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Zhou H, Hou T, Shen A, Yu W, Zhou L, Yuan W, Wang W, Yao Y, Wang J, Liu Y, Liang X. Elucidation of active components and target mechanism in Jinqiancao granules for the treatment of prostatitis and benign prostatic hyperplasia. JOURNAL OF ETHNOPHARMACOLOGY 2024; 328:118068. [PMID: 38513777 DOI: 10.1016/j.jep.2024.118068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/05/2024] [Accepted: 03/15/2024] [Indexed: 03/23/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Prostatitis and benign prostatic hyperplasia (BPH) are inflammations of the prostate gland, which surrounds the urethra in males. Jinqiancao granules are a traditional Chinese medicine used to treat kidney stones and this medicine consists of four herbs: Desmodium styracifolium (Osbeck) Merr., Pyrrosia calvata (Baker) Ching, Plantago asiatica L. and stigma of Zea mays L. AIM OF THE STUDY We hypothesized that Jinqiancao granules could be a potential therapy for prostatitis and BPH, and this work aimed to elucidate active compounds in Jinqiancao granules and their target mechanisms for the potential treatment of the two diseases. MATERIALS AND METHODS Jinqiancao granules were commercially available and purchased. Database-driven data mining and networking were utilized to establish a general correlation between Jinqiancao granules and the two diseases above. Ultra-performance liquid chromatography-mass spectrometry was used for compound separation and characterization. The characterized compounds were evaluated on four G-protein coupled receptors (GPCRs: GPR35, muscarinic acetylcholine receptor M3, alpha-1A adrenergic receptor α1A and cannabinoid receptor CB2). A dynamic mass redistribution technique was applied to evaluate compounds on four GPCRs. Nitric acid (NO) inhibition was tested on the macrophage cell line RAW264.7. Molecular docking was conducted on GPR35-active compounds and GPR35 crystal structure. Statistical analysis using GEO datasets was conducted. RESULTS Seventy compounds were isolated and twelve showed GPCR activity. Three compounds showed potent GPR35 agonistic activity (EC50 < 10 μM) and the GPR35 agonism action of PAL-21 (Scutellarein) was reported for the first time. Docking results revealed that the GPR35-targeting compounds interacted at the key residues for the agonist-initiated activation of GPR35. Five compounds showed weak antagonistic activity on M3, which was confirmed to be a disease target by statistical analysis. Seventeen compounds showed NO inhibitory activity. Several compounds showed multi-target properties. An experiment-based network reflected a pharmacological relationship between Jinqiancao granules and the two diseases. CONCLUSIONS This study identified active compounds in Jinqiancao granules that have synergistic mechanisms, contributing to anti-inflammatory effects. The findings provide scientific evidence for the potential use of Jinqiancao granules as a treatment for prostatitis and BPH.
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Affiliation(s)
- Han Zhou
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, 116023, Liaoning, China; Jiangxi Provincial Key Laboratory for Pharmacodynamic Material Basis of Traditional Chinese Medicine, Ganjiang Chinese Medicine Innovation Center, Nanchang, 330000, Jiangxi, China
| | - Tao Hou
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, 116023, Liaoning, China; Jiangxi Provincial Key Laboratory for Pharmacodynamic Material Basis of Traditional Chinese Medicine, Ganjiang Chinese Medicine Innovation Center, Nanchang, 330000, Jiangxi, China
| | - Aijin Shen
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, 116023, Liaoning, China; Jiangxi Provincial Key Laboratory for Pharmacodynamic Material Basis of Traditional Chinese Medicine, Ganjiang Chinese Medicine Innovation Center, Nanchang, 330000, Jiangxi, China
| | - Wenyi Yu
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, 116023, Liaoning, China; Jiangxi Provincial Key Laboratory for Pharmacodynamic Material Basis of Traditional Chinese Medicine, Ganjiang Chinese Medicine Innovation Center, Nanchang, 330000, Jiangxi, China
| | - Liangliang Zhou
- Jiangxi Provincial Key Laboratory for Pharmacodynamic Material Basis of Traditional Chinese Medicine, Ganjiang Chinese Medicine Innovation Center, Nanchang, 330000, Jiangxi, China
| | - Wenjie Yuan
- Jiangxi Provincial Key Laboratory for Pharmacodynamic Material Basis of Traditional Chinese Medicine, Ganjiang Chinese Medicine Innovation Center, Nanchang, 330000, Jiangxi, China
| | - Wanxian Wang
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, 116023, Liaoning, China
| | - Yumin Yao
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, 116023, Liaoning, China
| | - Jixia Wang
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, 116023, Liaoning, China; Jiangxi Provincial Key Laboratory for Pharmacodynamic Material Basis of Traditional Chinese Medicine, Ganjiang Chinese Medicine Innovation Center, Nanchang, 330000, Jiangxi, China.
| | - Yanfang Liu
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, 116023, Liaoning, China; Jiangxi Provincial Key Laboratory for Pharmacodynamic Material Basis of Traditional Chinese Medicine, Ganjiang Chinese Medicine Innovation Center, Nanchang, 330000, Jiangxi, China.
| | - Xinmiao Liang
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, 116023, Liaoning, China; Jiangxi Provincial Key Laboratory for Pharmacodynamic Material Basis of Traditional Chinese Medicine, Ganjiang Chinese Medicine Innovation Center, Nanchang, 330000, Jiangxi, China
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Shimizu S. Insights into the associative role of hypertension and angiotensin II receptor in lower urinary tract dysfunction. Hypertens Res 2024; 47:987-997. [PMID: 38351189 DOI: 10.1038/s41440-024-01597-8] [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] [Received: 10/18/2023] [Revised: 01/05/2024] [Accepted: 01/13/2024] [Indexed: 02/16/2024]
Abstract
In men, the lower urinary tract comprises the urinary bladder, urethra, and prostate, and its primary functions include urine storage and voiding. Hypertension is a condition that causes multi-organ damage and an age-dependent condition. Hypertension and the renin-angiotensin system activation are associated with the development of lower urinary tract dysfunction. Hypertensive animal models show bladder dysfunction, urethral dysfunction, and prostatic hyperplasia. In the renin-angiotensin system, angiotensin II and the angiotensin II type 1 receptor, which are expressed in the lower urinary tract, have been implicated in the pathogenesis of lower urinary tract dysfunction. Moreover, among the several antihypertensives, renin-angiotensin system inhibitors have proven effective in human and animal models of lower urinary tract dysfunction. This review aimed to elucidate the hitherto known mechanisms underlying the development of lower urinary tract dysfunction in relation to hypertension and the angiotensin II/angiotensin II type 1 receptor axis and the effect of renin-angiotensin system inhibitors on lower urinary tract dysfunction. Possible mechanisms through which hypertension or activation of Ang II/AT1 receptor axis causes LUTD such as bladder dysfunction, urethral dysfunction, and prostatic hyperplasia. LUT: lower urinary tract, LUTD: lower urinary tract dysfunction, AT1: angiotensin II type 1, ACE: angiotensin-converting enzyme.
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Affiliation(s)
- Shogo Shimizu
- Department of Pharmacology, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku, 783-8505, Japan.
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Suzuki Y, Kaneko H, Okada A, Fujiu K, Jo T, Takeda N, Tanaka A, Node K, Morita H, Yasunaga H, Komuro I. Benign Prostatic Hyperplasia and Incident Cardiovascular Disease. Circ J 2024; 88:408-416. [PMID: 38246651 DOI: 10.1253/circj.cj-23-0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Data regarding the relationship between benign prostatic hyperplasia (BPH) and incident cardiovascular disease (CVD) are scarce. We aimed to clarify the association of BPH with the risk of developing CVD using a nationwide epidemiological database.Methods and Results: This retrospective observational cohort study analyzed data from the JMDC Claims Database between 2005 and 2022, including 2,370,986 men (median age 44 years). The primary endpoints were myocardial infarction (MI), angina pectoris (AP), stroke, heart failure (HF), and atrial fibrillation (AF), which were assessed separately. BPH was observed in 48,651 (2.1%) men. During a mean (±SD) follow-up of 1,359±1,020 days, 7,638 MI, 52,167 AP, 25,355 stroke, 58,183 HF, and 16,693 AF events were detected. Hazard ratios of BPH for MI, AP, stroke, HF, and AF were 1.04 (95% confidence interval [CI] 0.92-1.18), 1.31 (95% CI 1.25-1.37), 1.26 (95% CI 1.18-1.33), 1.21 (95% CI 1.16-1.27), and 1.15 (95% CI 1.07-1.24), respectively. We confirmed the robustness of our primary findings through a multitude of sensitivity analyses. In particular, a history of BPH was associated with a higher risk of developing CVD, even in participants without obesity, hypertension, diabetes, or dyslipidemia. CONCLUSIONS Our analysis of a nationwide epidemiological dataset demonstrated that BPH was associated with a greater risk of developing CVD in middle-aged men.
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Affiliation(s)
- Yuta Suzuki
- Department of Cardiovascular Medicine, The University of Tokyo
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Advanced Cardiology, The University of Tokyo
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Advanced Cardiology, The University of Tokyo
| | - Taisuke Jo
- Department of Health Services Research, The University of Tokyo
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, The University of Tokyo
| | | | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo
- International University of Health and Welfare
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Halder P, Bhandari Y, Das A, Mamgai A. Association of Benign Prostatic Hyperplasia With Multimorbidity Among Older Adults: Insights From the Longitudinal Ageing Study in India (LASI), First Wave. Cureus 2023; 15:e50608. [PMID: 38226079 PMCID: PMC10788596 DOI: 10.7759/cureus.50608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/17/2024] Open
Abstract
Introduction Population ageing is expected to be accompanied by an increase in multi-morbidity, i.e. the co-occurrence of multiple chronic conditions simultaneously. Benign prostatic hyperplasia (BPH) is a non-malignant disease prevalent in ageing men. Both BPH and multi-morbidity are known to have a significant impact on quality of life. The objective of this study was to determine the association between BPH and multimorbidity among older adults and the elderly population in India. Methods This is an analytical cross-sectional study involving secondary data from the nationally representative Longitudinal Ageing Study in India (LASI) Wave I 2017-18. Multivariable logistic regression analysis was conducted to study the association between BPH and multimorbidity while accounting for other associated factors. Results Compared to those having no co-morbidities, the odds of having BPH increased with the increasing number of co-morbidities. Those with at least two co-morbidities were twice as likely (aOR=2.19; 95%CI 1.78-2.72), and those with at least four co-morbidities were almost six times as likely (aOR=5.78; 95%CI 2-16.72) to have BPH as compared to those with no co-morbidities. The association was stronger among males >60 years. Conclusion Self-reported benign prostatic hyperplasia was found to be strongly associated with multi-morbidity. The need of the hour is the inclusion of BPH within the framework of a national health programme. Health technology assessment of high-risk screening strategies for BPH may be conducted among patients with multimorbidity. Research into the impact on the quality of life of those affected by both BPH and multimorbidity will help highlight this as a priority problem for decision-makers.
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Affiliation(s)
- Pritam Halder
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Yukti Bhandari
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Aritrik Das
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Anshul Mamgai
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
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Müderrisoglu AE, Sakul AA, Murgas S, de la Rosette JJMCH, Michel MC. Association of diabetes, hypertension, and their combination with basal symptoms and treatment responses in overactive bladder patients. Front Pharmacol 2023; 14:1144470. [PMID: 37063295 PMCID: PMC10097919 DOI: 10.3389/fphar.2023.1144470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/17/2023] [Indexed: 04/01/2023] Open
Abstract
Introduction: Pelvic hypoperfusion caused by atherosclerosis has been proposed as a cause of lower urinary tract dysfunction including overactive bladder syndrome (OAB). Limited data indicate that OAB patients with concomitant diabetes or hypertension, known risk factors of atherosclerosis, may exhibit greater baseline OAB symptoms and slightly smaller therapeutic responses to treatment, but the impact of a combined presence of diabetes and hypertension has not been reported. Therefore, we have explored whether the combined presence of both comorbidities is associated with greater baseline OAB symptoms than that of either comorbidity alone. Secondary questions were exploration of the impact of either comorbidity on baseline symptoms, and of the impact of either comorbidity alone and their combination on therapeutic responses.Methods: Data from two non-interventional studies applying treatment with propiverine ER 30 or 45 mg/d for 12 weeks were analyzed.Results: Number of urgency episodes in the combination group was greater than with each comorbidity alone. The impact of comorbidities on baseline intensity of incontinence, frequency or nocturia or Patient Perception of Bladder Condition was less consistent or absent. Either comorbidity alone was associated with a smaller % improvement of symptoms, and their combination had a greater effect than either alone. However, all attenuations associated with comorbidity were small relative to the overall improvement. Conclusions: We conclude that comorbidities of diabetes and hypertension have detectable effects on OAB symptoms and treatment responses, but the small magnitude of these alterations does not justify changing existing paradigms for the clinical management of OAB.
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Affiliation(s)
- A. Elif Müderrisoglu
- Department of Medical Pharmacology, Istanbul Medipol University, Istanbul, Türkiye
| | - Ayse A. Sakul
- Department of Medical Pharmacology, Istanbul Medipol University, Istanbul, Türkiye
| | | | | | - Martin C. Michel
- Department of Pharmacology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
- *Correspondence: Martin C. Michel,
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Onigbinde SO, Asaleye CM, Salako AA, Idowu BM, Onigbinde AO, Laoye A. The effect of systemic hypertension on prostatic artery resistive indices in patients with benign prostate enlargement. Prostate Int 2023; 11:46-50. [PMID: 36910898 PMCID: PMC9995693 DOI: 10.1016/j.prnil.2022.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 10/14/2022] Open
Abstract
Background To investigate the effect of systemic hypertension on the prostatic artery resistive indices by a comparative ultrasonographic evaluation of the prostate gland in normotensive and hypertensive patients with benign prostatic enlargement (BPE). Materials and methods The participants had BPE and presented at the outpatient urologic clinic of a tertiary hospital. They were divided into normotensive and hypertensive groups. Each group had fifty patients. Calculation of international prostate symptom score, measurement of blood pressure, and transrectal ultrasonographic evaluation were done. Results The mean age for the normotensive and hypertensive groups were 66.9 ± 9.8 and 66.0 ± 10.7 years, respectively (P = 0.662). Patients with hypertensive BPE had a significantly higher mean transitional zone volume, transitional zone index, presumed circle area ratio, quality of life score, and prostatic arterial resistive indices than the age-matched normotensive BPE patients. Conclusion Patients with BPE and with hypertension had significantly higher prostate arteries resistive indices than normotensives with BPE. Even in patients with BPE and controlled hypertension, the prostatic artery resistance indices were still elevated than that of normotensive men with BPE.
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Affiliation(s)
- Stephen O Onigbinde
- Department of Anatomical Sciences, School of Medicine, St George's University, Grenada
| | - Christianah M Asaleye
- Department of Radiology, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Abdulkadir A Salako
- Department of Surgery, Obafemi Awolowo University and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Bukunmi M Idowu
- Department of Radiology, Union Diagnostics and Clinical Services Plc, Yaba, Lagos, Nigeria
| | - Abimbola O Onigbinde
- Department of Physiology, Neurology and Behavioral Sciences, School of Medicine, St George's University, Grenada
| | - Adeyinka Laoye
- Urology Department, Doncaster and Bassetlaw Teaching Hospitals NHS Found, South Yorkshire, United Kingdom
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Michel MC, Heemann U, de la Rosette JJMCH. Weak association between arterial hypertension and overactive bladder baseline symptoms and treatment responses. Front Pharmacol 2022; 13:1081074. [PMID: 36582525 PMCID: PMC9792767 DOI: 10.3389/fphar.2022.1081074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
While animal studies have suggested an association between the presence of hypertension and the presence and/or severity of overactive bladder syndrome (OAB) symptoms, little clinical data is available. We have conducted a pre-specified secondary analysis of a non-interventional study involving 4450 OAB patients being treated with solifenacin to explore the existence of an association between OAB and hypertension using three parallel and overlapping definitions of hypertension to enhance robustness of analysis. Regardless of definition, patients with hypertension were older and had greater OAB symptom severity in univariate analyses. In multiple regression models including age as explanatory covariate, most relationships held up but effect sizes of concomitant hypertension on OAB severity were small (odds ratios <1.35 in all cases) and were deemed to be unlikely of clinical relevance. % Changes in symptom severity were somewhat smaller in univariate analysis, but effect sizes were small. We conclude that OAB and arterial hypertension are associated but effect sizes are too small to justify adaptation of clinical practice for OAB patients with concomitant hypertension.
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Affiliation(s)
- Martin C. Michel
- Department of Pharmacology, Johannes Gutenberg University, Mainz, Germany,*Correspondence: Martin C. Michel,
| | - Uwe Heemann
- Department of Medicine, University Medical Center, Munich, Germany
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Elama HS, Shalan SM, El-Shabrawy Y, Eid MI, Zeid AM. A synchronous spectrofluorometric technique for simultaneous detection of alfuzosin and tadalafil: applied to tablets and spiked biological samples. ROYAL SOCIETY OPEN SCIENCE 2022. [PMID: 35845851 DOI: 10.5061/dryad.7m0cfxpwq] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A facile, accurate, eco-friendly and sensitive spectrofluorometric method was evolved to assay alfuzosin hydrochloride (AFH) and tadalafil (TDF) in different matrices. Such a co-administered combination is clinically used for the treatment of lower urinary tract symptoms. Both compounds are characterized by their native fluorescence spectra upon excitation at specific wavelengths. Their characteristic fluorescence spectra were used for sensitive assay of the studied analytes in tablets and human biological samples. The assay principle is based on first-order synchronous spectrofluorometric scan using Δλ = 60 nm in which AFH peaks were recorded at 366 nm. Meanwhile, TDF measurements were recorded at 293 nm in the same scans without overlap with AFH spectra. Recent analytical chemistry trends were implemented to lessen occupational and environmental perils, using ethanol as a diluting solvent for method optimization and application. Linearity ranges were 5.0-90.0 and 10.0-100.0 ng ml-1 for AFH and TDF, respectively in their raw materials with average % recoveries of 100.44% and 99.73% in raw materials, 100.15% and 100.20% in spiked plasma, and 97.14% and 99.99% in spiked urine. The proposed method was successfully applied to Prostetrol and Starkoprex commercial tablets with no interference with common tablet additives.
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Affiliation(s)
- Heba Samir Elama
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Shereen M Shalan
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Yasser El-Shabrawy
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Manal I Eid
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Abdallah M Zeid
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
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Elama HS, shalan SM, El-Shabrawy Y, Eid MI, Zeid AM. A synchronous spectrofluorometric technique for simultaneous detection of alfuzosin and tadalafil: applied to tablets and spiked biological samples. ROYAL SOCIETY OPEN SCIENCE 2022; 9:220330. [PMID: 35845851 PMCID: PMC9277242 DOI: 10.1098/rsos.220330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/14/2022] [Indexed: 05/06/2023]
Abstract
A facile, accurate, eco-friendly and sensitive spectrofluorometric method was evolved to assay alfuzosin hydrochloride (AFH) and tadalafil (TDF) in different matrices. Such a co-administered combination is clinically used for the treatment of lower urinary tract symptoms. Both compounds are characterized by their native fluorescence spectra upon excitation at specific wavelengths. Their characteristic fluorescence spectra were used for sensitive assay of the studied analytes in tablets and human biological samples. The assay principle is based on first-order synchronous spectrofluorometric scan using Δλ = 60 nm in which AFH peaks were recorded at 366 nm. Meanwhile, TDF measurements were recorded at 293 nm in the same scans without overlap with AFH spectra. Recent analytical chemistry trends were implemented to lessen occupational and environmental perils, using ethanol as a diluting solvent for method optimization and application. Linearity ranges were 5.0-90.0 and 10.0-100.0 ng ml-1 for AFH and TDF, respectively in their raw materials with average % recoveries of 100.44% and 99.73% in raw materials, 100.15% and 100.20% in spiked plasma, and 97.14% and 99.99% in spiked urine. The proposed method was successfully applied to Prostetrol and Starkoprex commercial tablets with no interference with common tablet additives.
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Affiliation(s)
- Heba Samir Elama
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Shereen M. shalan
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Yasser El-Shabrawy
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Manal I. Eid
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Abdallah M. Zeid
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
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Correia RR, Batista VRG, Veras ASC, Tavares MEDA, Souza FLA, Pacagnelli FL, Campos DHS, Giometti IC, Teixeira GR. High-intensity interval training attenuates the effects caused by arterial hypertension in the ventral prostate. Prostate 2022; 82:373-387. [PMID: 34905633 DOI: 10.1002/pros.24285] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/01/2021] [Accepted: 12/03/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The prostatic effects induced by arterial hypertension is very controversial and its mechanism is unclear. High-intensity interval training (HIIT) is an exercise considered to be hypotensive. The objective of this work was to investigate the molecular, biochemical, and morphological effects of 8 weeks of HIIT in the prostatic tissue of spontaneously hypertensive rats (SHR). METHODS Twenty male SHR rats, 51.4 weeks old, were used. The SHR animals were divided into two groups: spontaneously sedentary hypertensive and spontaneously hypertensive submitted to HIIT. We analyze androgens receptor and glucocorticoid receptors in the prostate. Still, we verify effects of the hypertension and HIIT on the physiopathology prostatic, for immunohistochemistry investigated BCL-2, BAX, IGF-1, FAS/CD95, data's inflammatory tumour necrosis factor α, nuclear factor kappa B and interleukin (IL)-6, anti-inflammatory IL-10. The echocardiographic evaluation was performed at the baseline and after the training period. RESULTS Arterial hypertension promote high prostatic intraepithelial neoplasia incidence in the prostate, increases IGF-1, BCL-2 (p < 0.05), and inflammatory proteins (p < 0.05). Eight weeks of HIIT training reduced the arterial pressure and increase the concentration of tissue collagen and intracellular glycogen and showed a higher expression of BAX, FAS/CD95, and IL-10 proteins (p < 0.05), coinciding with a lower incidence of lesions and lower prostate weight (p < 0.05) and reduction of the BCL-2 and IGF-1. CONCLUSION Our data suggested that arterial hypertension suppressed apoptosis and increased damage prostatic. On other hand, HIIT promotes morphology and function improves in the prostatic environment, inhibited inflammation, and increased apoptosis.
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Affiliation(s)
- Rafael Ribeiro Correia
- Department of Physical Education, Experimental Laboratory of Exercise Biology (LEBioEx), School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, São Paulo, Brazil
| | - Victor Rogério Garcia Batista
- Department of Physical Education, Experimental Laboratory of Exercise Biology (LEBioEx), School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, São Paulo, Brazil
| | - Allice Santos Cruz Veras
- Department of Physical Education, Experimental Laboratory of Exercise Biology (LEBioEx), School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, São Paulo, Brazil
- Multicentric Program of Postgraduate in Physiological Sciences, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Maria Eduarda de Almeida Tavares
- Department of Physical Education, Experimental Laboratory of Exercise Biology (LEBioEx), School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, São Paulo, Brazil
- Multicentric Program of Postgraduate in Physiological Sciences, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | | | - Francis Lopes Pacagnelli
- Postgraduate Animal Science Program, University of Western São Paulo (UNOESTE), Presidente Prudente, São Paulo, Brazil
| | - Dijon Henrique Salomé Campos
- Department of Clinical Medicine, Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, Brazil
| | - Ines Cristina Giometti
- Department of Reproduction, Faculty of Agricultural Sciences, University of Western São Paulo (UNOESTE), Presidente Prudente, São Paulo, Brazil
| | - Giovana Rampazzo Teixeira
- Department of Physical Education, Experimental Laboratory of Exercise Biology (LEBioEx), School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, São Paulo, Brazil
- Multicentric Program of Postgraduate in Physiological Sciences, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
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Akbar A, Liu K, Michos ED, Bancks MP, Brubaker L, Markossian T, Durazo-Arvizu R, Kramer H. Association of Overactive Bladder With Hypertension and Blood Pressure Control: The Multi-Ethnic Study of Atherosclerosis (MESA). Am J Hypertens 2022; 35:22-30. [PMID: 33899909 DOI: 10.1093/ajh/hpaa186] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/20/2020] [Accepted: 04/06/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The sudden urge to urinate, also known as overactive bladder (OAB), may reflect higher sympathetic activity and associate with higher blood pressure (BP). METHODS This cross-sectional analysis utilized data from sixth follow-up exam (2015-2016) of Multi-Ethnic Study of Atherosclerosis to examine the association of OAB with systolic (SBP) and diastolic blood pressure (DBP) levels, hypertension, and BP control. Information on urinary symptoms was obtained with the International Consultation on Incontinence Questionnaire (ICIQ). Sex-stratified regression models were constructed to examine differences in BP, hypertension prevalence, and BP control while adjusting for demographic factors, comorbidities, and medication use. RESULTS Among the 1,446 men and 1,628 women who completed the ICIQ (mean age 73.7 years [SD 8.4]), OAB was present in 31.6% of men and 38.9% of women. With no antihypertensive medication use, OAB was not associated with SBP or DBP in both men and women after adjusting for covariates. However, among the 894 men and 981 women on antihypertensive medication, OAB was associated with higher SBP among men (4.04 mm Hg; 95% confidence interval [CI] 1.02, 7.06) but not among women (-0.67 mm Hg; 95% CI -3.79, 2.46) while DBP did not differ by OAB presence in men or women. In addition, OAB was also associated with lower odds of BP control among men (odds ratio [OR] 0.69; 95% CI 0.49, 0.96) but not women (OR 0.96; 95% CI 0.71, 1.30). CONCLUSIONS Among men, OAB is associated with lower odds of BP control which suggests that OAB may impede hypertension management.
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Affiliation(s)
- Aelia Akbar
- Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois, USA
| | - Kiang Liu
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael P Bancks
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Linda Brubaker
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, California, USA
| | - Talar Markossian
- Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois, USA
| | - Ramon Durazo-Arvizu
- Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois, USA
| | - Holly Kramer
- Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois, USA
- Department of Medicine, Loyola University Chicago, Maywood, Illinois, USA
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Oxidative Stress Links Aging-Associated Cardiovascular Diseases and Prostatic Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:5896136. [PMID: 34336107 PMCID: PMC8313344 DOI: 10.1155/2021/5896136] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/17/2021] [Accepted: 07/03/2021] [Indexed: 11/29/2022]
Abstract
The incidence of chronic aging-associated diseases, especially cardiovascular and prostatic diseases, is increasing with the aging of society. Evidence indicates that cardiovascular diseases usually coexist with prostatic diseases or increase its risk, while the pathological mechanisms of these diseases are unknown. Oxidative stress plays an important role in the development of both cardiovascular and prostatic diseases. The levels of oxidative stress biomarkers are higher in patients with cardiovascular diseases, and these also contribute to the development of prostatic diseases, suggesting cardiovascular diseases may increase the risk of prostatic diseases via oxidative stress. This review summarizes the role of oxidative stress in cardiovascular and prostatic diseases and also focuses on the main shared pathways underlying these diseases, in order to provide potential prevention and treatment targets.
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Kabeshova A, Yu Y, Lukacs B, Bacry E, Gaïffas S. ZiMM: A deep learning model for long term and blurry relapses with non-clinical claims data. J Biomed Inform 2020; 110:103531. [PMID: 32818667 DOI: 10.1016/j.jbi.2020.103531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/25/2020] [Accepted: 08/09/2020] [Indexed: 11/28/2022]
Abstract
This paper considers the problems of modeling and predicting a long-term and "blurry" relapse that occurs after a medical act, such as a surgery. We do not consider a short-term complication related to the act itself, but a long-term relapse that clinicians cannot explain easily, since it depends on unknown sets or sequences of past events that occurred before the act. The relapse is observed only indirectly, in a "blurry" fashion, through longitudinal prescriptions of drugs over a long period of time after the medical act. We introduce a new model, called ZiMM (Zero-inflated Mixture of Multinomial distributions) in order to capture long-term and blurry relapses. On top of it, we build an end-to-end deep-learning architecture called ZiMM Encoder-Decoder (ZiMM ED) that can learn from the complex, irregular, highly heterogeneous and sparse patterns of health events that are observed through a claims-only database. ZiMM ED is applied on a "non-clinical" claims database, that contains only timestamped reimbursement codes for drug purchases, medical procedures and hospital diagnoses, the only available clinical feature being the age of the patient. This setting is more challenging than a setting where bedside clinical signals are available. Our motivation for using such a non-clinical claims database is its exhaustivity population-wise, compared to clinical electronic health records coming from a single or a small set of hospitals. Indeed, we consider a dataset containing the claims of almost all French citizens who had surgery for prostatic problems, with a history between 1.5 and 5 years. We consider a long-term (18 months) relapse (urination problems still occur despite surgery), which is blurry since it is observed only through the reimbursement of a specific set of drugs for urination problems. Our experiments show that ZiMM ED improves several baselines, including non-deep learning and deep-learning approaches, and that it allows working on such a dataset with minimal preprocessing work.
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Affiliation(s)
| | | | | | | | - Stéphane Gaïffas
- LPSM, Université de Paris, France; DMA, Ecole normale supérieure, Paris, France.
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Noh JW, Kim KB, Kwon YD, Kim JH. Association between sodium intake and lower urinary tract symptoms: does less sodium intake have a favorable effect or not? Transl Androl Urol 2020; 9:1135-1145. [PMID: 32676397 PMCID: PMC7354310 DOI: 10.21037/tau-19-808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Sodium intake is known to be related with hypertension (HTN), which could impact lower urinary tracts symptoms (LUTS) indirectly. To date, only limited clinical evidences exist upon the association between sodium preference and LUTS. This cross-sectional study analyzed the association between sodium preference and the severity of LUTS in men. Methods A cross-sectional analysis has been performed and a total of 86,637 participants among total registered population of 229,226 in Korean Community Health Survey (KCHS) were included for final analysis. The adjusted odds ratio (OR) or coefficient with 95% confidence interval (CI) estimates were described to show the association between sodium preference and LUTS using negative binomial regression (for the IPSS total, IPSS voiding, and IPSS storage symptoms), ordinal logistic regression (for the IPSS grade), and binomial logistic regression (for the IPSS nocturia symptoms). Results Preference of salty taste group (high sodium preference) were significantly associated with higher IPSS total score (Coef =0.31; 95% CI: 0.27, 0.35), increased risk of severe IPSS grade (OR =1.46; 95% CI: 1.35, 1.57), higher IPSS voiding score (Coef =0.38; 95% CI: 0.32, 0.44), higher IPSS storage score (Coef =0.25; 95% CI: 0.22, 0.29), and increased risk of having IPSS nocturia symptoms (OR =1.21; 95% CI: 1.16, 1.27) compared to subjects with neutral group (normal sodium preference). Prediction of IPSS score according to salty taste preference showed u shaped distribution. Conclusions Sodium preference for taste were significantly associated with LUTS including voiding symptom, storage symptom and nocturia. Both higher and lower intake of sodium could be unfavorable factor for severity of LUTS.
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Affiliation(s)
- Jin-Won Noh
- Department of Health Administration, Dankook University, Cheonan, Korea
| | - Kyoung-Beom Kim
- Department of Health Administration, Dankook University, Cheonan, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchuhyang University Medical College, Seoul, Korea
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Yoo S, Oh S, Suh J, Park J, Cho MC, Jeong H, Won S, Son H. Optimal high-density lipoprotein cholesterol level for decreasing benign prostatic hyperplasia in men not taking statin medication: A historical cohort study. Prostate 2020; 80:570-576. [PMID: 32196725 DOI: 10.1002/pros.23970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 02/05/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND We evaluated the optimal high-density lipoprotein cholesterol level for benign prostatic hyperplasia (BPH) prevention in men not taking statin medication using a large historical cohort. METHODS We initially selected 130 454 men who underwent health checkups in 2009 from the National Health Information Database of the National Health Insurance Service. After excluding 36 854 men with BPH in 2009, and 45 061 men for statin use, 48 539 men were ultimately included in the analysis. A Kaplan-Meier analysis and multivariable Cox regression analysis was performed to assess the optimal high-density lipoprotein cholesterol level for preventing BPH. RESULTS High-density lipoprotein cholesterol levels were less than 40 mg/dL in 7431 (15.3%) men, 40 to 49 in 15 861 (32.7%), 50 to 59 in 15 328 (27.5%), and greater than or equal to 60 in 11 919 (24.6%). The overall cumulative incidence of BPH was 4.4%, 8.7%, 13.0%, and 17.8% at the 1-, 2-, 3-, and 4-year follow-up periods, respectively. In multivariable analysis, high-density lipoprotein greater than or equal to 60 mg/dL were significantly associated with a decreased incidence of BPH, as were age, residence, income, body mass index, diabetes, hypertension, triglyceride, and increased annual clinic visits, especially in men in their 40s. CONCLUSION Elevated serum high-density lipoprotein cholesterol levels were negatively associated with BPH incidence. In addition, maintaining high-density lipoprotein greater than or equal to 60 mg/dL was associated with a decreased BPH incidence compared with high-density lipoprotein less than 40 mg/dL, especially in men in their 40s.
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Affiliation(s)
- Sangjun Yoo
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jungyo Suh
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Juhyun Park
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Min Chul Cho
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Hyeon Jeong
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Sungho Won
- Department of Public Health Science, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Hwancheol Son
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea
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Güven EO, Selvi I, Karaismailoğlu E. Association between benign prostate enlargement-related storage and voiding symptoms and systolic blood pressure: a single-center cross-sectional study. SAO PAULO MED J 2019; 137:446-453. [PMID: 31939570 PMCID: PMC9745816 DOI: 10.1590/1516-3180.2018.0543.r3.160919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/16/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Lower urinary tract symptoms significantly worsen quality of life. The hypothesis that they might lead to serious systolic blood pressure alterations through inducing sympathetic nervous activity has not been studied so far. OBJECTIVES To investigate the relationship between benign prostate enlargement-related storage and voiding symptoms and systolic blood pressure. DESIGN AND SETTING Cross-sectional single-center study on data from a hospital patient record system. METHODS We evaluated the medical records of all consecutive patients with benign prostate enlargement-related lower urinary tract symptoms admitted between January 2012 and December 2017. Storage and voiding symptoms were assessed separately. International Prostate Symptom Score, uroflowmetry, postvoiding residual urine volume and systolic blood pressure were recorded. Pearson correlation and linear regression analysis were used. RESULTS Positive correlations were found between systolic blood pressure and all of the storage symptoms. Among these, urgency had the most significant effect. There were 166 patients (41.4%) with urgency for urination, which increased mean systolic blood pressure from 124.88 mmHg (average value in elevated blood pressure group) to 132.28 mmHg (average value in stage-1 hypertension group). Hesitancy in urinating and feeling of incomplete bladder emptying had weak positive correlations with systolic blood pressure. There was a negative correlation between systolic blood pressure and intermittency of urination. CONCLUSIONS With increasing numbers of urine storage symptoms, systolic blood pressure also increases, while the opposite occurs for voiding symptoms in patients with benign prostate enlargement. We conjecture that storage symptoms may lead to this increase through inducing sympathetic hyperactivity. Further prospective studies with larger groups are needed to confirm these findings.
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Affiliation(s)
- Eşref Oğuz Güven
- MD. Associate Professor, Department of Urology, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | - Ismail Selvi
- MD. Urologist, Department of Urology, Karabük Üniversitesi Eğitim ve Araştırma Hastanesi, Karabük, Turkey.
| | - Eda Karaismailoğlu
- PhD. Research Assistant, Department of Biostatistics, Kastamonu Üniversitesi Tıp Fakültesi, Kastamonu, Turkey.
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Yue L, Wang T, Ge Y, Ge M, Zhang C, Hou Q, Wang W, Tian H, Ren B, Du B, Zhang W. Prevalence and heritability of benign prostatic hyperplasia and LUTS in men aged 40 years or older in Zhengzhou rural areas. Prostate 2019; 79:312-319. [PMID: 30450670 DOI: 10.1002/pros.23737] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 10/19/2018] [Indexed: 11/05/2022]
Abstract
BACKGROUND Benign prostate hyperplasia (BPH) is the most common disease among aging males, but no reports have addressed the prevalence of BPH in Zhengzhou. Therefore, we aimed to understand the prevalence of BPH in men aged 40 years or older in Zhengzhou's rural areas through a cross-sectional study and analyzed the correlation with epidemiologic factors and the heritability of the disease. MATERIALS AND METHODS A multistage sampling method was used to randomly select male respondents in Zhengzhou's rural areas. Men who were 40 years of age or older and their first-degree relatives were subjected to the International Prostate Symptom Score (IPSS) and related examinations. Heritability was calculated according to the prevalence of the first-degree relatives in the case and control groups. RESULTS The prevalence of BPH was 10.04%. Its prevalence increased with age, from 2.17% in men aged 40-44 years to 31.11% in men aged 80 years or older. The average volume of the prostate was 17.16 ± 7.96 mL, and the average IPSS was 5.89 ± 5.91. The analysis of the correlation between the associated risk factors and BPH revealed that prostatitis and a history of prostatic hyperplasia were significant factors. Obesity, smoking, drinking, diabetes, and hypertension were not correlated with BPH. Of the 94 first-degree relatives of the cases, 53 had BPH (56.38%); of the 106 first-degree relatives of the controls, five had BPH (4.72%). Heritability appeared to account for 40.48% of BPH cases. The heritability of incomplete emptying, frequency, intermittency, urgency, weak stream, straining, and nocturia was 43.28, 71.37, 9.67, 5.67, 2.70, 53.36, and 19.12%, respectively. CONCLUSION The total prevalence of BPH in men aged 40 years or older in Zhengzhou's rural areas was 10.04%, and the heritability of prostatic hyperplasia was 40.48%.
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Affiliation(s)
- Limin Yue
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Tao Wang
- Department of General Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yongchao Ge
- Department of Urology, Zhengzhou Third People's Hospital, Zhengzhou, Henan, China
| | - Mengying Ge
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Chengda Zhang
- Department of International Medicine, Beaumont Health System, Royal Oak, Michigan
| | - Quanliang Hou
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wenhua Wang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Huizi Tian
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Bingnan Ren
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Binghui Du
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Weidong Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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Synthesis and Pharmacological Evaluation of Novel Silodosin-Based Arylsulfonamide Derivatives as α 1A/α 1D-Adrenergic Receptor Antagonist with Potential Uroselective Profile. Molecules 2018; 23:molecules23092175. [PMID: 30158432 PMCID: PMC6225212 DOI: 10.3390/molecules23092175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/03/2018] [Accepted: 08/13/2018] [Indexed: 11/16/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is the most common male clinical problem impacting the quality of life of older men. Clinical studies have indicated that the inhibition of α1A-/α1D adrenoceptors might offer effective therapy in lower urinary tract symptoms. Herein, a limited series of arylsulfonamide derivatives of (aryloxy)ethyl alicyclic amines was designed, synthesized, and biologically evaluated as potent α1-adrenoceptor antagonists with uroselective profile. Among them, compound 9 (3-chloro-2-fluoro-N-([1-(2-(2-(2,2,2-trifluoroethoxy)phenoxy]ethyl)piperidin-4-yl)methyl)benzenesulfonamide) behaved as an α1A-/α1D-adrenoceptor antagonist (Ki(α1) = 50 nM, EC50(α1A) = 0.8 nM, EC50(α1D) = 1.1 nM), displayed selectivity over α2-adrenoceptors (Ki(α2) = 858 nM), and a 5-fold functional preference over the α1B subtype. Compound 9 showed adequate metabolic stability in rat-liver microsome assay similar to the reference drug tamsulosin (Clint = 67 and 41 µL/min/mg, respectively). Compound 9 did not decrease systolic and diastolic blood pressure in normotensive anesthetized rats in the dose of 2 mg/kg, i.v. These data support development of uroselective agents in the group of arylsulfonamides of alicyclic amines with potential efficacy in the treatment of lower urinary tract symptoms associated to benign prostatic hyperplasia.
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Kopp W. Diet-Induced Hyperinsulinemia as a Key Factor in the Etiology of Both Benign Prostatic Hyperplasia and Essential Hypertension? Nutr Metab Insights 2018; 11:1178638818773072. [PMID: 30455570 PMCID: PMC6238249 DOI: 10.1177/1178638818773072] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 04/04/2018] [Indexed: 01/09/2023] Open
Abstract
Benign prostatic hyperplasia and hypertension are common age-related comorbidities. Although the etiology of benign prostatic hyperplasia (BPH) is still largely unresolved and poorly understood, a significant age-independent association was found between BPH and hypertension, indicating a common pathophysiological factor for both diseases. It has previously been suggested that the development of essential hypertension may be related to diet-induced hyperinsulinemia. This study follows the question, whether BPH may develop due to the same mechanism, thereby explaining the well-known comorbidity of these 2 disorders. The scientific evidence presented shows that BPH and hypertension share the same pathophysiological changes, with hyperinsulinemia as the driving force. It further shows that significant dietary changes during human history cause disruption of a finely tuned metabolic balance that has evolved over millions of years of evolution: high-insulinemic food, typical of current “Western” diets, has the potential to cause hyperinsulinemia and insulin resistance, as well as an abnormally increased activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system, alterations that play a pivotal role in the pathogenesis of BPH and hypertension.
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Affiliation(s)
- Wolfgang Kopp
- Former head of the Diagnostikzentrum Graz, Graz, Austria
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20
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Shih HJ, Huang CJ, Lin JA, Kao MC, Fan YC, Tsai PS. Hyperlipidemia is associated with an increased risk of clinical benign prostatic hyperplasia. Prostate 2018; 78:113-120. [PMID: 29119583 DOI: 10.1002/pros.23451] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/16/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND A high fat diet is associated with risk of benign prostatic hyperplasia (BPH). However, whether hyperlipidemia is associated with BPH remains unclear. This population-based cohort study elucidated whether hyperlipidemia is associated with an increased risk of BPH. METHODS We used a new-exposure design and analyzed data retrieved from the Taiwan National Health Insurance Database between January 1, 2000 and December 31, 2013. The cohort of men with newly diagnosed hyperlipidemia and the age- and index-date-matched (1:3) nonhyperlipidemia cohort were tracked for incidence of BPH during a 1- to 14-year follow-up. Diagnosis of BPH using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, and the occurrence of BPH diagnosis plus the use of alpha-blockers or 5-alpha reductase inhibitors or receipt of transurethral resection of the prostate were the primary and secondary endpoints, respectively. The confounders in this study were diabetes mellitus, hypertension, coronary heart disease, obesity, liver cirrhosis, nonsteroidal anti-inflammatory drugs, metformin, aspirin, and number of urologist visits. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a multivariate Cox proportional hazards regression model adjusted for the propensity score. RESULTS A total of 35 860 subjects (aged 40-99 years)-including the hyperlipidemia cohort (n = 8,965) and nonhyperlipidemia cohort (n = 26 895)-were identified. Our data revealed that the hyperlipidemia cohort had significantly higher incidences of developing BPH (24.6% vs 12.3%, P < 0.001) and treated BPH (13% vs 5.7%, P < 0.001) compared with the nonhyperlipidemia cohort. The risk of developing BPH in the hyperlipidemia cohort was significantly higher than that in the nonhyperlipidemia cohort (HR = 1.73, 95% CI = 1.63-1.83, P < 0.001) after adjustment for the propensity score. CONCLUSIONS Hyperlipidemia is associated with an increased risk of clinical BPH.
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Affiliation(s)
- Hung-Jen Shih
- Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Jen Huang
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jui-An Lin
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ming-Chang Kao
- Department of Anesthesiology, Taipei Tzu Chi Hospital, Taipei, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yen-Chun Fan
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Kwon T, Park S, Park S, Moon KH. Metabolic syndrome is predictive of lower urinary tract symptom improvement after holmium laser enucleation of the prostate for benign prostatic obstruction. Int Urol Nephrol 2017; 49:1105-1110. [DOI: 10.1007/s11255-017-1580-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
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Higashi Y. Lower urinary tract symptoms/benign prostatic hypertrophy and vascular function: Role of the nitric oxide-phosphodiesterase type 5-cyclic guanosine 3',5'-monophosphate pathway. Int J Urol 2017; 24:412-424. [PMID: 28332240 DOI: 10.1111/iju.13336] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/19/2017] [Indexed: 11/30/2022]
Abstract
It is well known that there is an association of lower urinary tract symptoms/benign prostatic hypertrophy with cardiovascular disease, suggesting that lower urinary tract symptoms/benign prostatic hypertrophy is a risk factor for cardiovascular events. Vascular function, including endothelial function and vascular smooth muscle function, is involved in the pathogenesis, maintenance and development of atherosclerosis, leading to cardiovascular events. Vascular dysfunction per se should also contribute to lower urinary tract symptoms/benign prostatic hypertrophy. Both lower urinary tract symptoms/benign prostatic hypertrophy and vascular dysfunction have cardiovascular risk factors, such as hypertension, dyslipidemia, diabetes mellitus, aging, obesity and smoking. Inactivation of the phosphodiesterase type 5-cyclic guanosine 3',5'-monophosphate-nitric oxide pathway causes lower urinary tract symptoms/benign prostatic hypertrophy through an enhancement of sympathetic nervous activity, endothelial dysfunction, increase in Rho-associated kinase activity and vasoconstriction, and decrease in blood flow of pelvic viscera. Both endogenous nitric oxide and exogenous nitric oxide act as vasodilators on vascular smooth muscle cells through an increase in the content of cyclic guanosine 3',5'-monophosphate, which is inactivated by phosphodiesterase type 5. In a clinical setting, phosphodiesterase type 5 inhibitors are widely used in patients with lower urinary tract symptoms/benign prostatic hypertrophy. Phosphodiesterase type 5 inhibitors might have beneficial effects on vascular function through not only inhibition of cyclic guanosine 3',5'-monophosphate degradation, but also increases in testosterone levels and nitric oxide bioavailability, increase in the number and improvement of the function of endothelial progenitor cells, and decrease in insulin resistance. In the present review, the relationships between lower urinary tract symptoms/benign prostatic hypertrophy, the phosphodiesterase type 5-nitric oxide-cyclic guanosine 3',5'-monophosphate pathway, vascular function and cardiovascular outcomes are examined.
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Affiliation(s)
- Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University Hospital, Hiroshima, Japan.,Divivsion of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
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Kaplan SA. Re: Can Metabolic Disorders in Aging Men Contribute to Prostatic Hyperplasia Eligible for Transurethral Resection of the Prostate (TURP)? J Urol 2016; 197:220-222. [PMID: 27979543 DOI: 10.1016/j.juro.2016.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2016] [Indexed: 11/26/2022]
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Griebling TL. Re: Relationship between Metabolic Syndrome and Lower Urinary Tract Symptoms: Hallym Aging Study. J Urol 2016; 196:1217. [PMID: 27628814 DOI: 10.1016/j.juro.2016.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Vlachopoulos C, Oelke M, Maggi M, Mulhall JP, Rosenberg MT, Brock GB, Esler A, Büttner H. Impact of cardiovascular risk factors and related comorbid conditions and medical therapy reported at baseline on the treatment response to tadalafil 5 mg once-daily in men with lower urinary tract symptoms associated with benign prostatic hyperplasia: an integrated analysis of four randomised, double-blind, placebo-controlled, clinical trials. Int J Clin Pract 2015; 69:1496-507. [PMID: 26299520 DOI: 10.1111/ijcp.12722] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE The influence of cardiovascular risk factors/comorbidities on response to oral once-daily tadalafil 5 mg was explored in men with lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). METHODS This post hoc analysis pooled data from four double-blind studies in which 1498 men with > 6-mo history of LUTS/BPH were randomised and received either once-daily placebo (n = 746) or tadalafil 5 mg (n = 752) for 12 weeks. Descriptive statistics were reported for changes in total International Prostate Symptom Score (IPSS), IPSS voiding and storage subscores, and IPSS quality-of-life (QoL) index. Treatment group differences by baseline clinical and cardiovascular factors and medical therapies were examined using analysis of covariance. RESULTS Tadalafil was effective in men with LUTS/BPH and cardiovascular risk factors/comorbidities except for patients receiving > 1 antihypertensive medication. Placebo-adjusted least squares (LS) mean improvements in total IPSS were -1.2 (95% CI: -2.5 to -0.0) in men taking > 1 antihypertensive medication vs. -3.3 (95% CI: -4.4 to -2.1) in men taking one medication (interaction p = 0.020). In addition, placebo-adjusted LS mean improvements in total IPSS were -0.2 (95% CI, -2.1 to 1.7) in men who reported use of diuretics vs. -2.8 (95% CI, -3.7 to -1.9) in men who reported taking other antihypertensive medications vs. -2.3 (95% CI, -3.2 to -1.5) in men who reported not using any antihypertensive drug (p-value for interaction = 0.053). CONCLUSIONS Once-daily tadalafil 5 mg improved LUTS/BPH, regardless of severity, in men with coexisting cardiovascular risk factors/comorbidities, except for patients with history of > 1 drug for arterial hypertension. Use of diuretics may contribute to patients' perception of a negated efficacy of tadalafil on LUTS/BPH. Comorbidities should be considered when choosing the optimal medicine to treat men with LUTS/BPH.
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Affiliation(s)
- C Vlachopoulos
- 1st Department of Cardiology, Athens Medical School, Athens, Greece
| | - M Oelke
- Department of Urology, Hannover Medical School, Hannover, Germany
| | - M Maggi
- University of Florence, Florence, Italy
| | - J P Mulhall
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - G B Brock
- University of Western Ontario, London, ON, Canada
| | - A Esler
- Inventiv Health Clinical, Indianapolis, IN, USA
| | - H Büttner
- Eli Lilly Biomedicines BU - Men's Health Therapeutic Area Europe, c/o Lilly Deutschland, GmbH, Bad Homburg, Germany
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Kurokawa T, Zha X, Ito H, Aoki Y, Akino H, Kobayashi M, Yokoyama O. Underlying mechanisms of urine storage dysfunction in rats with salt-loading hypertension. Life Sci 2015; 141:8-12. [PMID: 26390819 DOI: 10.1016/j.lfs.2015.09.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 08/24/2015] [Accepted: 09/17/2015] [Indexed: 10/23/2022]
Abstract
AIMS Spontaneous hypertensive rats provide a genetic model for exploring the pathogenesis of urine storage dysfunction related to hypertension (HT). In humans, however, HT develops by both genetic and environmental factors including lifestyle factors such as a high-calorie diet, excessive salt intake and stress. We investigated the influence of salt-loading on bladder function and the underlying mechanisms of storage dysfunction related to HT. MAIN METHODS Six-week-old male Dahl salt-sensitive (DS) and Dahl salt-resistant (DR) rats were fed with a normal or high-salt diet for 12weeks. Micturition parameters were obtained from a metabolic cage. Whole bladders were excised from 18-week-old rats and distended in an organ bath. The releases of adenosine triphosphoric acid (ATP) and prostaglandin E2 (PGE2) from the distended bladder epithelia were measured. Changes in bladder blood flow (BBF) were determined with a laser-speckle-blood-flow imaging system. KEY FINDINGS An increase in mean blood pressure (BP) was noted only in DS rats after salt-loading. During the inactive (sleeping) period, voided volume per micturition gradually increased in DR rats fed a normal or high-salt diet and normal-diet DS rats, while it did not change in the DS rats fed a high-salt diet. Bladder distension significantly increased ATP and PGE2 release from the urothelium in DS rats fed a high-salt diet. BBF was significantly decreased in high-salt-diet DS rats. SIGNIFICANCE One mechanism behind the relationship between salt-sensitive HT and urine storage dysfunction may be an increase in ATP and PGE2 release from the urothelium via suppression of BBF.
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Affiliation(s)
- Tetsuyuki Kurokawa
- Department of Urology, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki, Fukui 910-1193, Japan
| | - Xinmin Zha
- Department of Urology, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki, Fukui 910-1193, Japan
| | - Hideaki Ito
- Department of Urology, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki, Fukui 910-1193, Japan
| | - Yoshitaka Aoki
- Department of Urology, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki, Fukui 910-1193, Japan
| | - Hironobu Akino
- Department of Urology, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki, Fukui 910-1193, Japan
| | - Motohiro Kobayashi
- Department of Urology, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki, Fukui 910-1193, Japan
| | - Osamu Yokoyama
- Department of Urology, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki, Fukui 910-1193, Japan.
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Relationship between Metabolic Syndrome and Lower Urinary Tract Symptoms: Hallym Aging Study. BIOMED RESEARCH INTERNATIONAL 2015. [PMID: 26199934 PMCID: PMC4493267 DOI: 10.1155/2015/130917] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the study was to test the hypothesis that the metabolic syndrome (MS) is linked to lower urinary tract symptoms (LUTS) in Korean men. This was a longitudinal study that used data collected from 328 men aged 50–89 years who were randomly selected among 1,520 participants in 2004. We collected information from 224 (68.3%) men among the original responders on the biological, medical, psychological, social, lifestyle, and economic factors in 2007. The prevalence of the MS was 187/328 (57.0%) in 2004 and 125/224 (55.8%) in 2007 among men, respectively. There was no significantly greater increase in the IPSS in men with the MS than in men without the MS over a 3-year period of time (2.0 ± 9.37 versus 3.0 ± 8.44, p = 0.402, resp.). In the multivariate logistic regression analysis with control for age and life style factors, the risk factors for moderate/severe LUTS were age and erectile dysfunction (p < 0.05). However, the presence of the MS did not increase the risk of moderate/severe LUTS (OR = 1.09, 95% CI 0.63–1.89, p = 0.748). Our cross-sectional and longitudinal risk factor analyses do not support the hypothesis that the MS is linked to LUTS in Korean men.
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Michel MC, Chess-Williams R, Hegde SS. Are blood vessels a target to treat lower urinary tract dysfunction? Naunyn Schmiedebergs Arch Pharmacol 2015; 388:687-94. [PMID: 26026700 DOI: 10.1007/s00210-015-1137-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 01/12/2023]
Abstract
Bladder dysfunction is common in the general population (Stewart et al. 2010) and even more so among patients seeing a physician for any reason (Goepel et al. 2002). It often manifests as lower urinary tract symptoms (LUTS), a term originally coined to describe voiding and storage symptoms in men with benign prostatic hyperplasia (BPH) but now more universally used to describe any type of voiding and storage symptoms in both sexes. Studies into possible causes of urinary bladder dysfunction have long focused on detrusor smooth muscle cells (Turner and Brading 1999). More recently, it became clear that several other types of cells and organs contribute to regulating detrusor smooth muscle function. These include the urothelium (Andersson and McCloskey 2014; Michel 2015), afferent nerves (Michel and Igawa 2015; Yoshimura et al. 2014b), and the central and autonomic nervous systems (Fowler and Griffiths 2010; Yoshimura et al. 2014a). Alterations in any of these may at least partly be responsible for detrusor dysfunction and, accordingly, be potential targets for the treatment of bladder dysfunction. As highlighted by an article in this issue of Naunyn-Schmiedeberg's Archives of Pharmacology (Bayrak et al. 2015), there is an additional suspect, the bladder vasculature. This article will discuss the currently available experimental and clinical evidence for a role of the vasculature in causing bladder dysfunction, and how existing and emerging treatments may modulate bladder function by acting on blood vessels. Due to a similarity in concept, data on prostate perfusion will also be discussed to some extent.
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Affiliation(s)
- Martin C Michel
- Department of Pharmacology, Johannes Gutenberg Universität, Obere Zahlbacher Str. 67, 55101, Mainz, Germany,
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Bouwman II, Voskamp MJH, Kollen BJ, Nijman RJM, van der Heide WK, Blanker MH. Do lower urinary tract symptoms predict cardiovascular diseases in older men? A systematic review and meta-analysis. World J Urol 2015; 33:1911-20. [PMID: 25971203 PMCID: PMC4655016 DOI: 10.1007/s00345-015-1560-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 04/08/2015] [Indexed: 12/29/2022] Open
Abstract
Purpose To study the incidence of CVD in men at risk, with and without LUTS.
Methods We searched all longitudinal studies describing the association between LUTS and CVD (mortality) in October 2013 and December 2014 using MEDLINE, EMBASE, and the Cochrane Library Central Register. PRISMA criteria were met. Results We included five studies with 6027 men with LUTS and 18,993 men without LUTS in the meta-analyses, with a follow-up period varying from 5 to 17 years. Studies totalled 2780 CVD events. No clear association between CVD and LUTS was demonstrated [pooled effect size: hazard ratio 1.09 (95 % CI 0.90–1.31); p = 0.40]. Two other studies reported the association between nocturia and (CVD) mortality. CVD-specific mortality risk was approximately two times higher for Japanese men with nocturia (357 men aged 70 years and over, 5-year follow-up). A univariable association between nocturia and all-cause mortality was found in Dutch men, but not in age-adjusted analyses (1114 men aged 50–78 years, 13-year follow-up).
Conclusion This meta-analysis conducted on longitudinal studies does not confirm LUTS to be a predictor of CVD in men without a history of CVD, despite the observed association between LUTS and CVD in cross-sectional studies.
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Affiliation(s)
- Iris I Bouwman
- Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Maarten J H Voskamp
- Department of Urology, University Medical Center Groningen, Groningen, The Netherlands.
| | - Boudewijn J Kollen
- Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Rien J M Nijman
- Department of Urology, University Medical Center Groningen, Groningen, The Netherlands.
| | - Wouter K van der Heide
- Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Marco H Blanker
- Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
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Rył A, Rotter I, Słojewski M, Jędrzychowska A, Marcinowska Z, Grabowska M, Laszczyńska M. Can metabolic disorders in aging men contribute to prostatic hyperplasia eligible for transurethral resection of the prostate (TURP)? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3327-42. [PMID: 25809513 PMCID: PMC4377967 DOI: 10.3390/ijerph120303327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/06/2015] [Accepted: 03/11/2015] [Indexed: 01/22/2023]
Abstract
PURPOSE The aim of this study was to evaluate the incidence and severity of metabolic disorders occurring in the metabolic syndrome in patients with benign prostatic hyperplasia eligible for surgical treatment. METHODS The study group consisted men with diagnosed benign prostatic hyperplasia. The control group consisted patients recruited from basic health care units. Abdominal circumference, body weight and blood serum metabolic parameters were determined in the experimental and control groups. The concentrations of glucose were determined, as well as total cholesterol (ChT), low-density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides (TAG), by spectrophotometric method using reagent kits. RESULTS In the study group 91 (60.3%) cases of metabolic syndrome (MetS) were diagnosed, while in the control group 71 (46.1%) men met the diagnostic criteria for this syndrome (p=0.018). The analysis shows a relationship between MetS in patients with BPH and concentration glucose, ChT, LDL, HDL, systolic blood pressure and diastolic blood pressure. We found no significant statistical relationship between body weight, abdominal circumference and concentration TAG, hypertension in patients and controls. CONCLUSIONS in the study presented in this article, statistically significant relationships between BPH and the diagnostic parameters of the metabolic syndrome were demonstrated. These results indicate to the necessity of the modification of the lifestyle, taking preventive measures in diabetes, and evaluation of lipid metabolism disorders. It is recommended to assess symptoms that may suggest BPH (as a manifestation of LUTS) in men over 50 years of age with diagnoses of metabolic disorders (including MetS), and provide them with specialist urological care in order to prevent surgical treatment of the prostate.
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Affiliation(s)
- Aleksandra Rył
- Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin 71-210, Poland.
| | - Iwona Rotter
- Laboratory of Rehabilitation Medicine, Pomeranian Medical University, Szczecin 71-210, Poland.
| | - Marcin Słojewski
- Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin 71-111, Poland.
| | - Adriana Jędrzychowska
- Laboratory Diagnostics and Molecular Medicine, Department of Laboratory Medicine, Pomeranian Medical University, Szczecin 71-111, Poland.
| | - Zuzanna Marcinowska
- Laboratory Diagnostics and Molecular Medicine, Department of Laboratory Medicine, Pomeranian Medical University, Szczecin 71-111, Poland.
| | - Marta Grabowska
- Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin 71-210, Poland.
| | - Maria Laszczyńska
- Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin 71-210, Poland.
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Abstract
Lower urinary tract symptoms (LUTS) are common and can affect up to 30% of men over the age of 65 years. The term LUTS encompasses storage, voiding and post-micturition symptoms; all of which can produce a significant impact on quality of life. There are many causes of LUTS. In addition to pathology within the urinary tract, LUTS can also be caused by medication, diabetes, heart failure, obstructive sleep apnoea and high levels of fluid intake. A common urological cause for symptoms is benign prostatic hyperplasia (BPH); a benign enlargement of the prostate gland that affects 30% of men between 50 and 60 years in age and up to 90% of men over the age of 85 years. This article aims to assist GPs to identify and understand the patient presenting with prostatic symptoms, and effectively manage BPH in a primary care setting.
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Sener NC, Zengin K, Ozturk U, Bas O, Ercil H, Ekici M, Evliyaoglu Y, Imamoglu MA. The Impact of Metabolic Syndrome on the Outcomes of Transurethral Resection of the Prostate. J Endourol 2015; 29:340-3. [DOI: 10.1089/end.2014.0562] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nevzat Can Sener
- Ministry of Health, Department of Urology, Adana Numune Teaching and Research Hospital, Adana, Turkey
| | - Kursad Zengin
- Department of Urology, Bozok University, Yozgat, Turkey
| | - Ufuk Ozturk
- Ministry of Health, Department of Urology, Ankara Dişkapi Yıldırım Beyazit Teaching and Research Hospital, Ankara, Turkey
| | - Okan Bas
- Ministry of Health, Department of Urology, Ankara Onkoloji Teaching and Research Hospital, Ankara, Turkey
| | - Hakan Ercil
- Ministry of Health, Department of Urology, Adana Numune Teaching and Research Hospital, Adana, Turkey
| | - Musa Ekici
- Ministry of Health, Department of Urology, Corum Teaching and Research Hospital, Corum, Turkey
| | - Yalcin Evliyaoglu
- Ministry of Health, Department of Urology, Adana Numune Teaching and Research Hospital, Adana, Turkey
| | - M. Abdurrahim Imamoglu
- Ministry of Health, Department of Urology, Ankara Dişkapi Yıldırım Beyazit Teaching and Research Hospital, Ankara, Turkey
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Zhang LT, Lee SW, Park K, Chung WS, Kim SW, Hyun JS, Moon DG, Yang SK, Ryu JK, Yang DY, Moon KH, Min KS, Park JK. Multicenter, prospective, comparative cohort study evaluating the efficacy and safety of alfuzosin 10 mg with regard to blood pressure in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia with or without antihypertensive medications. Clin Interv Aging 2015; 10:277-86. [PMID: 25653511 PMCID: PMC4303366 DOI: 10.2147/cia.s74102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The objective of this study was to assess the efficacy and safety of alfuzosin 10 mg monotherapy or combined antihypertensive medication on blood pressure (BP) in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH/LUTS) with or without antihypertensive medication. Methods This was a 3-month, multicenter, randomized, open-label study in 335 patients aged ≥45 years with a clinical diagnosis of BPH/LUTS by medical history and clinical examination, a total International Prostatic Symptom Score (IPSS) ≥8 points, a maximum flow rate >5 mL/sec and ≤15 mL/sec, and a voided volume ≥120 mL. Eligible subjects were randomized to receive alfuzosin 10 mg as monotherapy (group 1) or alfuzosin 10 mg + antihypertensive combination therapy (group 2). Based on baseline BP and hypertensive history with or without antihypertensive medications at first medical examination, group 1 was divided into two subgroups of normotensive and untreated hypertensive patients, and group 2 into two subgroups of controlled hypertensive and uncontrolled hypertensive patients. The primary study outcomes were change in IPSS, BP, and heart rate from baseline. Secondary outcomes were change in IPSS-quality of life score, maximum flow rate, average flow rate, voided volume, and post-voided volume. Results The overall BP change was not significantly different between groups 1 and 2 (systolic BP, P=0.825; diastolic BP, P>0.999). In patients with uncontrolled or untreated hypertension, alfuzosin 10 mg alone or combined with antihypertensive therapy significantly decreased systolic and diastolic BP. The mean difference in total IPSS and IPSS-quality of life scores from baseline between groups 1 and 2 was 0.45 (95% CI: −1.26, 2.16) and 0.12 (95% CI: −0.21, 0.45), respectively (both P>0.05). Maximum flow rate, average flow rate, voided volume, and post-voided volume at endpoint were numerically, but not significantly, changed from baseline (all P>0.05). Conclusion This study shows that alfuzosin 10 mg is effective and well tolerated in patients with BPH/LUTS with or without antihypertensive medications. However, in patients with uncontrolled or untreated hypertension, alfuzosin 10 mg alone or in combination with antihypertensive medication appears to decrease systolic and diastolic BP, and these patients should be warned about a decrease in BP on initiation of therapy.
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Affiliation(s)
- Li Tao Zhang
- Department of Urology, Chonbuk National University, Medical School and Biomedical Research Institute and Clinical Trial Center for Medical Devices of Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Sung Won Lee
- Department of Urology, College of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Kwangsung Park
- Department of Urology, College of Medicine, Chonnam National University, Gwangju, Republic of Korea
| | - Woo Sik Chung
- Department of Urology, College of Medicine, Ewha Woman's University, Seoul, Republic of Korea
| | - Sae Woong Kim
- Department of Urology, College of Medicine, Catholic University, Seoul, Republic of Korea
| | - Jae Seog Hyun
- Department of Urology, College of Medicine, Kyungsang National University, Jinju, Republic of Korea
| | - Doo Geon Moon
- Department of Urology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Sang-Kuk Yang
- Department of Urology, Chungju Hospital, College of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Ji Kan Ryu
- Department of Urology, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Dae Yul Yang
- Department of Urology, College of Medicine, Hallym University, Seoul, Republic of Korea
| | - Ki Hak Moon
- Department of Urology, College of Medicine, Youngnam University, Daegu, Republic of Korea
| | - Kweon Sik Min
- Department of Urology, College of Medicine, Inje University, Busan, Republic of Korea
| | - Jong Kwan Park
- Department of Urology, Chonbuk National University, Medical School and Biomedical Research Institute and Clinical Trial Center for Medical Devices of Chonbuk National University Hospital, Jeonju, Republic of Korea
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Bouwman II, Blanker MH, Schouten BWV, Bohnen AM, Nijman RJM, van der Heide WK, Bosch JLHR. Are lower urinary tract symptoms associated with cardiovascular disease in the Dutch general population? Results from the Krimpen study. World J Urol 2014; 33:669-76. [DOI: 10.1007/s00345-014-1398-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/01/2014] [Indexed: 10/24/2022] Open
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Shimizu S, Tsounapi P, Shimizu T, Honda M, Inoue K, Dimitriadis F, Saito M. Lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction: Are these conditions related to vascular dysfunction? Int J Urol 2014; 21:856-64. [DOI: 10.1111/iju.12501] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/16/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Shogo Shimizu
- Department of Pharmacology; Kochi Medical School, Kochi University; Nankoku Japan
| | - Panagiota Tsounapi
- Division of Urology; Tottori University School of Medicine; Yonago Japan
| | - Takahiro Shimizu
- Department of Pharmacology; Kochi Medical School, Kochi University; Nankoku Japan
| | - Masashi Honda
- Division of Urology; Tottori University School of Medicine; Yonago Japan
| | - Keiji Inoue
- Department of Urology; Kochi Medical School; Kochi University; Nankoku Japan
| | - Fotios Dimitriadis
- B' Urologic Department; Papageorgiou General Hospital; School of Medicine; Aristotle University; Thessaloniki Greece
| | - Motoaki Saito
- Department of Pharmacology; Kochi Medical School, Kochi University; Nankoku Japan
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Margreiter M, Heinisch BB, Schwarzer R, Klatte T, Shariat SF, Ferlitsch A. Lower urinary tract symptoms in patients with liver cirrhosis. World J Urol 2014; 33:315-21. [PMID: 24798455 DOI: 10.1007/s00345-014-1313-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 04/26/2014] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To evaluate the prevalence of lower urinary tract symptoms (LUTS) in men with liver cirrhosis. METHODS In total, 128 men with known liver cirrhosis were prospectively evaluated using the validated German version of the International Prostate Symptom Score (IPSS) questionnaire. In parallel, all men underwent a detailed examination including medical history; physical examination; Child-Pugh liver function score (CPS) assessment; and measurement of blood levels of prostate-specific antigen (PSA), total and free testosterone, sexual hormone-binding globulin (SHBG), prolactin, luteotropic hormone (LH), and follicle-stimulating hormone (FSH). RESULTS Mean patient age and mean IPSS was 56 ± 9 years and 8 ± 6, respectively. Mild (IPSS: 1-7), moderate (IPSS: 8-19), and severe (IPSS: 20-35) LUTS were present in 60.2 % (77/128), 31.3 % (40/128), and 7.0 % (9/128) of the patients, respectively. Storage symptoms increased with the CPS (p = 0.04). Voiding symptoms and overall IPSS did not differ between the CPS groups (p = 0.93 and p = 0.67). No correlation was found between ascites volume and IPSS, storage symptoms, voiding symptoms, or quality of life (QoL) (p = 0.46, p = 0.26, p = 0.81, p = 0.87). From CPS groups A to C, mean PSA levels (p = 0.04), total and free testosterone levels (p < 0.001 and p < 0.001), and SHBG levels decreased (p = 0.03); however, prolactin levels increased (p = 0.03). LH and FSH levels did not differ between the CPS groups (p = 0.15 and p = 0.35). CONCLUSIONS Men with liver cirrhosis commonly have LUTS, with a predominance of storage symptoms. Liver cirrhosis may also affect PSA-based prostate cancer risk assessment. Accurate diagnosis and therapy strategies are warranted to improve the QoL of these patients.
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Affiliation(s)
- Markus Margreiter
- Department of Urology, General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria,
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Vignozzi L, Filippi S, Comeglio P, Cellai I, Morelli A, Maneschi E, Sarchielli E, Gacci M, Carini M, Vannelli GB, Maggi M. Tadalafil effect on metabolic syndrome-associated bladder alterations: an experimental study in a rabbit model. J Sex Med 2014; 11:1159-72. [PMID: 24612540 DOI: 10.1111/jsm.12478] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) are often associated. Bladder detrusor hyper-contractility-a major LUTS determinant-is characterized by increased Ras homolog gene family, member A/Rho-associated protein kinase (RhoA/ROCK) signaling, which is often upregulated in MetS. AIM This study investigated the effects of tadalafil dosing on RhoA/ROCK signaling in bladder, in a rabbit model of high-fat diet (HFD)-induced MetS. METHODS Adult male rabbits feeding a HFD for 12 weeks. A subset of HFD animals was treated with tadalafil (2 mg/kg/day, 1 week: the last of the 12 weeks) and compared with HFD and control (feeding a regular diet) rabbits. MAIN OUTCOME MEASURES In vitro contractility studies to evaluate the relaxant effect of the selective ROCK inhibitor, Y-27632, in carbachol precontracted bladder strips. Evaluation of RhoA activation by its membrane translocation. Immunohistochemistry for ROCK expression has been performed to evaluate ROCK expression in bladder from the different experimental groups. mRNA expression of inflammation, pro-fibrotic markers by quantitative RT-PCR has been performed to evaluate the effect of tadalafil on MetS-induced inflammation and fibrosis within the bladder. The in vitro effect of tadalafil on RhoA/ROCK signaling in bladder smooth muscle cells was evaluated by using chemotaxis assay. RESULTS Bladder strips from HFD rabbits showed hyper-responsiveness to Y-27632, indicating RhoA/ROCK overactivity in HFD bladder compared with matched controls. Accordingly, the fraction of activated (translocated to the membrane) RhoA as well as ROCK expression are increased in HFD bladder. Tadalafil dosing normalized HFD-induced bladder hypersensitivity to Y-27632, by reducing RhoA membrane translocation and ROCK overexpression. Tadalafil dosing reduced mRNA expression of inflammatory, pro-fibrotic, and hypoxia markers. A direct inhibitory effect of tadalafil on RhoA/ROCK signaling in bladder smooth muscle cell was demonstrated by using chemotaxis assay. Pre-treatment with tadalafil inhibited both basal and PDGF-induced migration of bladder smooth muscle cells. CONCLUSIONS Tadalafil dosing reduced RhoA/ROCK signaling and smooth muscle overactivity in an animal model of MetS-associated bladder alterations. Our findings suggest a novel mechanism of action of tadalafil in alleviating LUTS in MetS patients.
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Affiliation(s)
- Linda Vignozzi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Bouwman II, Kollen BJ, van der Meer K, Nijman RJM, van der Heide WK. Are lower urinary tract symptoms in men associated with cardiovascular diseases in a primary care population: a registry study. BMC FAMILY PRACTICE 2014; 15:9. [PMID: 24422708 PMCID: PMC3898227 DOI: 10.1186/1471-2296-15-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 01/03/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although lower urinary tract symptoms (LUTS) seem to be related to cardiovascular disease (CVD) in men, it is unclear whether this relationship is unbiased. In order to investigate this relationship, we used longitudinal data for establishing the possible predictive value of LUTS for the development of CVD in a primary care population. METHODS We performed a registry study using data from the Registration Network Groningen (RNG). All data from men aged 50 years and older during the study period from 1 January 1998 up to 31 December 2008 were collected. Cox proportional hazard regression analysis was used to determine the association between the proportions of CVD (outcome) and LUTS in our population. RESULTS Data from 6614 men were analysed. The prevalence of LUTS increased from 92/1000 personyears (py) in 1998 up to 183/1000 py in 2008. For cardiovascular diseases the prevalence increased from 176/1000 py in 1998 up to 340/1000 py in 2008. The incidence numbers were resp. 10.2/1000 py (1998) and 5.1/1000 py (2008) for LUTS, and 12.9/1000 py (1998) and 10.4/1000 py (2008) for CVD. Of all men, 23.2% reported CVD (41.1% in men with LUTS vs 19.5% in men without LUTS, p < 0.01). The hazard ratio of LUTS for cardiovascular events, compared to no LUTS, in the adjusted multivariate model, was 0.921(95% CI: 0.824 - 1.030; p = 0.150). CONCLUSION Based on the results, LUTS is not a factor that must be taken into account for the early detection of CVD in primary care.
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Affiliation(s)
- Inge I Bouwman
- Department of general practice, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, Netherlands
| | - Boudewijn J Kollen
- Department of general practice, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, Netherlands
| | - Klaas van der Meer
- Department of general practice, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, Netherlands
| | - Rien JM Nijman
- Department of urology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, GZ 9713, Netherlands
| | - Wouter K van der Heide
- Department of general practice, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, AV 9713, Netherlands
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Comeglio P, Morelli A, Cellai I, Vignozzi L, Sarchielli E, Filippi S, Maneschi E, Corcetto F, Corno C, Gacci M, Vannelli GB, Maggi M. Opposite effects of tamoxifen on metabolic syndrome-induced bladder and prostate alterations: a role for GPR30/GPER? Prostate 2014; 74:10-28. [PMID: 24037776 DOI: 10.1002/pros.22723] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 07/23/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND BPH and LUTS have been associated to obesity, hypogonadism, and metabolic syndrome (MetS). MetS-induced prostate and bladder alterations, including inflammation and tissue remodeling, have been related to a low-testosterone and high-estrogen milieu. In addition to ERs, GPR30/GPER is able to mediate several estrogenic non-genomic actions. METHODS Supplementing a subgroup of MetS rabbits with tamoxifen, we analyzed the in vivo effects on MetS-induced prostate and bladder alterations. The effects of selective ER/GPER ligands and GPER silencing on prostate inflammation were also studied in vitro using hBPH cells. RESULTS ERα, ERβ, and PR expression was upregulated in MetS bladder, where tamoxifen decreased ERα and PR expression, further stimulating ERβ. In addition, tamoxifen-dosing decreased MetS-induced overexpression of inflammatory and tissue remodeling genes. In prostate, sex steroid receptors, pro-inflammatory and pro-fibrotic genes were upregulated in MetS. However, tamoxifen did not affect them and even increased COX-2. In hBPH cells, 17β-estradiol increased IL-8 secretion, an effect blunted by co-treatment with GPER antagonist G15 but not by ER antagonist ICI 182,780, which further increased it. GPER agonist G1 dose-dependently (IC50 = 1.6 nM) induced IL-8 secretion. In vitro analysis demonstrated that GPER silencing reverted these stimulatory effects. CONCLUSIONS GPER can be considered the main mediator of estrogen action in prostate, whereas in bladder the mechanism appears to rely on ERα, as indicated by in vivo experiments with tamoxifen dosing. Limiting the effects of the MetS-induced estrogen action via GPER could offer new perspectives in the management of BPH/LUTS, whereas tamoxifen dosing showed potential benefits in bladder.
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Affiliation(s)
- P Comeglio
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Association of a Missense ALDH2 Single Nucleotide Polymorphism (Glu504Lys) With Benign Prostate Hyperplasia in a Korean Population. Int Neurourol J 2013; 17:168-73. [PMID: 24466463 PMCID: PMC3895508 DOI: 10.5213/inj.2013.17.4.168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 12/02/2013] [Indexed: 01/31/2023] Open
Abstract
Purpose Aldehyde dehydrogenase 2 (ALDH2) is a well-known gene involved in alcohol and aldehyde metabolism. Moreover, recent studies have reported associations between ALDH2 and age-related disorders. Benign prostate hyperplasia (BPH) is an age-related disorder and genetic factors may contribute to its onset. In this study, we investigated the association of a well-studied ALDH2 single nucleotide polymorphism (SNP), rs671, with the onset and clinical features of BPH. Methods A total of 222 BPH patients and 214 control subjects were genotyped. The clinical features of the BPH patients (prostate volume, prostate-specific antigen level, and International Prostatic Symptom Score) were analyzed. Results The results show that rs671 was only associated with the volume of BPH in genotype and allele frequencies (P<0.05). Conclusion We propose that rs671 is an Asian-specific SNP in ALDH2 that may affect the disease progression of BPH in the Korean population.
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HWANG EC, KIM SO, NAM DH, YU HS, HWANG I, JUNG SI, KANG TW, KWON DD, KIM GS. Men with Hypertension are More Likely to Have Severe Lower Urinary Tract Symptoms and Large Prostate Volume. Low Urin Tract Symptoms 2013; 7:32-6. [DOI: 10.1111/luts.12046] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 09/29/2013] [Accepted: 10/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Eu Chang HWANG
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Sun-Ouck KIM
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Deok-Hyun NAM
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Ho Song YU
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Insang HWANG
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Seung Il JUNG
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Taek Won KANG
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
| | - Dong Deuk KWON
- Department of Urology; Chonnam National University Medical School; Gwangju South Korea,
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Schneider T, Marschall-Kehrel D, Hanisch JU, Michel MC. Does concomitant diabetes affect treatment responses in overactive bladder patients? Int J Clin Pract 2013; 67:1138-43. [PMID: 24165427 DOI: 10.1111/ijcp.12196] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 04/20/2013] [Indexed: 11/29/2022] Open
Abstract
AIMS To compare the efficacy and tolerability of a muscarinic receptor antagonist, darifenacin, in the treatment of overactive bladder (OAB) patients with concomitant diabetes as compared with those without comorbidities. METHODS Post hoc exploratory analysis of a published, large, non-interventional study in OAB patients treated with darifenacin including 532 diabetics and 1315 controls. Associations of diabetes with treatment responses were evaluated by multiple regression models. RESULTS Diabetics (largely type 2 patients) and controls differed in baseline age, body weight, duration of OAB symptoms and presence of co-medications. However, they exhibited similar OAB symptom episode frequency and problem rating and received similar starting doses of darifenacin. Presence of diabetes was associated with a significantly smaller reduction of OAB symptoms, but the effect attributable to diabetes was small relative to the overall treatment response. The presence of diabetes was not associated with differences in tolerability. DISCUSSION AND CONCLUSIONS We conclude that a muscarinic receptor antagonist has comparable efficacy and tolerability in the treatment of OAB patients with and without concomitant diabetes.
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Affiliation(s)
- T Schneider
- Praxisklinik Urologie Rhein-Ruhr, Mülheim, Germany
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de Lucia C, Femminella GD, Rengo G, Ruffo A, Parisi V, Pagano G, Liccardo D, Cannavo A, Iacotucci P, Komici K, Zincarelli C, Rengo C, Perrone-Filardi P, Leosco D, Iacono F, Romeo G, Amato B, Ferrara N. Risk of acute myocardial infarction after transurethral resection of prostate in elderly. BMC Surg 2013; 13 Suppl 2:S35. [PMID: 24267821 PMCID: PMC3851236 DOI: 10.1186/1471-2482-13-s2-s35] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Benign prostatic hyperplasia is a frequent disease among elderly, and is responsible for considerable disability. Benign prostatic hyperplasia can be clinically significant due to lower urinary tract symptoms that take place because the gland is enlarged and obstructs urine flow. Transurethral resection of the prostate remains the gold standard treatment for patients with moderate or severe symptoms who need active treatment or who either fail or do not want medical therapy. Moreover, perioperative and postoperative surgery complications as cardiovascular ones still occur. The incidence of acute myocardial infarction in patients undergoing transurethral resection of the prostate is controversial. The first studies showed an increase in mortality and relative risk of death from myocardial infarction in transurethral resection of the prostate group vs open prostatectomy but these results are in contrast with more recent data. Discussion Given the conflicting evidence of the studies in the literature, in this review we are going to discuss the factors that may influence the risk of myocardial infarction in elderly patients undergoing prostate surgery. We analyzed the possible common factors that lead to the development of myocardial infarction and benign prostatic hyperplasia (cardiovascular and metabolic), the stressor factors related to prostatectomy (surgical and haemodynamic) and the risk factors specific of the elderly population (comorbidity and therapies). Summary Although transurethral resection of the prostate is considered at low risk for severe complications, there are several reports indicating that cardiovascular events in elderly patients undergoing this surgical operation are more common than in the general population. Several cardio-metabolic, surgical and aging-related factors may help explain this observation but results in literature are not concord, especially due to the fact that most data derive from retrospective studies in which selection bias cannot be excluded. Subsequently, further studies are necessary to clarify the incidence of acute myocardial infarction in old people.
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Hyperglycemia, hyperinsulinemia, insulin resistance, and the risk of BPH/LUTS severity and progression over time in community dwelling black men: the Flint Men's Health Study. Urology 2013; 82:881-6. [PMID: 23915515 DOI: 10.1016/j.urology.2013.05.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 05/17/2013] [Accepted: 05/31/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the associations between fasting serum glucose, insulin concentrations, and insulin resistance and benign prostatic hyperplasia (BPH) in a population-based cohort of African American men. METHODS Using the Flint Men's Health Study (FMHS), we examined how fasting serum glucose and insulin concentrations and calculated Homeostasis Model of Assessment-Insulin Resistance (HOMA-IR) related to burden and progression of clinical markers of BPH in African American men aged 40-79 years. RESULTS Among 369 men at baseline, mean age was 56.6 years and approximately 70% were overweight/obese (body mass index [BMI] ≥25 kg/m(2)). One hundred forty-eight men (34.4%) reported moderate to severe lower urinary tract symptoms (LUTS) (American Urological Association Symptom Index [AUASI] ≥8). There were no significant trends of metabolic disturbances as measured by serum glucose, insulin, or HOMA-IR in men with indications of BPH compared to those without. CONCLUSION In this population-based study of African American men aged 40-79 years, we did not observe any significant associations between hyperglycemia, hyperinsulinemia, and insulin resistance and burden and progression of BPH after adjustment for age and BMI. This may be due, in part, to the single measurement of glucose and insulin, which may not adequately reflect average glucose metabolism. Further studies examining measures of long-term glycemic control and BPH in racially diverse populations are warranted.
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Wu MP, Weng SF, Hsu YW, Wang JJ, Kuo HC. Medical attendance for lower urinary tract symptoms is associated with subsequent increased risk of outpatient visits and hospitalizations based on a nationwide population-based database. PLoS One 2013; 8:e57825. [PMID: 23472108 PMCID: PMC3589460 DOI: 10.1371/journal.pone.0057825] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 01/26/2013] [Indexed: 11/19/2022] Open
Abstract
Introduction Lower urinary tract symptoms (LUTS), which encompass storage, voiding, and postmicturition symptoms, are highly prevalent and recognized globally. Based on a nationwide population-based database, this study tests the hypothesis that medical attendance for LUTS is associated with a subsequent increase in the number of outpatient visits and hospitalizations, with differences among medical specialties and age groups. Methods Participants were selected from a random population sample of approximately one million people as a representative cohort of National Health Insurance (NHI) enrollees in Taiwan. Participants had at least three outpatient service claims with a coding of LUTS during the recruitment period 2001–2004. Both the LUTS group and non-LUTS control group were monitored for subsequent outpatient visits and hospitalizations, excluding LUTS-related healthcare services, for 2 years following the index date. The results were categorized based on medical specialty and age group. Results The outpatient visit rates (no. per person-year) and adjusted incidence rate ratios (IRRs) (95% confidence interval (CI) were significantly higher in urology (4.51, 95%CI 4.15–4.91) and gynecology (1.82, 95%CI 1.76–1.89) for the LUTS group. They were also significantly high in other departments, including internal medicine (1.25), general practice (1.13), Chinese medicine (1.77), family medicine (1.19), surgery (1.38), and psychiatry (1.98). Similarly, the hospitalization rate (no. per 1000 person-year) and adjusted IRRs (95% CI) were significantly higher in urology (5.50, 95% CI = 4.60–6.50) and gynecology (1.60, 95% CI = 1.35–1.90), as well as in internal medicine (1.55) and surgery (1.56), but not in psychiatry (1.12). Furthermore, the IRRs differed among 3 age groups. Conclusions A significantly higher number of outpatient visits and hospitalizations were observed for individuals with LUTS, compared to the control group, and the effects differed with the advancement of age. This study broadens understanding of LUTS by viewing their impact on healthcare services with multiple and overlapping systems, rather than considering them exclusively as symptoms of traditional diseases of the bladder and urethra.
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Affiliation(s)
- Ming-Ping Wu
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan Authority
- Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan Authority
| | - Shih-Feng Weng
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan Authority
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan Authority
| | - Ya-Wen Hsu
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan Authority
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan Authority
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan Authority
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan Authority
- * E-mail:
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Inci M, Sarli B, Davarci M, Yalcinkaya FR, Rifaioğlu MM, Davran R, Arica S, Motor S, DemirbaŞ O. Relationship between endothelial dysfunction and nocturia with benign prostatic hyperplasia. Scand J Urol 2013; 47:384-9. [DOI: 10.3109/21681805.2012.762038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Marmiroli R, Antunes AA, Reis ST, Nakano E, Srougi M. Standard surgical treatment for benign prostatic hyperplasia is safe for patients over 75 years: analysis of 100 cases from a high-volume urologic center. Clinics (Sao Paulo) 2012; 67:1415-8. [PMID: 23295595 PMCID: PMC3521804 DOI: 10.6061/clinics/2012(12)11] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 07/26/2012] [Accepted: 08/20/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES In this study, we aimed to determine the complications of standard surgical treatments among patients over 75 years in a high-volume urologic center. METHODS We analyzed 100 consecutive patients older than 75 years who had undergone transurethral prostatic resection of the prostate or open prostatectomy for treatment of benign prostatic hyperplasia from January 2008 to March 2010. We analyzed patient age, prostate volume, prostate-specific antigen level, international prostatic symptom score, quality of life score, urinary retention, co-morbidities, surgical technique and satisfaction with treatment. RESULTS Median age was 79 years. Forty-eight patients had undergone transurethral prostatic resection of the prostate, and 52 had undergone open prostatectomy. The median International Prostatic Symptom Score was 20, the median prostate volume was 83 g, 51% were using an indwelling bladder catheter, and the median prostate-specific antigen level was 5.0 ng/ml. The most common comorbidities were hypertension, diabetes and coronary disease. After a median follow-up period of 17 months, most patients were satisfied. Complications were present in 20% of cases. The most common urological complication was urethral stenosis, followed by bladder neck sclerosis, urinary fistula, late macroscopic hematuria and persistent urinary incontinence. The most common clinical complication was myocardial infarction, followed by acute renal failure requiring dialysis. Incidental carcinoma of the prostate was present in 6% of cases. One case had urothelial bladder cancer. CONCLUSIONS Standard surgical treatments for benign prostatic hyperplasia are safe and satisfactory among the elderly. Complications are infrequent, and urethral stenosis is the most common. No clinical variable is associated with the occurrence of complications.
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Affiliation(s)
- Rafael Marmiroli
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Division of Urology, São Paulo/SP, Brazil
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Lee GJ, Kim MS, Song SM, Rho J, Cho WJ. Roles of urology as assessed by an analysis of inpatients referred to urology. Korean J Urol 2012; 53:619-24. [PMID: 23060999 PMCID: PMC3460004 DOI: 10.4111/kju.2012.53.9.619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 08/02/2012] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The purpose of this study was to identify the necessity for professional urology treatment and the roles of urology in the treatment of inpatients referred to the urology department. MATERIALS AND METHODS The subjects were patients referred to the department of urology among the inpatients of Chosun University Hospital from January 1, 2009, to December 31, 2011. The patients' sex and age, the referring department, and the disease group were extracted from the patients' medical records. Disease groups were classified as urination disorder, infection, tumor, calculus, trauma, pediatrics, andrology, and others. The urination disorder group was classified into the subcategories of neurogenic bladder, benign prostatic hypertrophy, urinary retention, urinary incontinence, and overactive bladder. RESULTS The total number of referrals was 3,261, and males made up 54.79%. In the age distribution, 2,321 patients (71.17%) were over 60 years of age and the largest population group was patients in their 70s (32.72%). According to the department referring the patients, internal medicine (34.06%) and orthopedic surgery (16.83%) made up a high percentage. Concerning the disease group, urination disorder was the highest, being 61.26%. In the subclassification of the urination disorder group, benign prostatic hypertrophy was the highest category at 32.23%. CONCLUSIONS In this urology cooperative behavior analysis of our hospital over 3 years, a high percentage of older patients over 60 years of age and a high percentage of urination disorders were found. Urination disorder-related diseases in persons of advanced age are expected to increase as Korea becomes an aged society, and doctors in other departments should be aware that professional treatment and management by a urologist is needed for the treatment of these disorders.
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Affiliation(s)
- Geun Jae Lee
- Department of Urology, Chosun University School of Medicine, Gwangju, Korea
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Wu MP, Su TH. Do lower urinary tract symptoms (LUTS) predispose the individuals to more admissions in Taiwanese women? - A preliminary report. Taiwan J Obstet Gynecol 2012; 51:402-4. [PMID: 23040925 DOI: 10.1016/j.tjog.2012.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Lower urinary tract symptoms (LUTS) are highly prevalent, and increase significantly as age advances. However, whether LUTS predispose women to more admissions and/or operations has not been well reported. We studied the risks of admissions among women with or without LUTS. MATERIALS AND METHODS Based on a nationwide population-based database, the risks of admissions among women of National Health Insurance enrollees with at least one outpatient service claim, with the coding of LUTS during 2001-2004, were compared with those without LUTS for the following 2 years. RESULTS Total admission rates (per 1000 person-years) were significantly higher in women with LUTS, as compared with the controls; 309.7 versus 173.6, respectively. The adjusted incidence rate ratio (IRR)=1.79 and 95% confidence interval (CI)=1.63-1.95. The adjusted IRRs=1.78 (95% CI=1.56-2.03), 2.02 (95% CI=1.75-2.33), 1.53 (95% CI=1.29-1.81), 2.09 (95% CI=1.13-3.86), 1.40 (95% CI=1.21-1.63), and 4.48 (95% CI=3.37-5.96) in the departments of internal medicine, gynecology, surgery, psychiatry, orthopedics and urology, respectively; all p values < 0.05. Meanwhile, the operation rates were also higher in women with LUTS, as compared with controls, in total and in the departments of gynecology, orthopedics, and surgery; all p values < 0.05. CONCLUSIONS The preliminary data showed a higher risk of admissions and operations among women with LUTS. The possible explanations included: more co-morbidities, a poorer quality of life, a lower threshold of admission, or potential early symptoms of either medical or surgical conditions. This highlights a broad understanding of multiple and overlapping systems in LUTS.
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Affiliation(s)
- Ming-Ping Wu
- Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan
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Teitsma CA, de la Rosette JJMCH, Michel MC. Are polymorphisms of the β(3)-adrenoceptor gene associated with an altered bladder function? Neurourol Urodyn 2012; 32:276-80. [PMID: 22972489 DOI: 10.1002/nau.22305] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 08/08/2012] [Indexed: 12/16/2022]
Abstract
AIMS As the presence of a Trp64Arg polymorphism of the gene encoding the β(3)-adrenoceptor (B3AR) has been linked to the presence of overactive bladder, we investigated whether additional polymorphisms are detectable in this gene and explore their relationships parameters related to lower urinary tract function. METHODS The coding region and adjacent stretches of the B3AR gene was sequenced in 91 patients. In total, 1015 patients from a single academic hospital were genotyped for the presence of two single nucleotide polymorphisms. Symptom scores and parameters from pressure-flow studies were analyzed relative to genotype in the B3AR gene. RESULTS No frequent novel polymorphisms were detected in the coding region. Five polymorphisms were found in the non-coding region of the gene but were in complete linkage with the 64Arg allele. Out of 32 parameters including bladder compliance, only prostate size was weakly (44 vs. 39 mL) but significantly associated with the 64Arg allele, but was not mirrored by an association with prostate-specific antigen levels. CONCLUSIONS Our data do not support the hypothesis that polymorphisms in the B3AR gene are associated with alterations of bladder function.
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Affiliation(s)
- Christine A Teitsma
- Department of Pharmacology and Pharmacotherapy, Academic Medical Center, University of Amsterdam, The Netherlands
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