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Csikós E, Horváth A, Ács K, Papp N, Balázs VL, Dolenc MS, Kenda M, Kočevar Glavač N, Nagy M, Protti M, Mercolini L, Horváth G, Farkas Á. Treatment of Benign Prostatic Hyperplasia by Natural Drugs. Molecules 2021; 26:7141. [PMID: 34885733 PMCID: PMC8659259 DOI: 10.3390/molecules26237141] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 12/08/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is one of the most common urinary diseases affecting men, generally after the age of 50. The prevalence of this multifactorial disease increases with age. With aging, the plasma level of testosterone decreases, as well as the testosterone/estrogen ratio, resulting in increased estrogen activity, which may facilitate the hyperplasia of the prostate cells. Another theory focuses on dihydrotestosterone (DHT) and the activity of the enzyme 5α-reductase, which converts testosterone to DHT. In older men, the activity of this enzyme increases, leading to a decreased testosterone/DHT ratio. DHT may promote prostate cell growth, resulting in hyperplasia. Some medicinal plants and their compounds act by modulating this enzyme, and have the above-mentioned targets. This review focuses on herbal drugs that are most widely used in the treatment of BPH, including pumpkin seed, willow herb, tomato, maritime pine bark, Pygeum africanum bark, rye pollen, saw palmetto fruit, and nettle root, highlighting the latest results of preclinical and clinical studies, as well as safety issues. In addition, the pharmaceutical care and other therapeutic options of BPH, including pharmacotherapy and surgical options, are discussed, summarizing and comparing the advantages and disadvantages of each therapy.
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Affiliation(s)
- Eszter Csikós
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
| | - Adrienn Horváth
- Department of Pharmaceutical Biology, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary;
| | - Kamilla Ács
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
| | - Nóra Papp
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
| | - Viktória Lilla Balázs
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
| | - Marija Sollner Dolenc
- University of Ljubljana, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia; (M.S.D.); (M.K.)
| | - Maša Kenda
- University of Ljubljana, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia; (M.S.D.); (M.K.)
| | - Nina Kočevar Glavač
- University of Ljubljana, Department of Pharmaceutical Biology, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia;
| | - Milan Nagy
- Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University in Bratislava, SK-832-32 Bratislava, Slovakia;
| | - Michele Protti
- Research Group of Pharmaco-Toxicological Analysis (PTA Lab), Department of Pharmacy and Biotechnology (FaBiT), Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (M.P.); (L.M.)
| | - Laura Mercolini
- Research Group of Pharmaco-Toxicological Analysis (PTA Lab), Department of Pharmacy and Biotechnology (FaBiT), Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (M.P.); (L.M.)
| | - Györgyi Horváth
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
| | - Ágnes Farkas
- Department of Pharmacognosy, Faculty of Pharmacy, University of Pécs, H-7624 Pécs, Hungary; (E.C.); (K.Á.); (N.P.); (V.L.B.); (G.H.)
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