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Bizzarri FP, Campetella M, Ragonese M, Scarciglia E, Russo P, Marino F, Filomena GB, Gavi F, Rossi F, D'Amico L, Gandi C, Foschi N, Recupero SM, Sacco E. The role of alternative medicine and complimentary therapies in urologic disease: New horizons. Urologia 2024; 91:641-646. [PMID: 39045632 DOI: 10.1177/03915603241258697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
The world of complementary and alternative medicine (CAM) encompasses a wide range of practices, treatments, and products that fall outside the realm of conventional (mainstream) medicine. The use of complementary and CAM has become increasingly popular in Western nations. People are turning to CAM for a variety of reasons, including managing chronic diseases, relieving symptoms of various conditions, and improving their overall health and well-being. There's a growing trend of people using and showing interest in complementary and alternative medicine therapies, especially in Western countries. CAM encompasses a wide range of treatments, some offering complete alternatives to conventional medicine, while others aim to complement existing medical approaches. Urologists should stay informed about CAM to guide their patients effectively to treat patients in a modern and personalized way. The aim of review is to analyze the scenario of complimentary and alternative medicine with a specific focus in the urological field.
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Affiliation(s)
- Francesco Pio Bizzarri
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Department of Urology, Gemelli isola Tiberina Hospital, Rome, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Marco Campetella
- Department of Urology, Gemelli isola Tiberina Hospital, Rome, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Mauro Ragonese
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Eros Scarciglia
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Pierluigi Russo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Filippo Marino
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Giovanni Battista Filomena
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Filippo Gavi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Francesco Rossi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Department of Urology, Gemelli isola Tiberina Hospital, Rome, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Lorenzo D'Amico
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Department of Urology, Gemelli isola Tiberina Hospital, Rome, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Carlo Gandi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Nazario Foschi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Salvatore Marco Recupero
- Department of Urology, Gemelli isola Tiberina Hospital, Rome, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
| | - Emilio Sacco
- Department of Urology, Gemelli isola Tiberina Hospital, Rome, Università Cattolica del Sacro Cuore, Roma, Italy
- Catholic University of Sacre Heart, Roma, Italy
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Csikós E, Horváth A, Ács K, Papp N, Balázs VL, Dolenc MS, Kenda M, Kočevar Glavač N, Nagy M, Protti M, Mercolini L, Horváth G, Farkas Á. Treatment of Benign Prostatic Hyperplasia by Natural Drugs. Molecules 2021; 26:7141. [PMID: 34885733 PMCID: PMC8659259 DOI: 10.3390/molecules26237141] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 12/08/2022] Open
Abstract
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.
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Affiliation(s)
- Eszter Csikós
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
| | - Adrienn Horváth
- Department of Pharmaceutical Biology, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary;
| | - Kamilla Ács
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
| | - Nóra Papp
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
| | - Viktória Lilla Balázs
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
| | - Marija Sollner Dolenc
- University of Ljubljana, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia; (M.S.D.); (M.K.)
| | - Maša Kenda
- University of Ljubljana, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia; (M.S.D.); (M.K.)
| | - Nina Kočevar Glavač
- University of Ljubljana, Department of Pharmaceutical Biology, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia;
| | - Milan Nagy
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University in Bratislava, SK-832-32 Bratislava, Slovakia;
| | - Michele Protti
- Research Group of Pharmaco-Toxicological Analysis (PTA Lab), Department of Pharmacy and Biotechnology (FaBiT), Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (M.P.); (L.M.)
| | - Laura Mercolini
- Research Group of Pharmaco-Toxicological Analysis (PTA Lab), Department of Pharmacy and Biotechnology (FaBiT), Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (M.P.); (L.M.)
| | - Györgyi Horváth
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
| | - Ágnes Farkas
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
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Zheng YZ, Fu ZM, Deng G, Guo R, Chen DF. Role of C‒H bond in the antioxidant activities of rooperol and its derivatives: A DFT study. PHYTOCHEMISTRY 2020; 178:112454. [PMID: 32692658 DOI: 10.1016/j.phytochem.2020.112454] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 06/11/2023]
Abstract
Rooperol and its derivatives, derived from the Hypoxis rooperi plant, are polyphenolic and norlignan compounds with excellent antioxidant activities. The reaction enthalpies for the free-radical scavenging by rooperol and its six derivatives were studied using density functional theory. We found that the C-H groups played a significant role in the antioxidant activities in non-polar phases. In the gas and benzene phases, rooperol and its derivatives preferentially underwent the free-radical scavenging process via the 3‒CH group by following the hydrogen atom transfer (HAT) mechanism. In polar phases, the sequential proton loss electron transfer (SPLET) was the most preferred mechanism, and the phenolic O‒H groups played a significant role. Additionally, we found that when the hydrogen atom in the OH group was replaced by a glucose moiety, the antioxidant activity of the adjacent OH group was reduced. ROP, DHROP-I, DHROP-II, ROP-4″-G and ROP-4'G have catechol moiety, they may proceed double step-wise mechanisms to trap free radicals. In the gas and benzene phases, the preferable mechanism is dHAT. In water phase, it is SPLHAT.
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Affiliation(s)
- Yan-Zhen Zheng
- College of Animal Sciences (College of Bee Science), Fujian Agriculture and Forestry University, Fuzhou, 350002, PR China
| | - Zhong-Min Fu
- College of Animal Sciences (College of Bee Science), Fujian Agriculture and Forestry University, Fuzhou, 350002, PR China
| | - Geng Deng
- Key Laboratory of Bioorganic Phosphorous Chemistry and Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, PR China
| | - Rui Guo
- College of Animal Sciences (College of Bee Science), Fujian Agriculture and Forestry University, Fuzhou, 350002, PR China
| | - Da-Fu Chen
- College of Animal Sciences (College of Bee Science), Fujian Agriculture and Forestry University, Fuzhou, 350002, PR China.
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Hasan I, Naqvi SF, Khan A, Hasan Y, UzairUllah M. A Short Scale Trial to Study and Evaluate the Safety and Efficacy of a Herbal Composition; Verona Anti-BPH Capsule to Treat Benign Prostatic Hyperplasia in Men Older than 40 Years of Age. CURRENT TRADITIONAL MEDICINE 2020. [DOI: 10.2174/2215083806666200127090140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aims and objective:
Benign Prostatic Hyperplasia (BPH) is a condition that causes
the proliferation of the cells of the prostate causing urine retention, renal insufficiency, bladder
calculi, recurrent Lower Urinary Tract Infections (LUTS) and in complicated cases, hematuria
with unbearable pain. The trial was conducted to study the safety and efficacy of novel herbal
product Verona anti- BPH capsules at a local clinic of Sharafi Goth, Karachi Pakistan.
Introduction:
Benign Prostatic Hyperplasia (BPH) is one major condition. The prevalence of
the disease increases to around 8-60% in men at the age of 40 years which is caused mainly by
hormonal change, lifestyle changes or diet. The disease is mainly defined as increased cellular
proliferation of the prostate glands or an enlarged prostate. 50% men of age 65 years and
above of the total population of Pakistan are at risk of having Benign Prostatic Hyperplasia
(BPH).
Method:
This was a single blind, placebo control phase I clinical trial. A total of 35 patients
were enrolled in the study, out of which 2 patients got dropped out. 23 patients received Verona
anti-BPH capsules and 10 patients received placebo. The sample paired t-test was applied
to evaluate the significant level.
Results:
Verona Anti-BPH capsules were found safe and effective in the treatment of Benign
Prostatic Hyperplasia (anti-BPH).
Conclusion:
Verona anti-BPH capsules were known to be effective with no harmful side effects.
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Affiliation(s)
- Ifrah Hasan
- Herbion Naturals, Medical Affairs and Pharmacovigilance, Karachi, Pakistan
| | | | - Amraa Khan
- Herbion Pharma, Medical Affairs, Karachi, Pakistan
| | - Yamna Hasan
- Herbion Pharma, Medical Affairs, Karachi, Pakistan
| | - Mir UzairUllah
- Herbion Pharma, Research and Development Department, Karachi, Pakistan
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Igongsan reduces testosterone-induced benign prostate hyperplasia by regulating 5α-reductase in rats. Mol Cell Toxicol 2018. [DOI: 10.1007/s13273-018-0023-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Choi HM, Jung Y, Park J, Kim HL, Youn DH, Kang J, Jeong MY, Lee JH, Yang WM, Lee SG, Ahn KS, Um JY. Cinnamomi Cortex (Cinnamomum verum) Suppresses Testosterone-induced Benign Prostatic Hyperplasia by Regulating 5α-reductase. Sci Rep 2016; 6:31906. [PMID: 27549514 PMCID: PMC4994048 DOI: 10.1038/srep31906] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 07/26/2016] [Indexed: 01/13/2023] Open
Abstract
Cinnamomi cortex (dried bark of Cinnamomum verum) is an important drug in Traditional Korean Medicine used to improve blood circulation and Yang Qi. Benign prostatic hyperplasia (BPH) is a common chronic disease in aging men. This study was conducted to determine the effect of Cinnamomi cortex water extract (CC) on BPH. BPH was induced by a pre-4-week daily injection of testosterone propionate (TP). Six weeks of further injection with (a) vehicle, (b) TP, (c) TP + CC, (d) TP + finasteride (Fi) was carried on. As a result, the prostate weight and prostatic index of the CC treatment group were reduced. Histological changes including epithelial thickness and lumen area were recovered as normal by CC treatment. The protein expressions of prostate specific antigen, estrogen receptor α (ERα), androgen receptor (AR), 5α-reductase (5AR), and steroid receptor coactivator 1 were suppressed by treatment of CC. Immunohistochemical assays supported the western blot results, as the expressions of AR and ERα were down-regulated by CC treatment as well. Further in vitro experiments showed CC was able to inhibit proliferation of RWPE-1 cells by suppressing 5AR and AR. These results all together suggest CC as a potential treatment for BPH.
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Affiliation(s)
- Hyun-Myung Choi
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
| | - Yunu Jung
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
| | - Jinbong Park
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
| | - Hye-Lin Kim
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
| | - Dong-Hyun Youn
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
| | - JongWook Kang
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
| | - Mi-Young Jeong
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
| | - Jong-Hyun Lee
- College of Pharmacy, Dongduk Women's University, 60 Hwarang-ro 13-gil, Seongbuk-gu, Seoul, 136-714, Republic of Korea
| | - Woong Mo Yang
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
| | - Seok-Geun Lee
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
| | - Kwang Seok Ahn
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
| | - Jae-Young Um
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea.,Department of Science in Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-Gu, Seoul, 130-701, Republic of Korea
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7
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What do we know about phytotherapy of benign prostatic hyperplasia? Life Sci 2015; 126:42-56. [DOI: 10.1016/j.lfs.2015.01.023] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 12/22/2014] [Accepted: 01/21/2015] [Indexed: 02/08/2023]
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Arslan D, Tural D, Akar E. Herbal Administration and Interaction of Cancer Treatment. J Palliat Med 2013; 16:1466-76. [DOI: 10.1089/jpm.2013.0126] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Deniz Arslan
- Department of Medical Oncology, Akdeniz University, Antalya, Turkey
| | - Deniz Tural
- Department of Medical Oncology, Istanbul University, Istanbul, Turkey
| | - Emre Akar
- Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
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10
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Application, chemical composition, and standardization of nettle raw material and related drugs (Review). Pharm Chem J 2012. [DOI: 10.1007/s11094-012-0690-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Abstract
Estrogens and androgens have both been implicated as causes of benign prostatic hyperplasia (BPH). Although epidemiological data on an association between serum androgen concentrations and BPH are inconsistent, it is generally accepted that androgens play a permissive role in BPH pathogenesis. In clinical practice, inhibitors of 5α-reductase (which converts testosterone to the more potent androgen dihydrotestosterone) have proven effective in the management of BPH, confirming an essential role for androgens in BPH pathophysiology. To date, multiple lines of evidence support a role for estrogens in BPH pathogenesis. Studies of the two estrogen receptor (ER) subtypes have shed light on their differential functions in the human prostate; ERα and ERβ have proliferative and antiproliferative effects on prostate cells, respectively. Effects of estrogens on the prostate are associated with multiple mechanisms including apoptosis, aromatase expression and paracrine regulation via prostaglandin E2. Selective estrogen receptor modulators or other agents that can influence intraprostatic estrogen levels might conceivably be potential therapeutic targets for the treatment of BPH.
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Lowe FC. The Role of Serenoa repens in the Clinical Management of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.eursup.2009.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Benign prostatic hyperplasia (BPH) and other prostatic diseases share many observational and mechanistic features with cardiovascular disease. Both BPH and cardiovascular disease increase significantly with age and affect a disproportionate number of men from racial/ethnic minority populations. Pharmacotherapy and surgical options are the treatments most often discussed in the medical literature for the 2 conditions, and these treatments have demonstrated remarkable effectiveness, regardless of the severity of the condition. Obesity, lack of physical activity, dyslipidemia, diabetes mellitus, higher blood pressure, a heart-unhealthy diet, and other factors that increase the risk for cardiovascular disease also appear to be associated with increased risk for BPH. However, the potential for lifestyle changes to prevent or reduce the severity of BPH, especially as an adjunct to conventional treatments, has not received significant attention, even in recent specialty treatment guidelines. Because lifestyle changes may affect the risk for developing BPH or its progression, clinicians are in need of guidelines they can use to educate patients about the potential links between increased risk of cardiovascular disease and increased risk or greater severity of BPH. Patients need to know that a heart-healthy lifestyle is also a prostate-healthy lifestyle. This article provides educational and lifestyle recommendations that may favorably affect BPH and improve overall health in men.
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Affiliation(s)
- Mark A Moyad
- Department of Urology, University of Michigan Medical Center, Ann Arbor, Michigan 48109-0330, USA.
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14
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Gur S, Kadowitz PJ, Hellstrom WJG. Guide to Drug Therapy for Lower Urinary Tract Symptoms in Patients with Benign Prostatic Obstruction. Drugs 2008; 68:209-29. [DOI: 10.2165/00003495-200868020-00005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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15
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Laporta O, Funes L, Garzón MT, Villalaín J, Micol V. Role of membranes on the antibacterial and anti-inflammatory activities of the bioactive compounds from Hypoxis rooperi corm extract. Arch Biochem Biophys 2007; 467:119-31. [PMID: 17888867 DOI: 10.1016/j.abb.2007.08.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Revised: 07/31/2007] [Accepted: 08/01/2007] [Indexed: 11/18/2022]
Abstract
Hypoxis rooperi corm extract ('African potato') is known for its traditional and ethnomedical uses in the treatment of a large variety of diseases. Its main bioactive compound hypoxoside (HYP) and its aglycone derivative rooperol (RO) were isolated and the interaction of these compounds with several types of model membranes was studied in order to contribute to the understanding of their molecular mechanism. The results show that RO abolishes the main transition phase and perturb the van der Waals interactions between phospholipid acyl chains in a stronger way than HYP in dimiristoylphosphatidylcholine (DMPC), dielaidoylphosphatidylethanolamine (DEPE) and dimiristoylphosphatidylglycerol membranes (DMPG), probably indicating that this molecule inserts into the bilayer. This effect decreases as the acyl chain length of the phospholipid increases. RO also promoted the formation of hexagonal H(II) phases at lower temperatures compared to pure DEPE. On the contrary, HYP showed a shallow interaction with phospholipids. This compound promoted the formation of gel-fluid like intermediate structures with isotropic motion in phosphatidylglycerol membranes at physiological pH, and affected the phospholipid/water interface probably through the variation of the surface charge of the phospholipid phosphate groups. Moreover, RO inhibited Staphylococcus aureus in a stronger manner than Escherichia coli and promoted a higher leakage level in E. coli, PG and PE-containing synthetic membranes. Furthermore, RO showed a significant degree of inhibition of cyclooxygenase-2 (COX-2) and cyclooxygenase-1 (COX-1) evidencing an approximate COX-2/COX-1 IC50 ratio of 1.9, therefore this compound may be responsible for the anti-inflammatory activity of H. rooperi corm extract. These results may contribute to understand the molecular mechanism of the antibacterial and/or anti-inflammatory properties of the bioactive compounds deriving from the African potato corm extract.
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Affiliation(s)
- Olga Laporta
- Instituto de Biología Molecular y Celular, Universidad Miguel Hernández, Avda. de la Universidad s/n. E-03202 Elche, Alicante, Spain
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16
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Affiliation(s)
- Choung Soo Kim
- Department of Urology, Ulsan University College of Medicine, Korea.
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17
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Abstract
Benign prostatic hyperplasia (BPH) is the nonmalignant enlargement of the prostate gland caused by increases in number of both epithelial and stromal cells. Clinically, BPH leads to voiding dysfunction, which is most often referred to as lower urinary tract symptoms (LUTS). Historically, the only treatments for LUTS due to BPH were watchful waiting or surgery (transurethral or open prostatectomy). However, over the last 20 years medical therapy has taken a prominent role in the management of BPH. Current medical treatments for BPH include alpha-adrenergic receptor antagonists, inhibitors of the 5-alpha reductase enzyme and various phytotherapies. These agents are generally effective and safe; however, many patients are unable to tolerate the side effects or are refractory to medical management and require surgery. In light of this, many potential new therapies for the treatment of BPH are under development. Some represent a variation of current treatments, whereas others target novel molecular pathways within the prostate. The aim of this review is to examine current pharmacotherapies as well as to highlight emerging drugs that may improve our treatment of patients with LUTS secondary to BPH.
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Affiliation(s)
- Travis L Bullock
- Division of Urology, Washington University School of Medicine, St. Louis, MO 63110, USA.
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Maccagnano C, Salonia A, Briganti A, Teillac P, Schulman C, Montorsi F, Rigatti P. A Critical Analysis of Permixon™ in the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Enlargement. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.eursup.2006.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Complementary and alternative medicine (CAM) includes various practices, measures and products which are not presently considered to be a part of conventional (mainstream) medicine. Herbal products, vitamins, minerals and amino acids are increasingly popular as dietary supplements for the treatment, improvement and prophylaxis of urological diseases, and to improve general health and well-being. As these products are freely available without prescription, conventional healthcare providers are often unaware that their patients are using CAM. It is essential to know that some herbal supplements may act in the same way as chemical drugs, and that they originate 'from nature' does not mean that they are safe and/or with no potential harmful effects and/or toxicity. Eventual interactions with conventional medications and contamination with prescription drugs and metals have been reported. The active components of many phytotherapeutic preparations and their mechanism(s) of action are still being determined and evaluated. There is scientific evidence for the effectiveness of some CAM treatments, but for most there are important key questions yet to be answered through basic research and well-designed studies according to established guidelines. Because of the increasing popularity and use of CAM, conventional healthcare providers, including urologists, should not ignore it, and be well informed about the benefits and potential risks of dietary supplements, so that they can advise their patients about this developing field. Whenever necessary and possible, lifestyle and behavioural changes should be recommended before using CAM, and eventually be supplemented by CAM as a second step.
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Affiliation(s)
- Kurt Dreikorn
- Department of Urology, Klinikum Bremen-Mitte, Bremen, Germany.
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20
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Correct answers to multiple choice questions appearing in the European Urology Update Series 2005. BJU Int 2005. [DOI: 10.1111/j.1464-410x.2005.05978.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Setty AR, Sigal LH. Herbal Medications Commonly Used in the Practice of Rheumatology: Mechanisms of Action, Efficacy, and Side Effects. Semin Arthritis Rheum 2005; 34:773-84. [PMID: 15942912 DOI: 10.1016/j.semarthrit.2005.01.011] [Citation(s) in RCA: 145] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To review the literature on herbal preparations commonly utilized in the treatment of rheumatic indications. METHODS Search of MEDLINE (PubMed) was performed using both the scientific and the common names of herbs. Relevant articles in English were collected from PubMed and reviewed. RESULTS This review summarizes the efficacy and toxicities of herbal remedies used in complementary and alternative medical (CAM) therapies for rheumatologic conditions, by elucidating the immune pathways through which these preparations have antiinflammatory and/or immunomodulatory activity and providing a scientific basis for their efficacy. Gammalinolenic acid suppresses inflammation by acting as a competitive inhibitor of prostaglandin E2 and leukotrienes (LTs) and by reducing the auto-induction of interleukin1alpha (IL-1alpha)-induced pro-IL-1beta gene expression. It appears to be efficacious in rheumatoid arthritis (RA) but not for Sjogrens disease. The antiinflammatory actions of Harpagophytum procumbens is due to its action on eicosanoid biosynthesis and it may have a role in treating low back pain. While in vitro experiments with Tanacetum parthenium found inhibition of the expression of intercellular adhesion molecule-1, tumor necrosis factor alpha (TNF-alpha), interferon-gamma, IkappaB kinase, and a decrease in T-cell adhesion, to date human studies have not proven it useful in the treatment of RA. Current experience with Tripterygium wilfordii Hook F, Uncaria tomentosa, finds them to be efficacious in the treatment of RA, while Urtica diocia and willow bark extract are effective for osteoarthritis. T. wilfordii Hook F extract inhibits the production of cytokines and other mediators from mononuclear phagocytes by blocking the up-regulation of a number of proinflammatory genes, including TNF-alpha, cyclooxygenase 2 (COX-2), interferon-gamma, IL-2, prostaglandin, and iNOS. Uncaria tomentosa and Urtica diocia both decrease the production of TNF-alpha. At present there are no human studies on Ocimum spp. in rheumatic diseases. The fixed oil appears to have antihistaminic, antiserotonin, and antiprostaglandin activity. Zingiber officinale inhibits TNF-alpha, prostaglandin, and leukotriene synthesis and at present has limited efficacy in the treatment of osteoarthritis. CONCLUSIONS Investigation of the mechanism and potential uses of CAM therapies is still in its infancy and many studies done to date are scientifically flawed. Further systematic and scientific inquiry into this topic is necessary to validate or refute the clinical claims made for CAM therapies. An understanding of the mechanism of action of CAM therapies allows physicians to counsel effectively on their proper and improper use, prevent adverse drug-drug interactions, and anticipate or appreciate toxicities. RELEVANCE The use of CAM therapies is widespread among patients, including those with rheumatic diseases. Herbal medications are often utilized with little to no physician guidance or knowledge. An appreciation of this information will help physicians to counsel patients concerning the utility and toxicities of CAM therapies. An understanding and elucidation of the mechanisms by which CAM therapies may be efficacious can be instrumental in discovering new molecular targets in the treatment of diseases.
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Affiliation(s)
- Arathi R Setty
- Massachusetts General Hospital, Department of Rheumatology, Boston, USA
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Buck AC. Is there a scientific basis for the therapeutic effects of serenoa repens in benign prostatic hyperplasia? Mechanisms of action. J Urol 2005; 172:1792-9. [PMID: 15540722 DOI: 10.1097/01.ju.0000140503.11467.8e] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The huge resurgence of interest in herbal remedies has spawned a global industry that now competes with conventional drugs as adjuncts and/or alternatives for various conditions. The medical treatment of benign prostatic hyperplasia (BPH) is no exception. Along with alpha-blockers and 5alpha-reductase inhibitors the extract of the American dwarf palm, Serenoa repens, is unquestionably the most widely used. Together with Pygeum africanum, an extract from the bark of the African plum tree, it is licensed in Germany, France and other European countries for symptomatic BPH. This review was done to analyze the large number of in vivo and in vitro laboratory studies that have been performed with extracts of Serenoa repens to elucidate mechanism(s) of action. MATERIALS AND METHODS A literature search (MEDLINE) revealed more than 30 publications relating to laboratory studies with extracts of Serenoa repens, addressing the question of a mechanism of action. It would appear that the n-hexane lipidosterolic extract of Serenoa repens, namely Permixon (Pierre Fabre Medicament, Boulogne, France), is a product that has uniquely been subjected to more scientific investigation than any other such preparation. RESULTS Placebo controlled and comparative clinical studies of Permixon indicate its efficacy for BPH/lower urinary tract symptoms. Numerous mechanisms of action have been proposed, including an antiandrogenic action, an anti-inflammatory effect and an antiproliferative influence through the inhibition of growth factors. CONCLUSIONS Set against the background of our current knowledge of the pathophysiology of the aging prostate, the results of these studies suggest a wide spectrum of activity. However, precise mechanism(s) of action remain obscure. Balance and caution are needed when extrapolating the results of in vitro laboratory studies to the complex human situation.
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Affiliation(s)
- A C Buck
- Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom.
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Abstract
PURPOSE OF REVIEW Benign prostatic hyperplasia is the most common human neoplasm and it is the most frequent tumour requiring surgical treatment in men. Not surprisingly, interest centres on either understanding of prostatic growth during ageing or on various medical or interventional treatments. RECENT FINDINGS Recent publications describe the interaction of various 5alpha-reductase inhibitors on the two 5alpha-reductase isoforms type 1 and 2, giving a potential new insight into the pathogenesis of benign prostatic hyperplasia. Likewise, chronic inflammation increases growth patterns of fibromuscular tissue in benign prostatic hyperplasia similar to wound healing, and a paracrine loop for chronic inflammation with overexpression of interleukin could be identified. This could be of particular importance in the further understanding of prostatic enlargement. Herbal drug treatment for lower urinary tract symptoms seems to be more effective than previously thought. According to recent publications the effectiveness is well beyond placebo effects. Likewise, alpha-blockers play an important role in treatment of lower urinary tract symptoms with alpha-1 adrenoreceptor antagonists preventing cell proliferation and apoptotic imbalances in prostatic tissue. The effect of alpha-blockers, however, may be limited by severe bladder outlet obstruction with patients at increased risk of treatment failure. Laser prostatectomy and microwave thermotherapy are under consideration as alternative treatments of benign prostatic hyperplasia. The efficacy of urodynamically proven de-obstruction as compared with transurethral resection of the prostate needs to be evaluated. Newer alternative treatments like ethanol installation or bipolar plasma kinetic vaporization have been described, but long-term results and larger patients cohort are still lacking. SUMMARY New insights into prostatic growth and pathogenesis of benign prostatic hyperplasia are presented. Medical treatment and interventional therapies are evaluated for their safety and efficacy. Only a few new therapeutical options, however, have been published during this review period.
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Affiliation(s)
- H Christoph Klingler
- Department of Urology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
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