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The Journal of Pathology Apr 2022Benign prostatic hyperplasia (BPH) is a progressive expansion of peri-urethral prostate tissue common in aging men. Patients with enlarged prostates are treated with...
Benign prostatic hyperplasia (BPH) is a progressive expansion of peri-urethral prostate tissue common in aging men. Patients with enlarged prostates are treated with 5-alpha reductase inhibitors (5ARIs) to shrink prostate volume by blocking the conversion of testosterone to dihydrotestosterone (DHT). A reduction in DHT levels can elicit atrophy and apoptosis of prostate secretory luminal cells, which results in a favorable clinical response characterized by improved lower urinary tract symptoms. However, the histologic response to 5ARI treatment is often heterogeneous across prostate acini and lower urinary tract symptoms can persist to require surgical intervention. We used two spatial profiling approaches to characterize gene expression changes across histologically normal and atrophied regions in prostates from 5ARI-treated men. Objective transcriptomic profiling using the Visium spatial gene expression platform showed that 5ARI-induced atrophy of prostate luminal cells correlated with reduced androgen receptor signaling and increased expression of urethral club cell genes including LTF, PIGR, OLFM4, SCGB1A1, and SCGB3A1. Prostate luminal cells within atrophied acini adapted to decreased DHT conditions by increasing NF-κB signaling and anti-apoptotic BCL2 expression, which may explain their survival. Using GeoMx digital spatial profiling with a probe set to assess ~18 000 RNA targets, we confirmed that atrophied acini expressing SCGB3A1 displayed higher levels of club cell markers compared with histologically normal acini with NKX3-1 expression. In addition, club-like cells within regions of 5ARI-induced atrophy closely resembled true club cells from the prostatic urethra. A comparison of histologically normal regions from 5ARI-treated men and histologically normal regions from untreated men revealed few transcriptional differences. Taken together, our results describe a heterogeneous response to 5ARI treatment where cells in atrophied acini undergo an adaptation from a prostate secretory luminal to a club cell-like state in response to 5ARI treatment. © 2021 The Pathological Society of Great Britain and Ireland.
Topics: 5-alpha Reductase Inhibitors; Atrophy; Dihydrotestosterone; Humans; Lower Urinary Tract Symptoms; Male; Prostate; Prostatic Hyperplasia
PubMed: 34928497
DOI: 10.1002/path.5857 -
Frontiers in Endocrinology 2023Both benign prostatic hyperplasia (BPH) and sarcopenic obesity (SO) are common conditions among older adult/adults males. The prevalent lifestyle associated with SO is a...
BACKGROUND
Both benign prostatic hyperplasia (BPH) and sarcopenic obesity (SO) are common conditions among older adult/adults males. The prevalent lifestyle associated with SO is a significant risk factor for the development of BPH. Therefore, we investigated the causal relationship between SO factors and BPH.
METHOD
The instrumental variables for SO factors were selected using the inverse variance-weighted method, which served as the primary approach for Mendelian randomization analysis to assess the causal effect based on summary data derived from genome-wide association studies of BPH.
RESULT
The increase in BMR (OR = 1.248; 95% CI = (1.087, 1.432); P = 0.002) and ALM (OR = 1.126; 95% CI = (1.032, 1.228); P = 0.008) was found to be associated with an elevated risk of BPH. However, no genetic causality between fat-free mass distribution, muscle mass distribution, and BPH was observed.
CONCLUSION
Our findings indicate that a genetic causal association between BMR, ALM and BPH. BMR and ALM are risk factors for BPH. The decrease in BMR and ALM signified the onset and progression of SO, thus SO is a protective factor for BPH.
Topics: Male; Humans; Aged; Sarcopenia; Prostatic Hyperplasia; Prostate; Genome-Wide Association Study; Hyperplasia; Obesity
PubMed: 38027182
DOI: 10.3389/fendo.2023.1290639 -
European Urology Jul 2021Prostatic artery embolisation (PAE) for the treatment of lower urinary tract symptoms secondary to benign prostatic obstruction (LUTS/BPO) still remains under... (Randomized Controlled Trial)
Randomized Controlled Trial
Prostatic Artery Embolisation Versus Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia: 2-yr Outcomes of a Randomised, Open-label, Single-centre Trial.
BACKGROUND
Prostatic artery embolisation (PAE) for the treatment of lower urinary tract symptoms secondary to benign prostatic obstruction (LUTS/BPO) still remains under investigation.
OBJECTIVE
To compare the efficacy and safety of PAE and transurethral resection of the prostate (TURP) in the treatment of LUTS/BPO at 2 yr of follow-up.
DESIGN, SETTING, AND PARTICIPANTS
A randomised, open-label trial was conducted. There were 103 participants aged ≥40 yr with refractory LUTS/BPO.
INTERVENTION
PAE versus TURP.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS
International Prostate Symptoms Score (IPSS) and other questionnaires, functional measures, prostate volume, and adverse events were evaluated. Changes from baseline to 2 yr were tested for differences between the two interventions with standard two-sided tests.
RESULTS AND LIMITATIONS
The mean reduction in IPSS after 2 yr was 9.21 points after PAE and 12.09 points after TURP (difference of 2.88 [95% confidence interval 0.04-5.72]; p = 0.047). Superiority of TURP was also found for most other patient-reported outcomes except for erectile function. PAE was less effective than TURP regarding the improvement of maximum urinary flow rate (3.9 vs 10.23 ml/s, difference of -6.33 [-10.12 to -2.54]; p < 0.001), reduction of postvoid residual urine (62.1 vs 204.0 ml; 141.91 [43.31-240.51]; p = 0.005), and reduction of prostate volume (10.66 vs 30.20 ml; 19.54 [7.70-31.38]; p = 0.005). Adverse events were less frequent after PAE than after TURP (total occurrence n = 43 vs 78, p = 0.005), but the distribution among severity classes was similar. Ten patients (21%) who initially underwent PAE required TURP within 2 yr due to unsatisfying clinical outcomes, which prevented further assessment of their outcomes and, therefore, represents a limitation of the study.
CONCLUSIONS
Inferior improvements in LUTS/BPO and a relevant re-treatment rate are found 2 yr after PAE compared with TURP. PAE is associated with fewer complications than TURP. The disadvantages of PAE regarding functional outcomes should be considered for patient selection and counselling.
PATIENT SUMMARY
Prostatic artery embolisation is safe and effective. However, compared with transurethral resection of the prostate, its disadvantages regarding subjective and objective outcomes should be considered for individual treatment choices.
Topics: Arteries; Embolization, Therapeutic; Humans; Lower Urinary Tract Symptoms; Male; Prostate; Prostatic Hyperplasia; Transurethral Resection of Prostate; Treatment Outcome
PubMed: 33612376
DOI: 10.1016/j.eururo.2021.02.008 -
Aging Jun 2019
Topics: Animals; Humans; Male; Mice; Prostate; Prostatic Hyperplasia; Stromal Cells
PubMed: 31195369
DOI: 10.18632/aging.102029 -
BMC Public Health Jun 2023The association between sleep quality and benign prostate hyperplasia (BPH) has rarely been studied. The aim of this study was to examine the relationship between sleep...
BACKGROUND
The association between sleep quality and benign prostate hyperplasia (BPH) has rarely been studied. The aim of this study was to examine the relationship between sleep quality and BPH among middle-aged and older men in India.
METHODS
This study used data from men over 45 years old in Wave 1 (2017-2018) of the Longitudinal Aging Study in India (LASI). Benign prostate hyperplasia was self-reported, and sleep symptoms were assessed using five questions modified from the Jenkins Sleep Scale. A total of 30,909 male participants were finally included. Multivariate logistic regression analysis, subgroup analysis, and interaction tests were performed.
RESULTS
Total 453 (1.49%) men reported benign prostatic hyperplasia and have higher sleep quality score (9.25 ± 3.89 vs. 8.13 ± 3.46). The results revealed that the sleep quality score and risk of benign prostatic hyperplasia were significantly correlated after adjusting for all confounding factors (OR:1.057, 95% CI: 1.031-1.084, p < 0.001]. After dividing people into four groups based on the quartile of sleep quality scores, compared with the first quartile group, the third quartile group was 1.32 times, and the fourth quartile group was 1.615 times more likely to develop benign prostate hyperplasia. A significant interaction effect of alcohol consumption was observed. (p for interaction < 0.05).
CONCLUSION
Worse sleep quality was significantly associated with a higher incidence of benign prostatic hyperplasia among middle-aged and older Indian men. A further prospective study is needed to clarify this association and explore potential mechanisms.
Topics: Middle Aged; Male; Humans; Aged; Female; Sleep Quality; Prostatic Hyperplasia; Hyperplasia; Prostate; India
PubMed: 37316942
DOI: 10.1186/s12889-023-15972-6 -
Frontiers in Cellular and Infection... 2022Apart from other risk factors, chronic inflammation is also associated with the onset of Prostate Cancer (PCa), wherein pathogen infection and tissue microbiome...
Apart from other risk factors, chronic inflammation is also associated with the onset of Prostate Cancer (PCa), wherein pathogen infection and tissue microbiome dysbiosis are known to play a major role in both inflammatory response and cancer development. However, except for a few studies, the link between microbes and PCa remained poorly understood. To explore the potential microbiome signature associated with PCa in Indian patients, we investigated differential compositions of commensal bacteria among patients with benign prostatic hyperplasia (BPH) and PCa using 16S rRNA amplicon sequencing followed by qPCR analyses using two distinct primer sets. Using two independent cohorts, we show that , , and represent the three most abundant bacteria in diseased prostate lesions. LEfSe analyses identified that while are distinctly elevated in PCa samples, and are significantly enriched in BPH samples. Furthermore, we identify that a number of human tumor viruses, including Epstein-Barr virus (EBV) and hepatitis B virus (HBV), along with two high-risk human papillomaviruses - HPV-16 and HPV-18, are significantly associated with the PCa development and strongly correlated with PCa bacterial signature. The study may thus offer to develop a framework for exploiting this microbial signature for early diagnosis and prognosis of PCa development.
Topics: Epstein-Barr Virus Infections; Herpesvirus 4, Human; Humans; Male; Prostatic Hyperplasia; Prostatic Neoplasms; RNA, Ribosomal, 16S
PubMed: 35865814
DOI: 10.3389/fcimb.2022.894777 -
JPMA. the Journal of the Pakistan... Dec 2023Here we discuss the interactions between prostatic health and diabetes. Diabetes may be associated with changes in prostatic anatomy, physiology, clinical morbidity, and...
Here we discuss the interactions between prostatic health and diabetes. Diabetes may be associated with changes in prostatic anatomy, physiology, clinical morbidity, and clinical outcomes. Certain glucose-lowering drugs may impact prostatic health, and some prostato-tropic medications can influence glycaemic control. One should be vigilant for symptoms and signs of prostate health in diabetes.
Topics: Male; Humans; Prostate; Erectile Dysfunction; Prostatic Hyperplasia; Diabetes Mellitus; Lower Urinary Tract Symptoms
PubMed: 38083941
DOI: 10.47391/JPMA.23-101 -
Military Medical Research Nov 2019Both periodontal disease and benign prostatic hyperplasia are age-related diseases that affect millions of people worldwide. Hence, this study aimed to investigate the...
BACKGROUND
Both periodontal disease and benign prostatic hyperplasia are age-related diseases that affect millions of people worldwide. Hence, this study aimed to investigate the association between periodontal disease and the risk of benign prostatic hyperplasia.
METHODS
A total of 4930 participants were selected from an available health examination that was carried out in 2017, only males were considered for further analysis. All eligible males were divided into benign prostatic hyperplasia and normal groups, the benign prostatic hyperplasia group was then divided into prostate volume ≤ 60 g and > 60 g subgroups; all their periodontal status was extracted and then into normal (CPI score of 0), periodontal disease (CPI score between 1 and 4), and periodontitis (CPI score between 3 and 4) groups. The correlation between periodontal disease and benign prostatic hyperplasia was investigated using logistic regression analyses and greedy matching case-control analysis. Subgroup analysis based on prostate volume was also performed. All analyses were conducted with SAS 9.4 software.
RESULTS
A total of 2171 males were selected for this analysis. The presence of periodontal disease significantly increased the risk of benign prostatic hyperplasia by 1.68 times (OR = 1.68, 95% CI: 1.26-2.24), and individuals with periodontitis showed a higher risk (OR = 4.18, 95% CI: 2.75-6.35). In addition, among matched cases and controls, this association remained robust (periodontal disease: OR = 1.85, 95% CI: 1.30-2.64; periodontitis: OR = 4.83, 95% CI: 2.57-9.07). Subgroup analysis revealed that periodontal disease significantly increased benign prostate hyperplasia risk as well (for prostate volume ≤ 60 g: OR = 1.64, 95% CI: 1.22-2.20; for volume > 60 g: OR = 2.17, 95% CI: 1.04-4.53), and there was a higher risk in the group with a prostate volume greater than 60 g.
CONCLUSION
Periodontal disease is significantly and positively associated with an increased risk of benign prostatic hyperplasia. Further validation studies should be performed to explore the relationship between periodontal treatment and benign prostate hyperplasia.
Topics: Adult; Aged; Case-Control Studies; China; Cross-Sectional Studies; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Periodontal Diseases; Prostate; Prostatic Hyperplasia
PubMed: 31718713
DOI: 10.1186/s40779-019-0223-8 -
International Journal of Biological... 2023Benign prostatic hyperplasia (BPH) and early-stage prostate cancer (PC) have similar symptoms, making it challenging to differentially diagnose these two conditions. The...
Benign prostatic hyperplasia (BPH) and early-stage prostate cancer (PC) have similar symptoms, making it challenging to differentially diagnose these two conditions. The study used Weighted Gene Co-Expression Network Analysis, as well as two machine learning strategies to identify BPH-specific biomarkers based on an integrated transcriptome data from 922 samples. Eight prognostic genes (, , , , , , , and ) were identified to be BPH-specific biomarkers with high accuracy and specificity. Moreover, we constructed a seven-gene diagnostic classifier to distinguish BPH from PC. The infiltrations of plasmacytoid dendritic cells and neutrophil cells showed distinct differences between BPH and non-BPH groups. Additionally, ursolic acid can reverse transcriptional features associated with the occurrence and progression of BPH. Both and experiments have confirmed that it induces apoptosis of BPH cells and inhibits cell proliferation by promoting cell cycle S-phase arrest. The diagnostic biomarkers, microenvironment characteristics, and therapeutic effect of ursolic acid explored in this study offer new diagnostic and therapeutic strategies for BPH.
Topics: Male; Humans; Prostatic Hyperplasia; Prostate; Hyperplasia; Prostatic Neoplasms; Tumor Microenvironment; Forkhead Transcription Factors; Cell Adhesion Molecules; Ursolic Acid
PubMed: 37705744
DOI: 10.7150/ijbs.85739 -
The Prostate Jun 2008Pharmacological approaches are available to medically-managed patients with symptomatic BPH before surgical intervention is required. These include daily treatment with... (Review)
Review
Pharmacological approaches are available to medically-managed patients with symptomatic BPH before surgical intervention is required. These include daily treatment with alpha-blockers and 5-alpha-reductase inhibitors alone or in combination. These medical approaches have two major problems. First, treatments are chronic and must be taken daily. Second, there are significant financial costs and quality of life issues for such chronic treatments. Is it possible to develop effective acute therapy for symptomatic BPH without the long-term androgen deprivation-induced side effects? Two seminal but rarely cited studies of Walsh [Peters, Walsh: N Engl J Med 317:599-604, 1987] and Coffey et al. [Sufrin et al.: Invest Urol 13:418-423, 1976], combined with the growing understanding of the stem cell organization of the prostate stromal (S) and epithelial (E) compartments and their reciprocal paracrine and autocrine interactions provides the rationale for an acute approach.The Walsh study documents that: (1) androgen deprivation disrupts the reciprocal interaction between the prostate S and E thereby decreasing the weight of both compartments and (2) once BPH develops, androgen deprivation does not decrease the number of stem cell units in either the S or E compartments since subsequent androgen restoration fully restores the enlarged gland. The Coffey study documents that acute androgen deprivation sensitizes S-E interactions to radiation induced disruptions so that following radiation, androgen restoration does not induce full gland regrowth. Therefore, effective therapy for symptomatic BPH should be achievable by acute treatment with reversible androgen deprivation for a limited period followed by a single dose of conformal external beam radiation before allowing the man to recovery his normal serum testosterone.
Topics: Adult Stem Cells; Androgen Antagonists; Animals; Epithelial Cells; Humans; Male; Prostatic Hyperplasia; Radiotherapy; Stromal Cells
PubMed: 18386293
DOI: 10.1002/pros.20763