PSA density is associated with BPH cellular composition

Endogenous Zinc-Ion-Triggered In Situ Gelation Enables Zn Capture to Reprogram Benign Hyperplastic Prostate Microenvironment and Shrink Prostate

Benign prostatic hyperplasia (BPH) as the leading cause of urination disorder is still a refractory disease, and there have no satisfied drugs or treatment protocols yet. With identifying excessive Zn2+ , inflammation, and oxidative stress as the etiology of aberrant hyperplasia, an injectable sodium alginate (SA) and glycyrrhizic acid (GA)-interconnected hydrogels (SAGA) featuring Zn2+ -triggered in situ gelation are developed to load lonidamine for reprogramming prostate microenvironment and treating BPH. Herein, SAGA hydrogels can crosslink with Zn2+ in BPH via coordination chelation and switch free Zn2+ to bound ones, consequently alleviating Zn2+ -arisen inflammation and glycolysis. Beyond capturing Zn2+ , GA with intrinsic immunoregulatory property can also alleviate local inflammation and scavenge reactive oxygen species (ROS). Intriguingly, Zn2+ chelation-bridged interconnection in SAGA enhances its mechanical property and regulates the degradation rate to enable continuous lonidamine release, favoring hyperplastic acini apoptosis and further inhibiting glycolysis. These multiple actions cooperatively reprogram BPH microenvironment to alleviate characteristic symptoms of BPH and shrink prostate. RNA sequencing reveals that chemotaxis, glycolysis, and tumor necrosis factor (TNF) inflammation-related pathways associated with M1-like phenotype polarization are discerned as the action rationales of such endogenous Zn2+ -triggered in situ hydrogels, providing a candidate avenue to treat BPH.

Is the Ellipsoid Formula Reliable in Prostate MRI?

Our study seeks to study the accuracy of the ellipsoidal formula in prostate MRI of different sizes and to establish the limits of its use. The study included 31 patients with a well-visualized, intact prostatic capsule, excluding malignantly transformed prostates, as well as treated prostates, in which the contrast between the prostatic capsule and parenchyma is reduced. Each patient's prostatic volume was recalculated according to the ellipsoidal formula, and then it was compared with the prostatic volume calculated by the segmentation method. The two calculated volumes were similar, in some cases almost identical, with a slight tendency to underestimate prostate volume below 100cm3, in total in 18 cases, on average by 7.6% (+/-6%), overestimation of those with a volume over 100cm3, a total of 13 cases, on average by 3.2% (+/-2.5%), and of all, in 4 cases the difference between the two formulas was below 1%. There was no statistical difference between the two variables, Student's t-test p-value=0.039. With a precision of 92% (+/-6%), the ellipsoidal formula can be considered accurate when it is correctly performed, but if we take into account the importance that PSA density is starting to have in diagnosis, treatment and follow-up, the calculation of a secondary value through the segmentation method or high-precision software can be motivated when the ellipsoidal formula returns a value close to a threshold.

Analysis of platelet and monocyte-to-lymphocyte ratio and diabetes mellitus with benign prostatic enlargement

Background

The etiology of benign prostatic hyperplasia (BPH) is still elusive. The aim of this study was to provide preventive and prognostic parameters associated with diabetes mellitus with benign prostatic enlargement (BPE).

Methods

Diabetic patients were collected retrospectively from February 2021 to December 2022, including monocyte-to-lymphocyte ratio (MLR). Diabetic patients were divided into two groups by whether the prostate volume was greater than or equal to 30 ml, which were diabetes mellitus without BPE (DM) and diabetes mellitus with BPE (DM+BPE). The baseline characteristics were compared, the risk and protective factors associated with DM+BPE were determined using univariate and multivariate logistic regression, and the parameters associated with prostate volume were determined using correlation analysis.

Results

Of the 671 patients collected, age and prostate volume were significantly higher in the DM+BPE than in the DM; MLR was higher in the DM+BPE than in the DM; and platelet was significantly lower in the DM+BPE than in the DM. Univariate logistic regression showed that age was a risk factor, while protective factors for DM+BPE were lymphocytes and platelet. Multifactorial logistic regression showed that age was a risk factor, while platelet was the protective factor for DM+BPE. In the total overall (n=671), prostate volume was positively correlated with age. Prostate volume was negatively correlated with lymphocytes and platelet. In DM+BPE (n=142), prostate volume was positively correlated with age and MLR.

Conclusion

Platelet was a protective factor for DM+BPE and was negatively correlated with prostate volume, whereas MLR was positively correlated with prostate volume in DM+BPE.