanum lycopersicum (100 mg), brassica oleracea (333 mg), silybum marianum (50 mg), glutathione (50 mg), aesculus hippocastanum (2 mg), tryptophane (25 mg), camellia sinensis (25 mg) (one capsule every 24 h) or placebo (one capsule every 24 h) for three months. At the enrolment time, all patients underwent baseline questionnaires (NIHCPSI, SF-36), urological examination and microbiological evaluation by using the Meares-Stamey test. Moreover, level of IL-6, IL-8 and IL-10 have been evaluated in seminal plasma collected at the enrolment time and at the follow-up time (3 months after the enrolment with a urological and microbiological examination and questionnaire collection). The main outcome measures were: the improvement of quality of life and the decrease of proinflammatory mediators, at the end of the whole study period.
Results: In the per-protocol analysis, 77 males (mean age of 31.9 ± 2.5 years) were randomly allocated to the dietary supplement (n = 38) or placebo (n = 39) groups. At the follow-up examination, in the dietary supplement group, 21/38 patients (55.3%) showed a significant reduction of the NIH-CPSI total score (more than 25% from baseline), compared with 12/39 (30.7%) in the control group (p < .0001). In addition, at the 3 months follow-up visit, the mean level of IL-8 was significantly lower in the dietary supplement group compared with control group [IL-8 316 pg/ml vs IL-8 986 pg/ml] (p < .0001). In the dietary supplement group, we found a statistically significant reduction of IL-8 level between the enrolment and follow-up visit [IL-8 856 pg/ml vs IL-8 298 pg/ml] (p < .0001). No statistically significant difference in terms of IL-6 or IL-10 evaluation have been reported.
Conclusions: This new antioxidant dietary supplement treatment is able to improve quality of life in patients affected by CP/CPPS through the reduction pro-inflammatory cytokine levels (IL-8).
Keywords
Ethics Approval
The food supplements are regulated by Directive 2002/46/EC (implemented in Italy through Legislative Decree 169/2004) and by national decrees and Ministry of Health guidelines. The Italian Medicines Agency (AIFA) does not require “ethical approval” for the study conductiong on food supplements as is the case for a medicinal product.
References
- 1. Magistro G, Wagenlehner FM, Grabe M, et al. Contemporary Management of Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Eur Urol 2016; 69:286-97. DOI: https://doi.org/10.1016/j.eururo.2015.08.061
- 2. Graziani A, Grande G, Martin M, et al. Chronic Prostatitis/ Chronic Pain Pelvic Syndrome and Male Infertility. Life (Basel) 2023;13:1700. DOI: https://doi.org/10.3390/life13081700
- 3. Krieger JN, Nyberg L Jr, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA 1999; 282:236-7. DOI: https://doi.org/10.1001/jama.282.3.236
- 4. Adamian L, Urits I, Orhurhu V, et al. A Comprehensive Review of the Diagnosis, Treatment, and Management of Urologic Chronic Pelvic Pain Syndrome. Curr Pain Headache Rep 2020; 24:27. DOI: https://doi.org/10.1007/s11916-020-00857-9
- 5. Sugimoto M, Hijikata Y, Tohi Y, et al. Low quality of life in men with chronic prostatitis-like symptoms. Prostate Cancer Prostatic Dis 2022; 25:785-790. DOI: https://doi.org/10.1038/s41391-022-00559-w
- 6. Parsons BA, Baranowski AP, Berghmans B, et al. Management of chronic primary pelvic pain syndromes. BJU Int 2022; 129:572-581. DOI: https://doi.org/10.1111/bju.15609
- 7. Hu M, Wazir J, Ullah R, et al. Phytotherapy and physical therapy in the management of chronic prostatitis-chronic pelvic pain syndrome. Int Urol Nephrol 2019; 51:1081-1088. DOI: https://doi.org/10.1007/s11255-019-02161-x
- 8. Zhang K, Guo RQ, Chen SW, et al. The efficacy and safety of Serenoa repens extract for the treatment of patients with chronic prostatitis/ chronic pelvic pain syndrome: a multicenter, randomized, double-blind, placebo-controlled trial. World J Urol 2021; 39:3489-3495. DOI: https://doi.org/10.1007/s00345-020-03577-2
- 9. Boeri L, Passarelli F, Basadonna LM, et al. Oxidative Stress and Semen Quality Among Night- and Day-Shift Workers: A Cross-Sectional Study. Antioxidants 2025; 14:802. DOI: https://doi.org/10.3390/antiox14070802
- 10. Cai T, Boeri L, Miacola C, et al. Can nutraceuticals counteract the detrimental effects of the environment on male fertility? A parallel systematic review and expert opinion. Minerva Endocrinol (Torino) 2025; 50:84-96. DOI: https://doi.org/10.23736/S2724-6507.24.04218-0
- 11. Bianchi AR, Vitale E, Guerretti V, et al. Antioxidant Characterization of Six Tomato Cultivars and Derived Products Destined for Human Consumption. Antioxidants (Basel) 2023; 12:761. DOI: https://doi.org/10.3390/antiox12030761
- 12. Meng T, Feng R, Zhu Y, et al. Sulforaphane relieved inflammation symptoms in EAP mice by blocking oxidative stress and NLRP3 inflammasome activation through the Nrf2 pathway. Clin Exp Immunol 2025; 219:uxaf022. DOI: https://doi.org/10.1093/cei/uxaf022
- 13. Pieretti JC, Armentano GM, Carneiro-Ramos MS, Seabra AB. Nitric oxide tuning enhances cytotoxicity and reduces inflammation in prostate cancer nanotherapy. Nitric Oxide 2025;158:124-131. DOI: https://doi.org/10.1016/j.niox.2025.08.001
- 14. Zhang FX, Chen X, Niu DC, et al. Chronic prostatitis/chronic pelvic pain syndrome induces metabolomic changes in expressed prostatic secretions and plasma. Asian J Androl 2025;27:101-112. DOI: https://doi.org/10.4103/aja202434
- 15. Cai T, Gallelli L, Cione E, et al. The efficacy and tolerability of pollen extract in combination with hyaluronic acid and vitamins in the management of patients affected by chronic prostatitis/chronic pelvic pain syndrome: a 26 weeks, randomized, controlled, singleblinded, phase III study. Minerva Urol Nephrol 2022; 74:780-788. DOI: https://doi.org/10.23736/S2724-6051.21.04141-2
- 16. European Association of Urology Guidelines - https:// d56bochluxqnz. cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Urological-infections-2025_2025-05-24-110339_pxmf.pdf - access on September 2025.
- 17. Vocca C, Abrego-Guandique DM, Cione E, et al. Probiotics in the Management of Chronic Bacterial Prostatitis Patients: A Randomized, Double-Blind Trial to Evaluate a Possible Link Between Gut Microbiota Restoring and Symptom Relief. Microorganisms 2025; 13:130. DOI: https://doi.org/10.3390/microorganisms13010130
- 18. Giubilei G, Mondaini N, Crisci A, et al. The Italian version of the National Institutes of Health Chronic Prostatitis Symptom Index. Eur Urol 2005; 47:805-11. DOI: https://doi.org/10.1016/j.eururo.2004.12.025
- 19. Nickel JC, Downey J, Hunter D, Clark J. Prevalence of prostatitis- like symptoms population based study using the National Institutes of Health chronic prostates symptoms index. J Urol 2001;165:843-5. DOI: https://doi.org/10.1016/S0022-5347(05)66541-X
- 20. Mazzoli S, Cai T, Rupealta V, et al. Interleukin 8 and antichlamydia trachomatis mucosal IgA as urogenital immunologic markers in patients with C. trachomatis prostatic infection. Eur Urol 2007; 51:1385-1393. DOI: https://doi.org/10.1016/j.eururo.2006.10.059
- 21. Cicero AFG, Allkanjari O, Busetto GM, et al. Nutraceutical treatment and prevention of benign prostatic hyperplasia and prostate cancer. Arch Ital Urol Androl 2019; 91:139. DOI: https://doi.org/10.4081/aiua.2019.3.139
- 22. Cai T, Verze P, La Rocca R, et al. The Clinical Efficacy of Pollen Extract and Vitamins on Chronic Prostatitis/Chronic Pelvic Pain Syndrome Is Linked to a Decrease in the Pro-Inflammatory Cytokine Interleukin-8. World J Mens Health 2017; 35:120-128. DOI: https://doi.org/10.5534/wjmh.2017.35.2.120
- 23. Penna G, Mondaini N, Amuchastegui S, et al. Seminal plasma cytokines and chemokines in prostate inflammation: interleukin 8 as a predictive biomarker in chronic prostatitis/chronic pelvic pain syndrome and benign prostatic hyperplasia. Eur Urol 2007; 51:524-33. DOI: https://doi.org/10.1016/j.eururo.2006.07.016
- 24. Colado-Velázquez JI, Mailloux-Salinas P, Arias-Chávez DJ, et al. Lipidic extract of whole tomato reduces hyperplasia, oxidative stress and inflammation on testosterone-induced BPH in obese rats. Int Urol Nephrol 2023; 55:529-539. DOI: https://doi.org/10.1007/s11255-022-03383-2
- 25. Nazeri M, Nemati H, Khazaei M. Nrf2 antioxidant pathway and apoptosis induction and inhibition of NF-κB-mediated inflammatory response in human prostate cancer PC3 cells by Brassica oleracea var. acephala: An in vitro study. Mol Biol Rep 2022; 49:7251-7261. DOI: https://doi.org/10.1007/s11033-022-07507-w
- 26. Siddiqui IA, Raisuddin S, Shukla Y. Protective effects of black tea extract on testosterone induced oxidative damage in prostate. Cancer Lett 2005; 227:125-32. DOI: https://doi.org/10.1016/j.canlet.2004.10.046
- 27. Marino C, Magliocchetti M, Di Lieto D, et al. Prostate health supporting by a novel nutraceutical compound with antioxidant property: results from a pilot study. Urologia Journal 2025. In press. DOI: https://doi.org/10.1177/03915603251408298
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