Materiały źródłowe

• #1 Benign Prostatic Hyperplasia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK558920/

  Benign prostatic hyperplasia (BPH) refers to the nonmalignant growth or hyperplasia of prostate tissue and is a common cause of lower urinary tract symptoms (LUTS) in older men. Disease prevalence has been shown to increase with advancing age. The histological prevalence of BPH at autopsy is as high as 50% to 60% for males in their 60s, increasing to 80% to 90% of those older than 70 years of age. […] The development of BPH is characterized by stromal and epithelial cell proliferation in the prostate transition zone, which surrounds the urethra. This leads to urethral compression and bladder outflow obstruction, which can result in clinical manifestations of LUTS, urinary retention, or infections due to incomplete bladder emptying. Long-term, untreated disease can lead to the development of chronic high-pressure retention (a potentially life-threatening condition) and long-term or permanent changes to the bladder detrusor muscle.

• #2 Benign Prostatic Hyperplasia (BPH) Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline

  Benign prostatic hyperplasia (BPH) is a histologic diagnosis that refers to the proliferation of smooth muscle and epithelial cells within the prostatic transition zone. […] The mechanism by which testosterone exerts many of its physiological effects on the prostate gland is through dihydrotestosterone (DHT). Androgens, including testosterone, are produced by the Leydig cells of the testes and the adrenal glands. After production, testosterone is circulated via the bloodstream to the prostate gland, and then enters into the cells by simple diffusion. Once intracytoplasmic, testosterone is converted to its active metabolite DHT by the enzyme 5 -reductase, type 2. DHT forms a complex with androgen receptors that is then transported to the nucleus. Within the nucleus, this complex exerts its effects on the transcription of DNA. These effects are necessary for the normal development of the prostate gland as well as the normal growth and hyperplasia of the prostate.

• #3 Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: Current concepts

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5509197/

  The precise molecular etiology of BPE/BPH is complicated and poorly understood, although several risk factors for the development of BPE/BPH and LUTS have been identified. These include age, genetics, hormones, growth factors, inflammation, and lifestyle factors. […] The aging process involves changes in cellular mitogenesis and hormonal homeostasis in the prostate gland, which later proceed to chromosomal aberration and apoptosis. […] Sex steroid hormones have been affirmatively linked with the development and maintenance of BPE/BPH. Androgen is perhaps the most extensively studied hormone of all. In the prostate, testosterone is converted to dihydrotestosterone (DHT) by type II 5 reductase through DHT/androgen receptor signaling and may influence cell proliferation, differentiation, morphogenesis, and functional maintenance. […] Several growth factors and their corresponding receptors have been identified in prostatic epithelium and stroma, which can stimulate or inhibit cell division and differentiation processes. […] There is a growing body of evidence that suggests that inflammation is closely linked to the development of BPE/BPH and LUTS. From a histological point of view, inflammatory infiltrates are the most prevalent feature coexisting with BPH, and the degree of inflammation is correlated with prostate volume and weight.

• #4 Mechanism of Androgen-Independent Stromal Proliferation in Benign Prostatic Hyperplasia

  https://www.mdpi.com/1422-0067/24/14/11634

  BPH is a multifactorial disease, and understanding the role of androgen-independent factors including immune responses contributes to elucidating the pathogenesis of BPH. […] Aging and androgens are necessary for the development of BPH, but the pathogenesis of BPH is still largely unresolved. […] Androgen-independent factors include ischemia, oxidative stress, metabolic syndrome, infection, autoimmune reactions, and inflammation, and these interact with each other to form more complicated pathophysiology. […] In particular, inflammation has received much attention, and various studies are underway. […] This review focuses on the role of androgen-independent factors in stromal proliferation of BPH and the potential for novel therapeutic agents targeting these factors. […] The role of androgen-independent factors in the proliferative process of BPH is also important as described above. Thus, BPH is a multifactorial disease, which further complicates the pathophysiology of BPH.

• #5 Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: Current concepts

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5509197/

  Lower urinary tract symptoms (LUTS) are highly prevalent in the aging population, particularly in men. Historically, prostate enlargement was thought to be responsible for most cases of male LUTS. Several risk factors for the development of benign prostate enlargement/hyperplasia (BPE/BPH) have been identified, including age, genetics, hormones, growth factors, inflammation, and lifestyle factors. […] In this article, we review current concepts in the epidemiology, etiology, and pathophysiology of BPE/BPH and male LUTS. […] The pathophysiology of LUTS could include bladder dysfunction (including bladder hypersensitivity, detrusor overactivity [DO]), bladder outlet obstruction (BOO), (including bladder neck dysfunction, prostatic obstruction, urethral stricture, poorly relaxed urethral sphincter, urethral sphincter dyssynergia), or a combination of these etiologies. […] The hyperplastic process in the prostate begins in the periurethral region, namely, the transition zone. As discussed earlier, this process is influenced by multiple factors, leading to an increase in the cell number and size through epithelial and stromal proliferation or apoptosis. As enlargement takes place, prostatic intrusion into the urethral lumen or bladder neck can considerably change bladder outlet resistance by causing mechanical obstruction. […] The prostatic capsule is another key to the development of LUTS by transmitting the pressure of tissue expansion to the urethra and increasing urethral resistance. […] Growing evidence has shown that, just as in BOO secondary to BPE/BPH, these anatomical and functional changes may, in turn, induce significant alterations in the morphology and physiology of the urothelium and detrusor muscles, which lead to bothersome LUTS.

• #6 Benign Prostatic Hyperplasia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK558920/

  BPH arises due to the loss of homeostasis between prostatic cellular proliferation and apoptosis or cell death. This imbalance favors cellular proliferation without intervention. The result is increased numbers of prostatic periurethral epithelial and stromal cells, which can be seen histopathologically. The etiology of BPH is influenced by a wide variety of risk factors, in addition to the direct hormonal effects of testosterone on prostate tissue. Men who are castrated before puberty or who have an androgen-related disorder do not develop BPH. […] Testicular androgens are required to develop BPH as dihydrotestosterone (DHT) promotes tissue growth and cellular proliferation by interacting directly with prostatic epithelium and stroma. DHT directly influences prostatic stromal and adjacent cells, which affect cellular proliferation and apoptosis. Interestingly, there does not appear to be any relationship between testosterone or DHT levels and the development of symptomatic BPH.

• #7 Benign prostatic hyperplasia – Wikipedia

  https://en.wikipedia.org/wiki/Benign_prostatic_hyperplasia

  Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. […] The underlying mechanism involves the prostate pressing on the urethra thereby making it difficult to pass urine out of the bladder. […] Most experts consider androgens (testosterone and related hormones) to play a permissive role in the development of BPH. […] Dihydrotestosterone (DHT), a metabolite of testosterone, is a critical mediator of prostatic growth. […] The importance of DHT in causing nodular hyperplasia is supported by clinical observations in which an inhibitor of 5-reductase such as finasteride is given to men with this condition. […] While there is some evidence that estrogen may play a role in the cause of BPH, this effect appears to be mediated mainly through local conversion of androgens to estrogen in the prostate tissue rather than a direct effect of estrogen itself.

• #8 Benign Prostatic Hyperplasia (BPH) Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline

  Benign prostatic hyperplasia (BPH) is a histologic diagnosis that refers to the proliferation of smooth muscle and epithelial cells within the prostatic transition zone. […] The mechanism by which testosterone exerts many of its physiological effects on the prostate gland is through dihydrotestosterone (DHT). Androgens, including testosterone, are produced by the Leydig cells of the testes and the adrenal glands. After production, testosterone is circulated via the bloodstream to the prostate gland, and then enters into the cells by simple diffusion. Once intracytoplasmic, testosterone is converted to its active metabolite DHT by the enzyme 5 -reductase, type 2. DHT forms a complex with androgen receptors that is then transported to the nucleus. Within the nucleus, this complex exerts its effects on the transcription of DNA. These effects are necessary for the normal development of the prostate gland as well as the normal growth and hyperplasia of the prostate.

• #9 Benign Prostatic Hyperplasia (BPH): Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/437359-overview

  However, the fact that serum testosterone levels decrease with age, yet the development of BPH increases, suggests that other agents play an etiologic role. Possible factors include the metabolic syndrome, hyperinsulinemia, norepinephrine, angiotensin II, and insulin-like growth factors. […] Increasing evidence indicates a role for autophagy (self-phagocytosis), the process by which cells degrade their cytoplasmic proteins and damaged organelles via lysosomes, in reducing apoptosis of prostate cells. […] Microscopically, BPH is characterized as a hyperplastic process. The hyperplasia results in enlargement of the prostate that may restrict the flow of urine from the bladder, resulting in clinical manifestations of BPH. […] The traditional theory behind BPH is that, as the prostate enlarges, the surrounding capsule prevents it from radially expanding, potentially resulting in urethral compression. However, obstruction-induced bladder dysfunction contributes significantly to LUTS.

• #10 Benign Prostatic Hyperplasia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK558920/

  BPH arises due to the loss of homeostasis between prostatic cellular proliferation and apoptosis or cell death. This imbalance favors cellular proliferation without intervention. The result is increased numbers of prostatic periurethral epithelial and stromal cells, which can be seen histopathologically. The etiology of BPH is influenced by a wide variety of risk factors, in addition to the direct hormonal effects of testosterone on prostate tissue. Men who are castrated before puberty or who have an androgen-related disorder do not develop BPH. […] Testicular androgens are required to develop BPH as dihydrotestosterone (DHT) promotes tissue growth and cellular proliferation by interacting directly with prostatic epithelium and stroma. DHT directly influences prostatic stromal and adjacent cells, which affect cellular proliferation and apoptosis. Interestingly, there does not appear to be any relationship between testosterone or DHT levels and the development of symptomatic BPH.

• #11 The etiology and pathogenesis of benign prostatic hyperplasia：The ro | RRU

  https://www.dovepress.com/the-etiology-and-pathogenesis-of-benign-prostatic-hyperplasia-the-role-peer-reviewed-fulltext-article-RRU

  Benign prostatic hyperplasia (BPH) mainly causes lower urinary tract symptoms in ageing men, but its exact etiology and pathogenesis have not been established. […] The objective of this review was to design an update on the advances of human BPH research. […] No evidence for the role of testosterone (T) or dihydrotestosterone (DHT) is found in BPH initiation. […] After cellular damage and subsequent inflammation generated, the intraprostatic DHT produced mainly from T by 5-reductase promotes BPH development. […] In conclusion, evidence in literature suggests that androgens are not etiological factors for BPH, and intraprostatic DHT along with chronic inflammation are mainly responsible for nodular proliferation of stromal and/or epithelial cells in prostatic TZ. […] The pathogenesis is defined as the process and factors associated with the perpetuation or progression of a disease.

• #12

  https://www.vin.com/apputil/content/defaultadv1.aspx?pId=22915&catId=124668&id=8896754&ind=283&objTypeID=17

  Due to normal growth and glandular hyperplasia, the prostate of intact normal male dogs increases in weight for the first 5 years, with a peak at 4 years of age. As many as 16% of dogs have been reported to have histologic evidence of benign prostatic hyperplasia (BPH) by 2 years of age. The incidence of BPH increases to over 80% with advanced age. Senile involution of the prostate occurs in animals aged 11 years or more. Like in humans, the prostate of a mature dog is chronically dependent upon a continuous supply of androgen to maintain its appropriate cell content and functional activity. In particular, prostatic growth and secretion are modulated by 5-alpha-dihydrotestosterone (DHT) that is the active androgen at intracellular level. […] The regulation of prostatic content of DHT is determined by the relationship between the rate of production and removal of this steroid in the prostate gland itself rather than by DHT blood levels. Normally, it is adequate to maintain a balance between prostatic cell loss and renewal such that neither involution nor proliferative overgrowth of the gland occurs. In both canine and human BPH, this balance is increasingly being shifted in favour of a large net increase in the total number of prostatic cells with advancing age. In addition, it has been well documented that, even in young dogs, the experimental development of BPH can be induced simply by treatment of animals for 34 months with androgen and, in this regard, several androgens have been tested for their potential abilities to induce this disorder.

• #13 The etiology and pathogenesis of benign prostatic hyperplasia：The ro | RRU

  https://www.dovepress.com/the-etiology-and-pathogenesis-of-benign-prostatic-hyperplasia-the-role-peer-reviewed-fulltext-article-RRU

  It has been known that both prostate volume ( 30 g) and age ( 62 years old) are two baseline predictors for an increase in risk of BPH progression, and a histological hallmark of BPH progression is enlargement of the prostate that is caused by nodular proliferation of epithelial and/or stromal cells in the TZ. […] However, the exact mechanisms by which the testicular function mediates the progression of BPH remain unclear. […] Taken together, these studies at least imply that a high level of serum T may be not required for BPH progression, and, in some cases, T may not be needed at all for the pathogenesis of BPH. […] The central role of DHT in the development of BPH has been further verified by successful clinical use of finasteride (an inhibitor of SRD5-2, 3) or dutasteride (an inhibitor of SRD5-1, 2, 3) in the management of BPH, showing that dutasteride at a dosage of 0.5 mg/day or finasteride at 5 mg/day significantly reduces serum or intraprostatic DHT of over 70% and prostate volume of approximately 30%. […] The potential of confounding of BPH for an accurate prediction of PCa progression is briefly reviewed.

• #14 Benign prostatic hyperplasia – Wikipedia

  https://en.wikipedia.org/wiki/Benign_prostatic_hyperplasia

  Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. […] The underlying mechanism involves the prostate pressing on the urethra thereby making it difficult to pass urine out of the bladder. […] Most experts consider androgens (testosterone and related hormones) to play a permissive role in the development of BPH. […] Dihydrotestosterone (DHT), a metabolite of testosterone, is a critical mediator of prostatic growth. […] The importance of DHT in causing nodular hyperplasia is supported by clinical observations in which an inhibitor of 5-reductase such as finasteride is given to men with this condition. […] While there is some evidence that estrogen may play a role in the cause of BPH, this effect appears to be mediated mainly through local conversion of androgens to estrogen in the prostate tissue rather than a direct effect of estrogen itself.

• #15 Benign Prostatic Hyperplasia: Epidemiology, Pathophysiology, and Clinical Manifestations | IntechOpen

  https://www.intechopen.com/chapters/81872

  Interestingly, it has been reported that involution of the prostate is related to an alteration of the immune system; the presence of bacteriuria increases with age in men with a sixfold increase in the number of white blood cells in the prostate secretions of those with BPH than in those without, as well as a presence of bacteria in the 36.7% of the cases. […] The action mechanism of androgens is carried out by binding to specific AR, which is expressed mainly within the lumen of epithelial cells and in a low proportion in prostate stromal cells. […] Interestingly, it has been shown that, like DHT, AR is upregulated in tissue with BPH compared with normal tissues. […] However, until now, there is insufficient evidence about the importance of elevated DHT and AR in the etiology of BPH.

• #16 Benign Prostatic Hyperplasia: Epidemiology, Pathophysiology, and Clinical Manifestations | IntechOpen

  https://www.intechopen.com/chapters/81872

  The prostate secretes 20% of the seminal fluid. One of its main pathologies is benign prostatic hyperplasia (BPH), the most common benign disease in older men. […] Although the etiology of BPH is not still fully known, testosterone and estradiol have shown a permissive role. Likewise, other factors have emerged, such as inflammation, growth factors, and prolactin, which influence the development of BPH. […] It is known that androgens play a permissive role. The imbalance between the levels of androgens and estrogens plays a decisive role in developing BPH and cancer. […] Furthermore, some studies have suggested the participation of other nonsteroidal hormones and proinflammatory cytokines in stimulating the growth of prostate epithelial tissue, contributing to the hyperproliferative process that accompanies BPH.

• #17 Benign Prostatic Hyperplasia: Epidemiology, Pathophysiology, and Clinical Manifestations | IntechOpen

  https://www.intechopen.com/chapters/81872

  The role of androgens in the development of the etiology of BPH has not yet been fully elucidated, so the evidence found shows contrasting results. […] Estrogens are steroid hormones synthesized mainly in the testes through the biotransformation of T to estradiol (E2) by the action of the aromatase enzyme. […] However, when estrogen exposure is excessive, it is correlated with susceptibility to both benign and malignant hyperproliferative disorders. […] Recently, evidence has emerged on the participation of inflammatory processes in BPH development. […] The initial stimulus causes the activation of T lymphocytes, as well as the release of cytokines and interleukins (IL) responsible for cell damage, as well as a cascade activation of different factors, among which are the increase in the expression of IL-15 in stromal cells; IL-17 on T cells; interferon- in basal and stromal cells and IL-8 in epithelial cells; events that promote a process of chronic inflammation whose consequence is the increase in the volume of the prostate gland. […] Therefore, inflammatory processes are decisive in developing BPH.

• #18 Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: Current concepts

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5509197/

  The precise molecular etiology of BPE/BPH is complicated and poorly understood, although several risk factors for the development of BPE/BPH and LUTS have been identified. These include age, genetics, hormones, growth factors, inflammation, and lifestyle factors. […] The aging process involves changes in cellular mitogenesis and hormonal homeostasis in the prostate gland, which later proceed to chromosomal aberration and apoptosis. […] Sex steroid hormones have been affirmatively linked with the development and maintenance of BPE/BPH. Androgen is perhaps the most extensively studied hormone of all. In the prostate, testosterone is converted to dihydrotestosterone (DHT) by type II 5 reductase through DHT/androgen receptor signaling and may influence cell proliferation, differentiation, morphogenesis, and functional maintenance. […] Several growth factors and their corresponding receptors have been identified in prostatic epithelium and stroma, which can stimulate or inhibit cell division and differentiation processes. […] There is a growing body of evidence that suggests that inflammation is closely linked to the development of BPE/BPH and LUTS. From a histological point of view, inflammatory infiltrates are the most prevalent feature coexisting with BPH, and the degree of inflammation is correlated with prostate volume and weight.

• #19 Frontiers | Immune Cell Proinflammatory Microenvironment and Androgen-Related Metabolic Regulation During Benign Prostatic Hyperplasia in Aging

  https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.842008/full

  However, in recent studies, inflammation has shown a potential role in the pathogenesis and progression of BPH. A recent histological and biochemical study showed that inflammation is more frequently found in prostate patients, and patients with prostatitis have a higher International Prostate Symptom Score (I-PSS) and larger prostate volume. Examination of 167 prostates showed that inflammation was more common in glands with BPH than in glands without BPH (75% vs 50%, p<0.01). Another study conducted a 4-year longitudinal evaluation of 4109 men and confirmed that chronic inflammation is associated with the occurrence and development of BPH. Tissue damage related to inflammation and subsequent chronic tissue healing may be an important reason for the inflammatory proliferation of BPH prostate tissue cells.

• #20 Frontiers | Immune Cell Proinflammatory Microenvironment and Androgen-Related Metabolic Regulation During Benign Prostatic Hyperplasia in Aging

  https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.842008/full

  The cellular and molecular mechanisms of the abnormal proliferation of the abovementioned cells have not been fully elucidated. Traditionally, the excessive proliferation of cells in the prostate is related to the expression and activity of androgens and their receptors. Recent clinical evidence shows that, for uncontrolled cell proliferation, the presence of inflammation contributes to the initiation and maintenance of proliferation, which is closely related to the occurrence and development of BPH. Its action pathways include tissue damage and subsequent chronic healing, autoimmunity, and synergy with the androgens. […] Inflammation causes cell and DNA damage, promotes cell replacement and creates a tissue microenvironment rich in cytokines and growth factors, thereby promoting cell proliferation and causing hyperplasia during tissue repair.

• #21 Frontiers | Immune Cell Proinflammatory Microenvironment and Androgen-Related Metabolic Regulation During Benign Prostatic Hyperplasia in Aging

  https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.842008/full

  The latest research also shows that BPH may be an immunoinflammatory disease. The prostate is an organ with immune activity, and its internal immune system is developed and complex. Approximately 90% of prostate immune cells are T lymphocytes. […] The immune disorder response in BPH may occur through increased expression of proinflammatory IL-17, and the autoimmune response associated with T cells may induce abnormal proliferation of epithelial cells and stromal cells. […] In summary, inflammation plays a vital role in the pathogenesis and disease development of BPH. Inflammation can independently affect the development of BPH in a variety of ways, and it can also interact with androgens. At the same time, BPH can also promote inflammation to expand its scope and aggravate the situation. Therefore, in the treatment process, early intervention in the occurrence and development of inflammation in prostate tissue can slow down the progression of BPH. The combination of standard therapies and anti-inflammatory measures may provide valuable new ideas for the treatment of BPH.

• #22 Frontiers | Immune Cell Proinflammatory Microenvironment and Androgen-Related Metabolic Regulation During Benign Prostatic Hyperplasia in Aging

  https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.842008/full

  The latest research also shows that BPH may be an immunoinflammatory disease. The prostate is an organ with immune activity, and its internal immune system is developed and complex. Approximately 90% of prostate immune cells are T lymphocytes. […] The immune disorder response in BPH may occur through increased expression of proinflammatory IL-17, and the autoimmune response associated with T cells may induce abnormal proliferation of epithelial cells and stromal cells. […] In summary, inflammation plays a vital role in the pathogenesis and disease development of BPH. Inflammation can independently affect the development of BPH in a variety of ways, and it can also interact with androgens. At the same time, BPH can also promote inflammation to expand its scope and aggravate the situation. Therefore, in the treatment process, early intervention in the occurrence and development of inflammation in prostate tissue can slow down the progression of BPH. The combination of standard therapies and anti-inflammatory measures may provide valuable new ideas for the treatment of BPH.

• #23 Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: Current concepts

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5509197/

  The precise molecular etiology of BPE/BPH is complicated and poorly understood, although several risk factors for the development of BPE/BPH and LUTS have been identified. These include age, genetics, hormones, growth factors, inflammation, and lifestyle factors. […] The aging process involves changes in cellular mitogenesis and hormonal homeostasis in the prostate gland, which later proceed to chromosomal aberration and apoptosis. […] Sex steroid hormones have been affirmatively linked with the development and maintenance of BPE/BPH. Androgen is perhaps the most extensively studied hormone of all. In the prostate, testosterone is converted to dihydrotestosterone (DHT) by type II 5 reductase through DHT/androgen receptor signaling and may influence cell proliferation, differentiation, morphogenesis, and functional maintenance. […] Several growth factors and their corresponding receptors have been identified in prostatic epithelium and stroma, which can stimulate or inhibit cell division and differentiation processes. […] There is a growing body of evidence that suggests that inflammation is closely linked to the development of BPE/BPH and LUTS. From a histological point of view, inflammatory infiltrates are the most prevalent feature coexisting with BPH, and the degree of inflammation is correlated with prostate volume and weight.

• #24 Mechanistic targets for BPH and prostate cancer–a review

  https://www.degruyter.com/document/doi/10.1515/reveh-2020-0051/html?lang=en

  The pathophysiological origin involves enhanced cell proliferation along with a reduction in cell death. […] Due to fibroblast growth factor (bFGF/FGF), Insulin-like growth factors (IGFs), Epidermal Growth Factor (EGF), Transforming growth factor (TGF-b), Vascular Endothelial Growth Factor (VEGF) and release of inflammatory mediators such as interleukin 1 (IL-1), IL-6, and tumour necrosis factor-a (TNF-a), growth factors, and chemotactic factors. Along with it, imbalanced apoptosis, oxidative stress, and microbial infection also key factors that significantly affect the pathogenesis of BPH. […] Inflammation is the primary cause of BPH affected in 70% of elderly males. The BPH nodules mainly made up of inflammatory infiltrate. […] Dysregulation of apoptosis directly linked to BPH. […] Oxidative stress leads to impaired cellular proliferation and hyperplasic cell growth. […] The micro-organisms can cause prostatitis and can trigger the proinflammatory reaction.

• #25 Mechanistic targets for BPH and prostate cancer–a review

  https://www.degruyter.com/document/doi/10.1515/reveh-2020-0051/html?lang=en

  The pathophysiological origin involves enhanced cell proliferation along with a reduction in cell death. […] Due to fibroblast growth factor (bFGF/FGF), Insulin-like growth factors (IGFs), Epidermal Growth Factor (EGF), Transforming growth factor (TGF-b), Vascular Endothelial Growth Factor (VEGF) and release of inflammatory mediators such as interleukin 1 (IL-1), IL-6, and tumour necrosis factor-a (TNF-a), growth factors, and chemotactic factors. Along with it, imbalanced apoptosis, oxidative stress, and microbial infection also key factors that significantly affect the pathogenesis of BPH. […] Inflammation is the primary cause of BPH affected in 70% of elderly males. The BPH nodules mainly made up of inflammatory infiltrate. […] Dysregulation of apoptosis directly linked to BPH. […] Oxidative stress leads to impaired cellular proliferation and hyperplasic cell growth. […] The micro-organisms can cause prostatitis and can trigger the proinflammatory reaction.

• #26 Oxidative stress in prostate hyperplasia and carcinogenesis | Journal of Experimental & Clinical Cancer Research | Full Text

  https://jeccr.biomedcentral.com/articles/10.1186/s13046-016-0418-8

  Prostatic hyperplasia (PH) is a common urologic disease that affects mostly elderly men. […] Oxidative stress (OS) is considered to be one of the mechanisms that trigger the chain of reactions involved in the development and progression of prostatic hyperplasia (PH). […] Like many different cancer types, OS has been linked with benign prostatic hyperplasia (BPH) and prostate cancer (PCa) development, progression and the response to therapy. […] Several mechanisms for prostate hyperplasia development have been suggested and these include; oxidative stress (OS), inflammatory mediators, hormones, enzymatic factors, dietary factors, inflammatory genes and Gleason score grading system. […] It is known that OS contributes to the initiation and progression of PCa by regulating molecules such as DNA, transcription factors, and cell cycle regulators.

• #27 Mechanistic targets for BPH and prostate cancer–a review

  https://www.degruyter.com/document/doi/10.1515/reveh-2020-0051/html?lang=en

  The pathophysiological origin involves enhanced cell proliferation along with a reduction in cell death. […] Due to fibroblast growth factor (bFGF/FGF), Insulin-like growth factors (IGFs), Epidermal Growth Factor (EGF), Transforming growth factor (TGF-b), Vascular Endothelial Growth Factor (VEGF) and release of inflammatory mediators such as interleukin 1 (IL-1), IL-6, and tumour necrosis factor-a (TNF-a), growth factors, and chemotactic factors. Along with it, imbalanced apoptosis, oxidative stress, and microbial infection also key factors that significantly affect the pathogenesis of BPH. […] Inflammation is the primary cause of BPH affected in 70% of elderly males. The BPH nodules mainly made up of inflammatory infiltrate. […] Dysregulation of apoptosis directly linked to BPH. […] Oxidative stress leads to impaired cellular proliferation and hyperplasic cell growth. […] The micro-organisms can cause prostatitis and can trigger the proinflammatory reaction.

• #28 Oxidative stress in prostate hyperplasia and carcinogenesis | Journal of Experimental & Clinical Cancer Research | Full Text

  https://jeccr.biomedcentral.com/articles/10.1186/s13046-016-0418-8

  Chronic increases in ROS over time are known to induce somatic mutations and neoplastic transformation. […] The new insight into the role of oxidative stress in the pathogenesis of PCa has led to the exploitation of this mechanism as a potential strategic target for PCa treatment. […] Significantly increased levels of oxidative stress and DNA damage suggest that oxidative damage plays an important role in prostate tumorigenesis and timely management of oxidative stress can be of importance in preventing the occurrence of prostatic hyperplasia. […] Oxidative stress influences the pathophysiology of both PCa and BPH. […] Oxidative stress and body composition contribute to the progression of PCa. […] The role of OS and diet in PCa mechanism was observed with the prostate-specific ablation of PPAR in mice.

• #29 Prostatic vascular damage induced by cigarette smoking as a risk factor for recovery after holmium laser enucleation of the prostate (HoLEP) | Oncotarget

  https://www.oncotarget.com/article/12538/text/

  Benign prostatic hyperplasia (BPH), one of the most common proliferative disorders in older males, is characterized by increasing tissue mass in prostatic transition zone. The pathogenic process of BPH involves various factors, including chronic inflammation, oxidative stress, hypoxia and ischaemia. […] These pathogenic factors may result in generalized or localized vessel disorder, which play significant role in BPH. […] In a vicious circle, vascular damage also results in ischemia and hypoxia, which aggravates the disease progression. […] Although some researchers have argued that hypoxia and ischemia may accelerate cell proliferation and vascular damage may contribute to BPH, the anti-apoptotic effect is dependent on the severity and duration of anoxia. […] Thus, prostatic vascularity has always been a focus of studies about prostate enlargement.

• #30 Prostatic vascular damage induced by cigarette smoking as a risk factor for recovery after holmium laser enucleation of the prostate (HoLEP) | Oncotarget

  https://www.oncotarget.com/article/12538/text/

  The significantly lower CPI and higher RI values in smoking BPH patients indicated the presence of considerable vascular damage in these subjects. […] Moreover, cigarette smoking extended the surgical duration and prolonged the recovery period of overactive bladder (OAB) syndrome. […] The detailed mechanism underlying these findings had not previously been clarified. […] Cigarette smoking, as is widely accepted, has been demonstrated to cause vascular injury via local hypoxia, oxidative stress, endothelial injury and chronic inflammation in different organs. […] In addition, vessel damage might cause the above adverse factors leading to a vicious circle. […] Moreover, damage of small vessels tends to result in organic or local ischemia. […] It has been reported that chronic prostatic vascular ischemia, hypoxia and chronic inflammation result in increased prostate volume.

• #31 Benign Prostatic Hyperplasia (BPH) – Life Extension

  https://www.lifeextension.com/protocols/male-reproductive/benign-prostatic-hyperplasia?srsltid=AfmBOopcDn6IPb6qKvQ86Jp0KCGpisnsN9IGTkrS1tvJp8lcrlr-pvli

  Benign prostatic hyperplasia (BPH) is caused by several factors, including reduced prostate cell regulation, hormonal imbalance (abundance of dihydrotestosterone or estrogens), and increased levels of insulin-like growth factors and inflammatory markers. […] The development of BPH is a multifactorial process. As men age, prostate cell growth becomes less well controlled by cell signaling activity. Also, the cells in the prostate become less responsive to signals that induce apoptosis or programmed cell death. This results in an overabundance of cells in the prostate, also known as prostate hyperplasia. […] Imbalanced hormone levels contribute to BPH. A derivative of testosterone called dihydrotestosterone (DHT) stimulates growth of the prostate. DHT is derived from testosterone via conversion by the enzyme 5-reductase, which is an important pharmacologic target for BPH therapies.

• #32 Benign Prostatic Hyperplasia (BPH): Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/437359-overview

  Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a histologic diagnosis characterized by proliferation of the cellular elements of the prostate, leading to an enlarged prostate gland. […] Cellular accumulation and gland enlargement may result from epithelial and stromal proliferation, impaired preprogrammed cell death (apoptosis), or both. […] BPH involves the stromal and epithelial elements of the prostate arising in the periurethral and transition zones of the gland (see Pathophysiology). The hyperplasia presumably results in enlargement of the prostate that may restrict the flow of urine from the bladder. […] Prostatic enlargement depends on the potent androgen dihydrotestosterone (DHT). In the prostate gland, type II 5-alpha-reductase metabolizes circulating testosterone into DHT, which works locally, not systemically. DHT binds to androgen receptors in the cell nuclei, potentially resulting in BPH.

• #33 Benign Prostatic Hyperplasia (BPH): Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/437359-overview

  However, the fact that serum testosterone levels decrease with age, yet the development of BPH increases, suggests that other agents play an etiologic role. Possible factors include the metabolic syndrome, hyperinsulinemia, norepinephrine, angiotensin II, and insulin-like growth factors. […] Increasing evidence indicates a role for autophagy (self-phagocytosis), the process by which cells degrade their cytoplasmic proteins and damaged organelles via lysosomes, in reducing apoptosis of prostate cells. […] Microscopically, BPH is characterized as a hyperplastic process. The hyperplasia results in enlargement of the prostate that may restrict the flow of urine from the bladder, resulting in clinical manifestations of BPH. […] The traditional theory behind BPH is that, as the prostate enlarges, the surrounding capsule prevents it from radially expanding, potentially resulting in urethral compression. However, obstruction-induced bladder dysfunction contributes significantly to LUTS.

• #34 Mechanistic targets for BPH and prostate cancer–a review

  https://www.degruyter.com/document/doi/10.1515/reveh-2020-0051/html?lang=en

  The pathophysiological origin involves enhanced cell proliferation along with a reduction in cell death. […] Due to fibroblast growth factor (bFGF/FGF), Insulin-like growth factors (IGFs), Epidermal Growth Factor (EGF), Transforming growth factor (TGF-b), Vascular Endothelial Growth Factor (VEGF) and release of inflammatory mediators such as interleukin 1 (IL-1), IL-6, and tumour necrosis factor-a (TNF-a), growth factors, and chemotactic factors. Along with it, imbalanced apoptosis, oxidative stress, and microbial infection also key factors that significantly affect the pathogenesis of BPH. […] Inflammation is the primary cause of BPH affected in 70% of elderly males. The BPH nodules mainly made up of inflammatory infiltrate. […] Dysregulation of apoptosis directly linked to BPH. […] Oxidative stress leads to impaired cellular proliferation and hyperplasic cell growth. […] The micro-organisms can cause prostatitis and can trigger the proinflammatory reaction.

• #35 Prostate BPH- pathophysiology | PPT

  https://www.slideshare.net/slideshow/prostate-bph-pathophysiology/248946103

  6) Etiology of Benign Prostatic Hyperplasia BPH is characterized by an increased number of epithelial and stromal cells in the periurethral area of the prostate. increase in cell number 1.epithelial and stromal proliferation 2.impaired programmed cell death […] 12) The Role of Androgens Androgens do not cause BPH, the development of BPH requires the presence of testicular androgens during prostate development, puberty, and aging castrated prior to puberty do not develop BPH. genetic diseases impair androgen action or production prostatic levels of DHT AR remain high with aging . (peripheral levels of testosterone are decreasing.) Androgen withdrawal – partial involution of established BPH. […] 23) Regulation of Programmed Cell Death Programmed cell death (apoptosis) is a physiologic mechanism crucial to the maintenance of normal glandular homeostasis. Androgens – suppress programmed cell death Following castration, active cell death is increased in the luminal epithelial population as well as in the distal region of each duct.

• #36 Benign Prostatic Hyperplasia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK558920/

  The development of LUTS and bladder outlet obstruction in men with BPH can be attributable to static and dynamic components. Static obstruction is a direct consequence of prostate enlargement, resulting in periurethral compression and bladder outlet obstruction. Prostate enlargement distorts the bladder outlet, causing urinary obstruction, while periurethral compression requires increasing voiding pressures to overcome flow resistance. […] Dynamic components include the prostatic smooth muscle tension (hence using five alpha-reductase inhibitors to reduce prostate volume and alpha-blockers to relax prostatic smooth muscle). This is explained by decreased elasticity and collagen in the prostatic urethra in men with BPH, which exacerbates symptoms of bladder outlet obstruction due to loss of compliance and increased flow resistance. It also explains why prostate size alone is not always a reliable predictor of disease.

• #37 Benign Prostatic Hyperplasia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK558920/

  The development of LUTS and bladder outlet obstruction in men with BPH can be attributable to static and dynamic components. Static obstruction is a direct consequence of prostate enlargement, resulting in periurethral compression and bladder outlet obstruction. Prostate enlargement distorts the bladder outlet, causing urinary obstruction, while periurethral compression requires increasing voiding pressures to overcome flow resistance. […] Dynamic components include the prostatic smooth muscle tension (hence using five alpha-reductase inhibitors to reduce prostate volume and alpha-blockers to relax prostatic smooth muscle). This is explained by decreased elasticity and collagen in the prostatic urethra in men with BPH, which exacerbates symptoms of bladder outlet obstruction due to loss of compliance and increased flow resistance. It also explains why prostate size alone is not always a reliable predictor of disease.

• #38 Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: Current concepts

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5509197/

  Lower urinary tract symptoms (LUTS) are highly prevalent in the aging population, particularly in men. Historically, prostate enlargement was thought to be responsible for most cases of male LUTS. Several risk factors for the development of benign prostate enlargement/hyperplasia (BPE/BPH) have been identified, including age, genetics, hormones, growth factors, inflammation, and lifestyle factors. […] In this article, we review current concepts in the epidemiology, etiology, and pathophysiology of BPE/BPH and male LUTS. […] The pathophysiology of LUTS could include bladder dysfunction (including bladder hypersensitivity, detrusor overactivity [DO]), bladder outlet obstruction (BOO), (including bladder neck dysfunction, prostatic obstruction, urethral stricture, poorly relaxed urethral sphincter, urethral sphincter dyssynergia), or a combination of these etiologies. […] The hyperplastic process in the prostate begins in the periurethral region, namely, the transition zone. As discussed earlier, this process is influenced by multiple factors, leading to an increase in the cell number and size through epithelial and stromal proliferation or apoptosis. As enlargement takes place, prostatic intrusion into the urethral lumen or bladder neck can considerably change bladder outlet resistance by causing mechanical obstruction. […] The prostatic capsule is another key to the development of LUTS by transmitting the pressure of tissue expansion to the urethra and increasing urethral resistance. […] Growing evidence has shown that, just as in BOO secondary to BPE/BPH, these anatomical and functional changes may, in turn, induce significant alterations in the morphology and physiology of the urothelium and detrusor muscles, which lead to bothersome LUTS.

• #39 Prostate BPH- pathophysiology | PPT

  https://www.slideshare.net/slideshow/prostate-bph-pathophysiology/248946103

  33) presence of the prostatic capsule – development of LUTS. transmits the pressure of tissue expansion to the urethra – increase in urethral resistance. incision of the prostatic capsule – significant improvement in outflow obstruction, DESPITE THE VOLUME OF THE PROSTATE REMAINS THE SAME. […] 36) Importance of Prostatic Smooth Muscle prostatic smooth muscle represents a significant volume of the gland. both passive and active forces in prostatic tissue play a major role in the pathophysiology of BPH. […] 47) Summary The exact etiology of BPH is yet to be elucidated Androgens do not cause BPH but the presence of androgens during developmental, puberty and aging is required for BPH Androgens regulate the effects of growth hormones.

• #40 Benign Prostatic Hyperplasia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK558920/

  The development of LUTS and bladder outlet obstruction in men with BPH can be attributable to static and dynamic components. Static obstruction is a direct consequence of prostate enlargement, resulting in periurethral compression and bladder outlet obstruction. Prostate enlargement distorts the bladder outlet, causing urinary obstruction, while periurethral compression requires increasing voiding pressures to overcome flow resistance. […] Dynamic components include the prostatic smooth muscle tension (hence using five alpha-reductase inhibitors to reduce prostate volume and alpha-blockers to relax prostatic smooth muscle). This is explained by decreased elasticity and collagen in the prostatic urethra in men with BPH, which exacerbates symptoms of bladder outlet obstruction due to loss of compliance and increased flow resistance. It also explains why prostate size alone is not always a reliable predictor of disease.

• #41 Benign Prostatic Hyperplasia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK558920/

  The development of LUTS and bladder outlet obstruction in men with BPH can be attributable to static and dynamic components. Static obstruction is a direct consequence of prostate enlargement, resulting in periurethral compression and bladder outlet obstruction. Prostate enlargement distorts the bladder outlet, causing urinary obstruction, while periurethral compression requires increasing voiding pressures to overcome flow resistance. […] Dynamic components include the prostatic smooth muscle tension (hence using five alpha-reductase inhibitors to reduce prostate volume and alpha-blockers to relax prostatic smooth muscle). This is explained by decreased elasticity and collagen in the prostatic urethra in men with BPH, which exacerbates symptoms of bladder outlet obstruction due to loss of compliance and increased flow resistance. It also explains why prostate size alone is not always a reliable predictor of disease.

• #42 Prostate BPH- pathophysiology | PPT

  https://www.slideshare.net/slideshow/prostate-bph-pathophysiology/248946103

  33) presence of the prostatic capsule – development of LUTS. transmits the pressure of tissue expansion to the urethra – increase in urethral resistance. incision of the prostatic capsule – significant improvement in outflow obstruction, DESPITE THE VOLUME OF THE PROSTATE REMAINS THE SAME. […] 36) Importance of Prostatic Smooth Muscle prostatic smooth muscle represents a significant volume of the gland. both passive and active forces in prostatic tissue play a major role in the pathophysiology of BPH. […] 47) Summary The exact etiology of BPH is yet to be elucidated Androgens do not cause BPH but the presence of androgens during developmental, puberty and aging is required for BPH Androgens regulate the effects of growth hormones.

• #43 Benign Prostatic Hyperplasia (BPH): Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/437359-overview

  However, the fact that serum testosterone levels decrease with age, yet the development of BPH increases, suggests that other agents play an etiologic role. Possible factors include the metabolic syndrome, hyperinsulinemia, norepinephrine, angiotensin II, and insulin-like growth factors. […] Increasing evidence indicates a role for autophagy (self-phagocytosis), the process by which cells degrade their cytoplasmic proteins and damaged organelles via lysosomes, in reducing apoptosis of prostate cells. […] Microscopically, BPH is characterized as a hyperplastic process. The hyperplasia results in enlargement of the prostate that may restrict the flow of urine from the bladder, resulting in clinical manifestations of BPH. […] The traditional theory behind BPH is that, as the prostate enlarges, the surrounding capsule prevents it from radially expanding, potentially resulting in urethral compression. However, obstruction-induced bladder dysfunction contributes significantly to LUTS.

• #44 Benign Prostatic Hyperplasia (BPH): Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/437359-overview

  This increased sensitivity (detrusor overactivity), even with small volumes of urine in the bladder, is believed to contribute to urinary frequency and LUTS. […] In the bladder, obstruction leads to smooth-muscle-cell hypertrophy. Biopsy specimens of trabeculated bladders demonstrate evidence of scarce smooth-muscle fibers with an increase in collagen. The collagen fibers limit compliance, leading to higher bladder pressures upon filling.

• #45 Benign Prostatic Hyperplasia (BPH): Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/437359-overview

  This increased sensitivity (detrusor overactivity), even with small volumes of urine in the bladder, is believed to contribute to urinary frequency and LUTS. […] In the bladder, obstruction leads to smooth-muscle-cell hypertrophy. Biopsy specimens of trabeculated bladders demonstrate evidence of scarce smooth-muscle fibers with an increase in collagen. The collagen fibers limit compliance, leading to higher bladder pressures upon filling.

• #46 Pathophysiology of benign prostate enlargement and lower urinary tract symptoms: Current concepts

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5509197/

  Lower urinary tract symptoms (LUTS) are highly prevalent in the aging population, particularly in men. Historically, prostate enlargement was thought to be responsible for most cases of male LUTS. Several risk factors for the development of benign prostate enlargement/hyperplasia (BPE/BPH) have been identified, including age, genetics, hormones, growth factors, inflammation, and lifestyle factors. […] In this article, we review current concepts in the epidemiology, etiology, and pathophysiology of BPE/BPH and male LUTS. […] The pathophysiology of LUTS could include bladder dysfunction (including bladder hypersensitivity, detrusor overactivity [DO]), bladder outlet obstruction (BOO), (including bladder neck dysfunction, prostatic obstruction, urethral stricture, poorly relaxed urethral sphincter, urethral sphincter dyssynergia), or a combination of these etiologies. […] The hyperplastic process in the prostate begins in the periurethral region, namely, the transition zone. As discussed earlier, this process is influenced by multiple factors, leading to an increase in the cell number and size through epithelial and stromal proliferation or apoptosis. As enlargement takes place, prostatic intrusion into the urethral lumen or bladder neck can considerably change bladder outlet resistance by causing mechanical obstruction. […] The prostatic capsule is another key to the development of LUTS by transmitting the pressure of tissue expansion to the urethra and increasing urethral resistance. […] Growing evidence has shown that, just as in BOO secondary to BPE/BPH, these anatomical and functional changes may, in turn, induce significant alterations in the morphology and physiology of the urothelium and detrusor muscles, which lead to bothersome LUTS.

• #47 Mechanism of Androgen-Independent Stromal Proliferation in Benign Prostatic Hyperplasia

  https://www.mdpi.com/1422-0067/24/14/11634

  Benign prostatic hyperplasia (BPH) is a chronic proliferative disease showing stromal-dominant proliferation. […] Although aging and androgen have been reported as definitive risk factors for BPH, recent studies have focused on the involvement of androgen-independent factors. […] Inflammation in BPH tissues by various factors finally leads to tissue remodeling and stromal proliferation through the wound healing process of the prostate. […] To elucidate the proliferative mechanism of BPH, a study using whole-genome gene expression analysis in a stromal-dominant BPH rat model was performed and showed that immune response-related pathways and complement classical pathways are activated. […] Furthermore, expression analysis using this BPH rat model showed that the autoimmune reaction triggered complement pathway activation in the proliferative process of BPH.

• #48 Mechanism of Androgen-Independent Stromal Proliferation in Benign Prostatic Hyperplasia

  https://www.mdpi.com/1422-0067/24/14/11634

  Benign prostatic hyperplasia (BPH) is a chronic proliferative disease showing stromal-dominant proliferation. […] Although aging and androgen have been reported as definitive risk factors for BPH, recent studies have focused on the involvement of androgen-independent factors. […] Inflammation in BPH tissues by various factors finally leads to tissue remodeling and stromal proliferation through the wound healing process of the prostate. […] To elucidate the proliferative mechanism of BPH, a study using whole-genome gene expression analysis in a stromal-dominant BPH rat model was performed and showed that immune response-related pathways and complement classical pathways are activated. […] Furthermore, expression analysis using this BPH rat model showed that the autoimmune reaction triggered complement pathway activation in the proliferative process of BPH.

• #49 Mechanism of Androgen-Independent Stromal Proliferation in Benign Prostatic Hyperplasia

  https://www.mdpi.com/1422-0067/24/14/11634

  Inflammation in prostate tissues has been implicated as having the greatest role in the androgen-independent pathways in the BPH proliferative process. […] Chronic inflammation in BPH has been implicated in tissue remodeling through the wound healing process. […] Inflammation induces cell and DNA damage, promotes cell replacement, and creates a tissue microenvironment abundance in cytokines and growth factors, thereby promoting cell proliferation and causing hyperplasia during tissue healing process. […] The immune response in BPH proliferation might be caused by an autoimmune reaction that responds to autoantigens in prostatic tissues. […] The activation of complement classical and lectin pathways is reported to be involved in tissue regeneration, angiogenesis, and amplification of inflammation in addition to the well-appreciated properties of defending against foreign pathogens. […] Autoimmune reactions might be involved in BPH proliferation including epithelial and stromal cells through the activation of the complement classical pathway.

• #50 A genetic study to identify pathogenic mechanisms and drug targets for benign prostatic hyperplasia: a multi-omics Mendelian randomization study | Scientific Reports

  https://www.nature.com/articles/s41598-024-73466-w

  However, the causal relationship between immune pathways and circulating metabolites and BPH remains to be elucidated, as traditional observational studies are limited by inherent shortcomings, including environmental confounders, selection bias, and reverse causality. […] We used a multi-omics approach to comprehensively and deeply explore the biomolecules closely associated with BPH. […] We defined genes with Joint P0.05, SMR PFDR0.05, PIP0.8, PP.H40.8, and PHEIDI0.05 as high-confidence genes. High-confidence genes may have a causal effect on BPH. […] Our study identified a potential pathogenic pathway for BPH, that lower cg14345882 levels upregulated BTN3A2 expression, which increased the risk of BPH. […] Our study suggests that the C4A gene mediates the development of BPH through hyperactivation of the complement system. […] Our study identified many BPH-related traits, from genes to immune pathways to circulating metabolites, laying a solid foundation for BPH research and providing directions for basic and translational research on therapeutic drugs.

• #51 Mechanism of RhoA regulating benign prostatic hyperplasia: RhoA-ROCK-β-catenin signaling axis and static & dynamic dual roles | Molecular Medicine | Full Text

  https://molmed.biomedcentral.com/articles/10.1186/s10020-023-00734-2

  Our novel data demonstrated that RhoA regulated both static and dynamic factors of BPH, RhoA-ROCK–catenin signaling axis played an important role in the development of BPH and might provide more possibilities for the formulation of subsequent clinical treatment strategies. […] RhoA was found to be up-regulated in hyperplastic human prostate tissue and rat prostate tissue. Further knockdown and overexpression of RhoA in human prostate cell lines identified potential static dynamic dual roles of RhoA in BPH, including cell proliferation, apoptosis, fibrosis, EMT, and cell contraction. More importantly, we found that RhoA-ROCK and the -catenin-dependent canonical Wnt pathway constituted a signaling axis that mediated multiple phenotypic changes in the development of BPH. Finally, we found that Y-27632 partially reversed prostatic hyperplasia in rats, suggesting the therapeutic potential of RhoA-ROCK in BPH.

• #52 Mechanism of RhoA regulating benign prostatic hyperplasia: RhoA-ROCK-β-catenin signaling axis and static & dynamic dual roles | Molecular Medicine | Full Text

  https://molmed.biomedcentral.com/articles/10.1186/s10020-023-00734-2

  RhoA-ROCK is up-regulated in human prostate tissues and increases the tension of human prostate strips. […] RhoA promotes the cell proliferation of WPMY-1 and BPH-1 cells. […] RhoA inhibits the cell apoptosis of WPMY-1 and BPH-1 cells, but do not affect the cell cycle. […] RhoA promotes the fibrosis, EMT, cell contraction and non-muscle myosin of WPMY-1 and BPH-1 cells. […] RhoA-ROCK positively regulates the canonical Wnt/-catenin signaling pathway. […] RhoA-ROCK promotes cell proliferation, fibrosis and EMT, inhibits cell apoptosis of WPMY-1 and BPH-1 cells by regulating -catenin. […] In summary, we found that RhoA regulated the static and dynamic dual factors of BPH, including cell proliferation, apoptosis, fibrosis, EMT and contraction. There was a crosstalk between RhoA-ROCK and canonical Wnt/-catenin signaling pathway in human prostate cell lines. The RhoA-ROCK–catenin signaling axis affected multiple progresses in the development of BPH, providing potential therapeutic targets for patients with BPH.

• #53 Serotonin regulates prostate growth through androgen receptor modulation | Scientific Reports

  https://www.nature.com/articles/s41598-017-15832-5

  Aging and testosterone almost inexorably cause benign prostatic hyperplasia (BPH) in Human males. However, etiology of BPH is largely unknown. […] Here, we show that 5-HT is a strong negative regulator of prostate growth. […] Since peripheral 5-HT production is specifically regulated by tryptophan hydroxylase 1(Tph1), we showed that Tph1 knockout mice present higher prostate mass and up-regulation of AR when compared to wild-type, whereas 5-HT treatment restored the prostate weight and AR levels. […] As 5-HT is decreased in BPH, we present here evidence that links 5-HT depletion to BPH etiology through modulation of AR. […] The neuroendocrine prostatic cells secrete various neuroendocrine factors with 5-HT being one of the most abundant. […] However, comparing BPH tissue with normal transition zone (without BPH) the number of neuroendocrine cells is extraordinarily decreased.

• #54 Serotonin regulates prostate growth through androgen receptor modulation | Scientific Reports

  https://www.nature.com/articles/s41598-017-15832-5

  Aging and testosterone almost inexorably cause benign prostatic hyperplasia (BPH) in Human males. However, etiology of BPH is largely unknown. […] Here, we show that 5-HT is a strong negative regulator of prostate growth. […] Since peripheral 5-HT production is specifically regulated by tryptophan hydroxylase 1(Tph1), we showed that Tph1 knockout mice present higher prostate mass and up-regulation of AR when compared to wild-type, whereas 5-HT treatment restored the prostate weight and AR levels. […] As 5-HT is decreased in BPH, we present here evidence that links 5-HT depletion to BPH etiology through modulation of AR. […] The neuroendocrine prostatic cells secrete various neuroendocrine factors with 5-HT being one of the most abundant. […] However, comparing BPH tissue with normal transition zone (without BPH) the number of neuroendocrine cells is extraordinarily decreased.

• #55 Mechanism of RhoA regulating benign prostatic hyperplasia: RhoA-ROCK-β-catenin signaling axis and static & dynamic dual roles | Molecular Medicine | Full Text

  https://molmed.biomedcentral.com/articles/10.1186/s10020-023-00734-2

  RhoA-ROCK is up-regulated in human prostate tissues and increases the tension of human prostate strips. […] RhoA promotes the cell proliferation of WPMY-1 and BPH-1 cells. […] RhoA inhibits the cell apoptosis of WPMY-1 and BPH-1 cells, but do not affect the cell cycle. […] RhoA promotes the fibrosis, EMT, cell contraction and non-muscle myosin of WPMY-1 and BPH-1 cells. […] RhoA-ROCK positively regulates the canonical Wnt/-catenin signaling pathway. […] RhoA-ROCK promotes cell proliferation, fibrosis and EMT, inhibits cell apoptosis of WPMY-1 and BPH-1 cells by regulating -catenin. […] In summary, we found that RhoA regulated the static and dynamic dual factors of BPH, including cell proliferation, apoptosis, fibrosis, EMT and contraction. There was a crosstalk between RhoA-ROCK and canonical Wnt/-catenin signaling pathway in human prostate cell lines. The RhoA-ROCK–catenin signaling axis affected multiple progresses in the development of BPH, providing potential therapeutic targets for patients with BPH.

• #56 Mechanism of RhoA regulating benign prostatic hyperplasia: RhoA-ROCK-β-catenin signaling axis and static & dynamic dual roles | Molecular Medicine | Full Text

  https://molmed.biomedcentral.com/articles/10.1186/s10020-023-00734-2

  RhoA-ROCK is up-regulated in human prostate tissues and increases the tension of human prostate strips. […] RhoA promotes the cell proliferation of WPMY-1 and BPH-1 cells. […] RhoA inhibits the cell apoptosis of WPMY-1 and BPH-1 cells, but do not affect the cell cycle. […] RhoA promotes the fibrosis, EMT, cell contraction and non-muscle myosin of WPMY-1 and BPH-1 cells. […] RhoA-ROCK positively regulates the canonical Wnt/-catenin signaling pathway. […] RhoA-ROCK promotes cell proliferation, fibrosis and EMT, inhibits cell apoptosis of WPMY-1 and BPH-1 cells by regulating -catenin. […] In summary, we found that RhoA regulated the static and dynamic dual factors of BPH, including cell proliferation, apoptosis, fibrosis, EMT and contraction. There was a crosstalk between RhoA-ROCK and canonical Wnt/-catenin signaling pathway in human prostate cell lines. The RhoA-ROCK–catenin signaling axis affected multiple progresses in the development of BPH, providing potential therapeutic targets for patients with BPH.

• #57 :: ICU :: Investigative and Clinical Urology

  https://icurology.org/DOIx.php?id=10.4111/icu.20200605

  The negative correlation between BPH-size and incidence of prostate cancer (PCa) is well-documented in the literature, however the exact mechanism is not well-understood. […] The results suggest that growth of the transition zone in BPH causes increased fibrosis of the PZ, leading to atrophy and fibrosis of glandular cells. […] There is overwhelming evidence in the literature for an inverse relationship between BPH size and PCa incidence. […] The mechanism of this relationship is still not well understood, and new research techniques have focused on this in recent years. […] The results of our study showed that expansion of the TZ seen in BPH causes histo-anatomical changes within the PZ. The decreased glandular density and increased capsular thickness seen in larger prostates suggest that growth of the TZ causes widespread atrophy and apoptosis of the PZ glands along with fibrosis of tissue surrounding the glands.

• #58 :: ICU :: Investigative and Clinical Urology

  https://icurology.org/DOIx.php?id=10.4111/icu.20200605

  The negative correlation between BPH-size and incidence of prostate cancer (PCa) is well-documented in the literature, however the exact mechanism is not well-understood. […] The results suggest that growth of the transition zone in BPH causes increased fibrosis of the PZ, leading to atrophy and fibrosis of glandular cells. […] There is overwhelming evidence in the literature for an inverse relationship between BPH size and PCa incidence. […] The mechanism of this relationship is still not well understood, and new research techniques have focused on this in recent years. […] The results of our study showed that expansion of the TZ seen in BPH causes histo-anatomical changes within the PZ. The decreased glandular density and increased capsular thickness seen in larger prostates suggest that growth of the TZ causes widespread atrophy and apoptosis of the PZ glands along with fibrosis of tissue surrounding the glands.

• #59 :: ICU :: Investigative and Clinical Urology

  https://icurology.org/DOIx.php?id=10.4111/icu.20200605

  This study outlines a possible mechanism of the histoanatomical changes explaining the well-documented inverse correlation between BPH and PCa. The TZ enlargement in BPH patients compresses the PZ against the prostate’s anatomical capsule and causes the capsule to thicken while simultaneously inducing glandular atrophy and fibrosis within the PZ. This mechanism, in large BPH prostates, may be protective against PCa.

• #60 Computer simulations suggest that prostate enlargement due to benign prostatic hyperplasia mechanically impedes prostate cancer growth – ADS

  https://ui.adsabs.harvard.edu/abs/2019PNAS..116.1152L/abstract

  Benign prostatic hyperplasia (BPH) is a common disease in aging men that causes the prostate to enlarge progressively. […] The underlying mechanisms that explain this interaction between BPH and prostate cancer (PCa) are largely unknown. […] Here, we propose that BPH may mechanically impede PCa growth by producing increasingly intense mechanical stresses in the prostate over time, which are known to slow down tumor dynamics. […] The proposed mechanism suggests relevant shifts in clinical management of PCa and BPH.

• #61 Benign prostatic hyperplasia (BPH) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/symptoms-causes/syc-20370087

  Enlarged prostate compared with prostate at usual size Enlarged prostate […] When enlarged, the prostate may block the flow of urine from the bladder to the outside of the body. […] The prostate is a gland that typically keeps growing throughout life. This growth often enlarges the prostate enough to cause symptoms or to block urine flow. […] It isn’t clear what causes the prostate to get bigger. It might be due to changes in the balance of sex hormones as you grow older.

• #62 Benign prostatic hyperplasia (BPH) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/symptoms-causes/syc-20370087

  Enlarged prostate compared with prostate at usual size Enlarged prostate […] When enlarged, the prostate may block the flow of urine from the bladder to the outside of the body. […] The prostate is a gland that typically keeps growing throughout life. This growth often enlarges the prostate enough to cause symptoms or to block urine flow. […] It isn’t clear what causes the prostate to get bigger. It might be due to changes in the balance of sex hormones as you grow older.

• #63 Benign Prostatic Hyperplasia – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/benign-prostate-disease/benign-prostatic-hyperplasia

  Multiple fibroadenomatous nodules develop in the periurethral region of the prostate, probably originating within the periurethral glands rather than in the true fibromuscular prostate (surgical capsule), which is displaced peripherally by progressive growth of the nodules. […] As the lumen of the prostatic urethra narrows and lengthens, urine outflow is progressively obstructed. Increased pressure associated with micturition and bladder distention can progress to hypertrophy of the bladder detrusor, trabeculation, cellule formation, and diverticula. Incomplete bladder emptying causes stasis and predisposes to calculus formation and infection. Prolonged urinary tract obstruction, even if incomplete, can cause hydronephrosis and compromise renal function. […] The etiology is unknown but probably involves hormonal changes associated with aging.

• #64

  https://www.vin.com/apputil/content/defaultadv1.aspx?pId=22915&catId=124668&id=8896754&ind=283&objTypeID=17

  One of the most serious consequence is due to the presence of fluid-filled cysts making the prostate susceptible to infection from bacteria ascending the urethra, as accumulated prostatic fluid is an excellent media for bacterial growth. Hematogenous spread of bacteria and spread from the kidneys and bladder via urine or from the testicles and epididymis via semen can also occur. Bacterial prostatic infection can be acute and fulminant or chronic and insidious leading to abscessation. […] The hyperplastic prostate is highly vascularized and therefore the gland bleeds easily, which explains the common clinical sign of blood from the tip of the penis or blood in the urine. Blood loss in the prostatic urethra can be so intense that the ejaculate may appear completely red. Although presence of blood in the semen is typically considered to be a cause for infertility, dogs with blood in their ejaculates may be fertile. The reason for BPH being a common cause of infertility in the dog is probably due to the alteration of the biochemistry of the prostatic fluid, whose important action of nutrition of spermatozoa is decreased. Prostatitis or abscessation are likely consequences of presence of blood in the prostate.

• #65 Cialis for Treating Benign Prostatic Hyperplasia – The Bryn Mawr Urology Group

  https://www.brynmawrurology.com/bph/cialis-for-treating-benign-prostatic-hyperplasia/

  The great achievements of recent years have been the possibility of conducting fundamental scientific research on the study of the main mechanisms of the pathogenesis of BPH and the development of effective drugs based on the results of these studies 5-reductase inhibitors and 1-adrenergic blockers, which have made it possible to change approaches to the treatment of BPH, significantly improving the possibilities of conservative therapy for this disease. […] Phosphodiesterase type 5 inhibitors are the first-line drugs in the treatment of BPH. The mechanism of action of these drugs is associated with the effect on the system that controls the intracellular concentration of cyclic guanosine monophosphate. Cialis is the best medication for patients with mild to moderate BPH.

• #66 Enlarged Prostate: Symptoms, Causes, and More

  https://www.verywellhealth.com/enlarged-prostate-2781989

  Medications called 5-alpha-reductase enzyme inhibitors reduce the action of testosterone to shrink the prostate gland in cases of BPH and prostate cancer. These include Avodart (dutasteride) and Proscar (finasteride). […] Prostatitis is inflammation of the prostate. This may occur as the result of an infection, an inflammatory process, irritation, or an injury.

• #67 Diagnosis and Management of Benign Prostatic Hyperplasia | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0515/p1403.html

  Benign prostatic hyperplasia (BPH) is a common condition affecting older men. […] Histologically, it is characterized by the presence of discrete nodules in the periurethral zone of the prostate gland. Clinical manifestations of BPH are caused by extrinsic compression of the prostatic urethra leading to impaired voiding. […] Prostate growth is stimulated by androgenic hormones, especially dihydrotestosterone. Finasteride and dutasteride inhibit the conversion of testosterone to dihydrotestosterone, suppressing prostate growth. […] The 5-alpha reductase inhibitors do not provide immediate symptom relief, and approximately six months of therapy is required to achieve clinical benefit. Unlike alpha blockers, 5-alpha reductase inhibitors have been shown to affect the clinical course of BPH, reducing the risk of acute urinary retention and surgical intervention four years after therapy.

• #68 What is the mechanism of Silodosin?

  https://synapse.patsnap.com/article/what-is-the-mechanism-of-silodosin

  Silodosin is a medication primarily used for the treatment of benign prostatic hyperplasia (BPH), a condition characterized by an enlarged prostate gland. […] Silodosin works by competitively inhibiting the binding of norepinephrine to alpha-1A adrenergic receptors. This inhibition prevents the contraction of smooth muscle in the prostate and bladder neck, leading to their relaxation. […] In summary, Silodosin’s mechanism of action as a selective alpha-1A adrenergic receptor antagonist underlies its effectiveness in alleviating the symptoms of benign prostatic hyperplasia. By relaxing the smooth muscle tissues in the prostate and bladder neck, Silodosin enhances urinary flow and reduces the bothersome symptoms associated with BPH, offering patients much-needed relief and an improved quality of life.

• #69 About tamsulosin – NHS

  https://www.nhs.uk/medicines/tamsulosin/about-tamsulosin/

  Tamsulosin is used to treat men with symptoms of an enlarged prostate (benign prostate enlargement). […] Tamsulosin helps to reduce the symptoms of an enlarged prostate gland by relaxing the muscle around the bladder and prostate gland so you can pee more easily. […] Tamsulosin is sometimes combined with other ingredients to treat bladder problems and enlarged prostate.

• #70 Cialis for Treating Benign Prostatic Hyperplasia – The Bryn Mawr Urology Group

  https://www.brynmawrurology.com/bph/cialis-for-treating-benign-prostatic-hyperplasia/

  The great achievements of recent years have been the possibility of conducting fundamental scientific research on the study of the main mechanisms of the pathogenesis of BPH and the development of effective drugs based on the results of these studies 5-reductase inhibitors and 1-adrenergic blockers, which have made it possible to change approaches to the treatment of BPH, significantly improving the possibilities of conservative therapy for this disease. […] Phosphodiesterase type 5 inhibitors are the first-line drugs in the treatment of BPH. The mechanism of action of these drugs is associated with the effect on the system that controls the intracellular concentration of cyclic guanosine monophosphate. Cialis is the best medication for patients with mild to moderate BPH.

• #71 Newer Medications for Lower Urinary Tract Symptoms (LUTS) Associated with Benign Prostatic Hyperplasia (BPH) | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/prostatic-hyperplasia-medications/research-protocol

  Monotherapy with 5-ARI agents finasteride and dutasteride is another option for LUTS/BPH and BPE. […] The AUA guideline also lists AB/5-ARI combinations as appropriate and effective treatment options for men with LUTS/BPH and prostate enlargement. […] Recently, newer drugs and other drug classes have shown promise in treating LUTS/BPH. […] A new class of drugs, beta-3 adrenoceptor agonists, was recently developed to treat OAB. […] Tadalafil, a phosphodiesterase (PDE-5) inhibitor (FDA-approved for the treatment of erectile dysfunction [ED] since 2003) was approved by the FDA for the treatment of BPH in 2011. […] The primary intent of treatment is to reduce LUTS, improve prostate-related quality of life, and prevent or delay disease progression. […] Current AUA guidelines are available and relevant to current practice. However, these guidelines need to be updated to account for more recently approved medications for LUTS/BPH.

• #72 Newer Medications for Lower Urinary Tract Symptoms (LUTS) Associated with Benign Prostatic Hyperplasia (BPH) | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/prostatic-hyperplasia-medications/research-protocol

  Monotherapy with 5-ARI agents finasteride and dutasteride is another option for LUTS/BPH and BPE. […] The AUA guideline also lists AB/5-ARI combinations as appropriate and effective treatment options for men with LUTS/BPH and prostate enlargement. […] Recently, newer drugs and other drug classes have shown promise in treating LUTS/BPH. […] A new class of drugs, beta-3 adrenoceptor agonists, was recently developed to treat OAB. […] Tadalafil, a phosphodiesterase (PDE-5) inhibitor (FDA-approved for the treatment of erectile dysfunction [ED] since 2003) was approved by the FDA for the treatment of BPH in 2011. […] The primary intent of treatment is to reduce LUTS, improve prostate-related quality of life, and prevent or delay disease progression. […] Current AUA guidelines are available and relevant to current practice. However, these guidelines need to be updated to account for more recently approved medications for LUTS/BPH.

• #73 Fexapotide for BPH | NYMOX

  https://nymox.com/science/fexapotide-for-bph

  Fexapotide Triflutate is a protein injectable for benign prostatic hyperplasia (prostate enlargement, „BPH”) and for low grade localized prostate cancer. […] FT works by a mechanism of inducing apoptosis (programmed cell death) which selectively removes cells in the enlarged BPH prostate gland, and that also is useful in removing low grade localized early stage prostate cancers. […] In research studies, FT is associated with increased expression of important apoptosis markers, and all of the cellular signs of the hallmarks of apoptotic cell loss. […] FT has remarkable selectivity for the overgrowth of the prostate gland cells in BPH and in low grade localized prostate cancer. […] Studies of FT’s cellular effects, metabolism and kinetics have shown that FT does not have any effects on nearby structures or on important distant organs.

• #74 Fexapotide for BPH | NYMOX

  https://nymox.com/science/fexapotide-for-bph

  Fexapotide Triflutate is a protein injectable for benign prostatic hyperplasia (prostate enlargement, „BPH”) and for low grade localized prostate cancer. […] FT works by a mechanism of inducing apoptosis (programmed cell death) which selectively removes cells in the enlarged BPH prostate gland, and that also is useful in removing low grade localized early stage prostate cancers. […] In research studies, FT is associated with increased expression of important apoptosis markers, and all of the cellular signs of the hallmarks of apoptotic cell loss. […] FT has remarkable selectivity for the overgrowth of the prostate gland cells in BPH and in low grade localized prostate cancer. […] Studies of FT’s cellular effects, metabolism and kinetics have shown that FT does not have any effects on nearby structures or on important distant organs.

• #75 Benign Prostatic Hyperplasia: Evaluation and Medical Management in Primary Care

  https://consultqd.clevelandclinic.org/benign-prostatic-hyperplasia-evaluation-and-medical-management-in-primary-care

  Given its superior efficacy and benefits in preventing disease progression, combination therapy (the alpha-blocker, doxazosin, and the 5-Alpha reductase inhibitor, finasteride) should be considered for men with an enlarged prostate and moderate to severe lower urinary tract symptoms. […] Even with effective medical therapy, the disease will progress in some men.

• #76 Newer Medications for Lower Urinary Tract Symptoms (LUTS) Associated with Benign Prostatic Hyperplasia (BPH) | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/prostatic-hyperplasia-medications/research-protocol

  Monotherapy with 5-ARI agents finasteride and dutasteride is another option for LUTS/BPH and BPE. […] The AUA guideline also lists AB/5-ARI combinations as appropriate and effective treatment options for men with LUTS/BPH and prostate enlargement. […] Recently, newer drugs and other drug classes have shown promise in treating LUTS/BPH. […] A new class of drugs, beta-3 adrenoceptor agonists, was recently developed to treat OAB. […] Tadalafil, a phosphodiesterase (PDE-5) inhibitor (FDA-approved for the treatment of erectile dysfunction [ED] since 2003) was approved by the FDA for the treatment of BPH in 2011. […] The primary intent of treatment is to reduce LUTS, improve prostate-related quality of life, and prevent or delay disease progression. […] Current AUA guidelines are available and relevant to current practice. However, these guidelines need to be updated to account for more recently approved medications for LUTS/BPH.

• #77 A new mechanism to explain benign prostatic hyperplasia – Baylor College of Medicine Blog Network

  https://blogs.bcm.edu/2016/10/14/a-new-mechanism-to-explain-benign-prostatic-hyperplasia/

  Our result that disruption of androgen receptor signaling in luminal cells can drive inflammation is consistent with the observation that luminal cells of inflamed human prostate glands have fewer androgen receptors than luminal cells from non-inflamed prostates. […] This research has clinical implications related to the treatment of BPH with androgen-targeting therapy, the goal of which is to deplete androgen to starve proliferating cells that require androgen to survive. […] Our results may explain why some BPH patients respond to androgen-targeting therapies, such as finasteride, while in other patients the disease continues to progress, said Xin. We suggest that treatment for BPH might be more effective if patients received androgen-targeting therapy together with drugs that target inflammation.

• #78 :: WJMH :: World Journal of Men’s Health

  https://wjmh.org/DOIx.php?id=10.5534/wjmh.230122

  Benign prostate hyperplasia (BPH) is a common age-related chronic condition. Its pathogenesis involves androgen imbalance, inflammation, oxidative stress, and endoplasmic reticulum (ER) stress. […] This study suggests that finasteride prevents BPH-associated symptoms by regulating angiogenesis, reactive oxygen species, ER stress responses, and inflammation, another mechanism to explain the effect of the 5-reductase against BPH. […] The study aims to assess the protective effect of finasteride as an antioxidant against testosterone propionate (TP)-induced BPH in rats and explore its potential mechanism of action. […] Finasteride administration inhibited prostate enlargement, DHT, 5-AR2, and PSA levels in BPH rats. […] Moreover, components of oxidative stress, inflammation, and ER stress responses were significantly regulated by finasteride treatment.

• #79 :: WJMH :: World Journal of Men’s Health

  https://wjmh.org/DOIx.php?id=10.5534/wjmh.230122

  This study demonstrates the potential role of inflammation, ROS, and ER stress responses in the protective effect of finasteride in TP-induced BPH. […] Together, these findings strongly suggest the broader involvement of ROS, inflammation, and ER stress responses in the development of BPH where finasteride regulates those mechanism-associated signalings. […] Finasteride as an ER stress inhibitor with an antioxidative effect, ultimately linked to inflammation and BPH, has been recognized as the novel aspect of the present study.

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