[Phytotherapy in urology. Current scientific evidence of its application in benign prostatic hyperplasia and prostate adenocarcinoma]

Treatment of Benign Prostatic Hyperplasia by Natural Drugs

Benign prostatic hyperplasia (BPH) is one of the most common urinary diseases affecting men, generally after the age of 50. The prevalence of this multifactorial disease increases with age. With aging, the plasma level of testosterone decreases, as well as the testosterone/estrogen ratio, resulting in increased estrogen activity, which may facilitate the hyperplasia of the prostate cells. Another theory focuses on dihydrotestosterone (DHT) and the activity of the enzyme 5α-reductase, which converts testosterone to DHT. In older men, the activity of this enzyme increases, leading to a decreased testosterone/DHT ratio. DHT may promote prostate cell growth, resulting in hyperplasia. Some medicinal plants and their compounds act by modulating this enzyme, and have the above-mentioned targets. This review focuses on herbal drugs that are most widely used in the treatment of BPH, including pumpkin seed, willow herb, tomato, maritime pine bark, Pygeum africanum bark, rye pollen, saw palmetto fruit, and nettle root, highlighting the latest results of preclinical and clinical studies, as well as safety issues. In addition, the pharmaceutical care and other therapeutic options of BPH, including pharmacotherapy and surgical options, are discussed, summarizing and comparing the advantages and disadvantages of each therapy.

Local/traditional uses, secondary metabolites and biological activities of Mashua (Tropaeolum tuberosum Ruíz & Pavón)

ETHNOPHARMACOLOGICAL RELEVANCE

Tropaeolum tuberosum Ruíz & Pavón (Tropaeolaceae). Sim (commonly called Mashua) is an indigenous plant that has medicinal values for various ethnic groups of the regions of the Andes mountain range of South America, which use it for the treatment of diseases venereal, lung and skin; for the healing of internal and external wounds; and as an analgesic for kidney and bladder pain.

AIM OF THE REVIEW

We critically summarised the current evidence on the botanic characterisation and distribution, ethnopharmacology, secondary metabolites, pharmacological activities, qualitative and quantitative analysis, and toxicology of T. tuberosum.

MATERIALS AND METHODS

The relevant information on T. tuberosum was gathered from worldwide accepted scientific databases via electronic search (Google scholar, Elsevier, SciFinder, ScienceDirect, PubMed, SpringerLink, Web of Science, Scopus, Wiley Online, Mendeley, Scielo and Dialnet electronic databases). Information was also obtained from the literature and books as well as PhD and MSc dissertations. Plant names were validated by 'The Plant List' (www.theplantlist.org).

RESULTS

T. tuberosum has diverse uses in local and popular medicine, specifically for relieving pain and infections in humans. Regarding its biological activities, polar extracts (aqueous, hydroalcoholic) and isolated compounds from the tubers have exhibited a wide range of in vitro and in vivo pharmacological effects, including antibacterial, antioxidant, anti-inflammatory activities. Quantitative analysis (e.g., NMR, HPLC, GC-MS) indicated the presence of a set of secondary metabolites, including hydroxybenzoic acids, tannins, flavanols, anthocyanins, glucosinolates, isothiocyanates, phytosterols, fatty acids and alkamides in the tubers of T. tuberosum. Likewise, glucosinolates have been identified in the seeds and isothiocyanates have been detected in leaves, flowers and seeds.

CONCLUSIONS

T. tuberosum has been tested for various biological activities and the extracts (tubers in particular) demonstrated a promising potential as an antibacterial, antioxidant, anti-inflammatory and inhibitors of benign prostatic hyperplasia. A lack of alignment between the ethno-medicinal uses and existing biological screenings was observed, indicating the need to explore its potential for the treatment against respiratory affections, urinary affections and blood diseases. Likewise, it is necessary to analyse deeply the relationship that exists between the different tuber colours of T. tuberosum and its use for the treatment of certain diseases. Validation of clinical studies of the antibacterial, antioxidant/anti-inflammatory, anti-spermatogenic activities and as inhibitors of benign prostatic hyperplasia is required. Moreover, studies on the toxicity, bioavailability, and pharmacokinetics, in addition to clinical trials, are indispensable for assessing the safety and efficacy of the active metabolites or extracts obtained from T. tuberosum. Other areas that need investigation are the development of future applications based on their active metabolites, such as neurodegenerative diseases (Alzheimer's disease, Parkinson's disease, Huntington's disease). Finally, the work purposes to motivate other research groups to carry out a series of scientific studies that can fill the gaps that exist with respect to Mashua properties, and thus be able to change the focus of T. tuberosum (Mashua) that currently has in the consumer society.

Phytotherapy of benign prostatic hyperplasia. A minireview

Benign prostate hyperplasia (BPH) is a common condition affecting older men, with an incidence that is age-dependent. Histological BPH, which typically develops after the age of 40 years, ranges in prevalence from >50% at 60 years to as high as 90% by 85 years of age. Typical symptoms include increased frequency of urination, nocturia, urgency, hesitancy, and weak urine stream. Conventional medicines used for the treatment of BPH include alpha blockers and 5-alpha reductase inhibitors. This articles review the mode of action, the efficacy, and the safety, including herb-drug interactions of the most common botanicals (Serenoa repens, Pygeum africanum, Urtica dioica, and Cucurbita pepo) and nutraceuticals (isoflavones, lycopene, selenium, and β-Sitosterol) in controlling the lower urinary tract symptoms associated to BPH.

Prunus africana (Hook.f.) Kalkman: the overexploitation of a medicinal plant species and its legal context

The linkage between herbal medicines and the sustainability of medical plants from which they are manufactured is increasingly being understood and receiving attention through international accords and trade labeling systems. However, little attention is paid to the fair trade aspects of this sector, including the issue of benefit-sharing agreements with traditional societies whose knowledge and resources are being exploited for commercial herbal medicine development and production. This article examines the case of Prunus africana (Hook.f.) Kalkman, from equatorial Africa. While the conservation and cultivation dimension of the trade in P. africana has been much discussed in literature, no research appears to have focused on the traditional resource rights and related ethical dimensions of this trade in traditional medicine of Africa. Serving as a cautionary tale for the unbridled exploitation of medicinal plants, the history of P. africana extraction is considered here in the context of relevant treaties and agreements existing today. These include the Nagoya Protocol, a supplementary agreement to the Convention on Biological Diversity, the Trade-Related Aspects of Intellectual Property Rights agreement from the World Trade Organization, and two African regional frameworks: the Swakopmund Protocol and the Organisation Africaine de la Propriété Intellectuelle Initiative. In the context of strengthening medicinal plant research in Africa, a novel international capacity-building project on traditional medicines for better public health in Africa will be discussed, illustrating how access and benefit sharing principles might be incorporated in future projects on traditional medicines.