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Pfaff DW, Baum MJ. Hormone-dependent medial preoptic/lumbar spinal cord/autonomic coordination supporting male sexual behaviors. Mol Cell Endocrinol 2018; 467:21-30. [PMID: 29100889 DOI: 10.1016/j.mce.2017.10.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 10/19/2017] [Accepted: 10/30/2017] [Indexed: 11/19/2022]
Abstract
Testosterone (T) can act directly through neural androgen receptors (AR) to facilitate male sexual behavior; however, T's metabolites also can play complicated and interesting roles in the control of mating. One metabolite, dihydrotestosterone (DHT) binds to AR with significantly greater affinity than that of T. Is that important behaviorally? Another metabolite, estradiol (E), offers a potential alternative route of facilitating male mating behavior by acting through estradiol receptors (ER). In this review we explore the roles and relative importance of T as well as E and DHT at various levels of the neuroaxis for the activation of male sex behavior in common laboratory animals and, when relevant research findings are available, in man.
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Affiliation(s)
- Donald W Pfaff
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, NY 10065, United States.
| | - Michael J Baum
- Department of Biology, Boston University, Boston, MA 02215, United States
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Yagi H, Sato R, Nishio K, Arai G, Soh S, Okada H. Effects of a supplement combining Pycnogenol ® and l-arginine aspartate on lower urinary dysfunction compared with saw palmetto extract. J Tradit Complement Med 2016; 7:117-120. [PMID: 28053897 PMCID: PMC5198833 DOI: 10.1016/j.jtcme.2016.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 04/26/2016] [Accepted: 05/24/2016] [Indexed: 11/04/2022] Open
Abstract
Objectives Lower urinary tract symptoms (LUTS) and sexual dysfunction (SDys) are common problems that affect quality of life (QOL) in elderly men. In addition to prescribed drugs, many over-the-counter medications including supplements are used to treat QOL diseases. Phosphodiesterase inhibitors are reported to be effective for both LUTS and SDys by increasing nitric oxide levels. French maritime pine bark extract Pycnogenol®, which is a potent nitric oxide donor, is reported to be effective for SDys. However, no reports have been published on whether it ameliorates LUTS. Design Open-labeled, randomized study. The effects of two supplements, Nokogiriyashi EX® containing 160 mg saw palmetto (SP) extract per tablet and Edicare® containing 10 mg of Pycnogenol®, 115 mg of l-arginine and 92 mg of aspartate (PAA) per tablet on International Prostate Symptom Score (IPSS), IPSS–QOL, Overactive Bladder Symptom Score (OABSS), International Index of Erectile Function 5 (IIEF5), Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), urinary 8-OHdG and uroflowmetry (UFM) of total 40 men with LUTS and SDys were examined. Results 19 subjects were instructed to take two tablets of SP, on the other 20 were on four tablets of PAA for 16 weeks. IPSS and IPSS–QOL showed statistically significant improvements in both groups. OABSS and IIEF5 were significantly improved in the PAA group. Conversely, ICIQ-SF, 8-OHdG and UFM did not change in either group. Conclusions PAA might be an effective therapeutic alternative for elderly patients with LUTS and SDys.
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Affiliation(s)
- Hiroshi Yagi
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Ryo Sato
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Kojiro Nishio
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Gaku Arai
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Shigehiro Soh
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Hiroshi Okada
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
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Lai KP, Huang CK, Fang LY, Izumi K, Lo CW, Wood R, Kindblom J, Yeh S, Chang C. Targeting stromal androgen receptor suppresses prolactin-driven benign prostatic hyperplasia (BPH). Mol Endocrinol 2013; 27:1617-31. [PMID: 23893956 DOI: 10.1210/me.2013-1207] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Stromal-epithelial interaction plays a pivotal role to mediate the normal prostate growth, the pathogenesis of benign prostatic hyperplasia (BPH), and prostate cancer development. Until now, the stromal androgen receptor (AR) functions in the BPH development, and the underlying mechanisms remain largely unknown. Here we used a genetic knockout approach to ablate stromal fibromuscular (fibroblasts and smooth muscle cells) AR in a probasin promoter-driven prolactin transgenic mouse model (Pb-PRL tg mice) that could spontaneously develop prostate hyperplasia to partially mimic human BPH development. We found Pb-PRL tg mice lacking stromal fibromuscular AR developed smaller prostates, with more marked changes in the dorsolateral prostate lobes with less proliferation index. Mechanistically, prolactin mediated hyperplastic prostate growth involved epithelial-stromal interaction through epithelial prolactin/prolactin receptor signals to regulate granulocyte macrophage-colony stimulating factor expression to facilitate stromal cell growth via sustaining signal transducer and activator of transcription-3 activity. Importantly, the stromal fibromuscular AR could modulate such epithelial-stromal interacting signals. Targeting stromal fibromuscular AR with the AR degradation enhancer, ASC-J9(®), led to the reduction of prostate size, which could be used in future therapy.
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Affiliation(s)
- Kuo-Pao Lai
- George Whipple Distinguished University of Rochester Medical Center, 601 Elmwood Avenue, Box 626, Rochester, New York 14642.
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Hernández Fernández C, Brenes Bermúdez F, Moncada Iribarren I. [Update of the usefulness of α-blockers in the treatment of different urologic pathologies]. Med Clin (Barc) 2012; 139:582-7. [PMID: 22982131 DOI: 10.1016/j.medcli.2012.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 06/24/2012] [Accepted: 06/28/2012] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To review the role of α-blockers in various urological conditions such as benign prostatic hyperplasia, overactive bladder, chronic prostatitis, and erectile dysfunction and as expulsive treatment of distal ureteral stones. MATERIAL AND METHODS We reviewed the latest scientific evidence in all the fields mentioned above, performing a critical analysis. CONCLUSION α-blockers are now considered first-line treatment in lower urinary tract symptoms secondary to benign prostatic hyperplasia, but the indications go beyond, and are able to improve, alone or in combination with other drugs, the previously mentioned pathologies. The uroselective properties of some α-blockers make them a highly safe medication.
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Gur S, Kadowitz PJ, Hellstrom WJG. Effects of 5-alpha reductase inhibitors on erectile function, sexual desire and ejaculation. Expert Opin Drug Saf 2012; 12:81-90. [DOI: 10.1517/14740338.2013.742885] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Gharaee-Kermani M, Kasina S, Moore BB, Thomas D, Mehra R, Macoska JA. CXC-type chemokines promote myofibroblast phenoconversion and prostatic fibrosis. PLoS One 2012; 7:e49278. [PMID: 23173053 PMCID: PMC3500280 DOI: 10.1371/journal.pone.0049278] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 10/08/2012] [Indexed: 12/22/2022] Open
Abstract
Recent studies from our group suggest that extracellular matrix (ECM) deposition and fibrosis characterize the peri-urethral prostate tissues of some men suffering from Lower Urinary Tract Symptoms (LUTS) and that fibrosis may be a contributing factor to the etiology of LUTS. Fibrosis can generally be regarded as an errant wound-healing process in response to chronic inflammation, and several studies have shown that the aging prostate tissue microenvironment is rich with inflammatory cells and proteins. However, it is unclear whether these same inflammatory proteins, particularly CXC-type chemokines, can mediate myofibroblast phenoconversion and the ECM deposition necessary for the development of prostatic tissue fibrosis. To examine this, immortalized and primary prostate stromal fibroblasts treated with TGF-β1, CXCL5, CXCL8, or CXCL12 were evaluated morphologically by microscopy, by immunofluorescence and qRT-PCR for αSMA, collagen 1, vimentin, calponin, and tenascin protein and transcript expression, and by gel contraction assays for functional myofibroblast phenoconversion. The results of these studies showed that that immortalized and primary prostate stromal fibroblasts are induced to express collagen 1 and 3 and αSMA gene transcripts and proteins and to undergo complete and functional myofibroblast phenoconversion in response to CXC-type chemokines, even in the absence of exogenous TGF-β1. Moreover, CXCL12-mediated myofibroblast phenoconversion can be completely abrogated by inhibition of the CXCL12 receptor, CXCR4. These findings suggest that CXC-type chemokines, which comprise inflammatory proteins known to be highly expressed in the aging prostate, can efficiently and completely mediate myofibroblast phenoconversion and may thereby promote fibrotic changes in prostate tissue architecture associated with the development and progression of male lower urinary tract dysfunction.
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Affiliation(s)
- Mehrnaz Gharaee-Kermani
- Department of Urology, The University of Michigan School of Medicine, Ann Arbor, Michigan, United States of America
| | - Sathish Kasina
- Department of Urology, The University of Michigan School of Medicine, Ann Arbor, Michigan, United States of America
| | - Bethany B. Moore
- Department of Internal Medicine, The University of Michigan School of Medicine, Ann Arbor, Michigan, United States of America
- Department of Microbiology and Immunology, The University of Michigan School of Medicine, Ann Arbor, Michigan, United States of America
| | - Dafydd Thomas
- Department of Pathology, The University of Michigan School of Medicine, Ann Arbor, Michigan, United States of America
| | - Rohit Mehra
- Department of Pathology, The University of Michigan School of Medicine, Ann Arbor, Michigan, United States of America
| | - Jill A. Macoska
- Department of Urology, The University of Michigan School of Medicine, Ann Arbor, Michigan, United States of America
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Suter A, Saller R, Riedi E, Heinrich M. Improving BPH symptoms and sexual dysfunctions with a saw palmetto preparation? Results from a pilot trial. Phytother Res 2012; 27:218-26. [PMID: 22522969 DOI: 10.1002/ptr.4696] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 03/15/2012] [Accepted: 03/16/2012] [Indexed: 11/05/2022]
Abstract
In elderly men, benign prostatic hyperplasia (BPH) is a major risk factor for sexual dysfunctions (SDys). Additionally, the standard treatments for BPH symptoms, alpha blockers and 5-alpha-reductase inhibitors, cause SDys themselves. Preparations from saw palmetto berries are an efficacious and well-tolerated symptomatic treatment for mild to moderate BPH and have traditionally been used to treat SDys. We conducted an open multicentric clinical pilot trial to investigate whether the saw palmetto berry preparation Prostasan® influenced BPH symptoms and SDys. Eighty-two patients participated in the 8-week trial, taking one capsule of 320 mg saw palmetto extract daily. At the end of the treatment, the International Prostate Symptom Score was reduced from 14.4 ± 4.7 to 6.9 ± 5.2 (p < 0.0001); SDys measured with the brief Sexual Function Inventory improved from 22.4 ± 7.2 to 31.4 ± 9.2 (p < 0.0001), and the Urolife BPH QoL-9 sex total improved from 137.3 ± 47.9 to 195.0 ± 56.3 (p < 0.0001). Investigators' and patients' assessments confirmed the good efficacy, and treatment was very well tolerated and accepted by the patients. Correlation analyses confirmed the relationship between improved BPH symptoms and reduced SDys. This was the first trial with saw palmetto to show improvement in BPH symptoms and SDys as well. [Corrections made here after initial online publication.]
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Affiliation(s)
- Andreas Suter
- Medical Department, A. Vogel Bioforce AG, Roggwil, Switzerland.
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Decaluwé K, Pauwels B, Verpoest S, Van de Voorde J. New Therapeutic Targets for the Treatment of Erectile Dysfunction. J Sex Med 2011; 8:3271-90. [DOI: 10.1111/j.1743-6109.2011.02459.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Imatinib Mesylate (Gleevec) as Protein-tyrosine Kinase Inhibitor Elicits Smooth Muscle Relaxation in Isolated Human Prostatic Tissue. Urology 2011; 78:968.e1-6. [DOI: 10.1016/j.urology.2011.06.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 06/14/2011] [Accepted: 06/14/2011] [Indexed: 11/21/2022]
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Mirone V, Sessa A, Giuliano F, Berges R, Kirby M, Moncada I. Current benign prostatic hyperplasia treatment: impact on sexual function and management of related sexual adverse events. Int J Clin Pract 2011; 65:1005-13. [PMID: 21718399 DOI: 10.1111/j.1742-1241.2011.02731.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Benign prostatic hyperplasia (BPH) is a common disease in older men that can lead to lower urinary tract symptoms (LUTS). Male sexual dysfunction is also an age-related condition. Epidemiological studies have confirmed an association between BPH/LUTS and sexual dysfunction in ageing men that is independent of the effects of age, other co-morbidities and lifestyle factors. Proposed pathophysiological mechanisms for BPH/LUTS-associated sexual dysfunction include the nitric oxide/cyclic guanosine monophosphate (NO/cGMP) pathway, rho-kinase and endothelin-1 activity, autonomic nervous system overactivity and the metabolic syndrome, and pelvic organ atherosclerosis. Both BPH/LUTS and sexual dysfunction can have a substantial negative impact on a man's quality of life. However, urologists and primary care physicians appear to under-recognise sexual dysfunction in men with BPH/LUTS. Current guidelines recommend alpha-blockers and 5-alpha reductase inhibitors, either alone or in combination, among appropriate medical treatment options for BPH/LUTS. Randomised, controlled trials demonstrate that these therapies can be associated with sexual adverse effects (AEs) such as loss of libido, erectile dysfunction and ejaculatory disorders. Sexual dysfunction should be fully evaluated in men requiring treatment for BPH/LUTS using validated questionnaires. Management of sexual dysfunction in men treated for BPH/LUTS should involve assessment of co-morbidities and concomitant medications, consideration of lifestyle interventions such as weight loss and increased physical activity to improve risk factors and, if necessary, introduction of pharmacotherapies. In addition, physicians should provide patients with proper counselling on the possible sexual AEs of medical therapies for BPH/LUTS and their impact on sexual satisfaction, while being aware of the possibility that counselling in itself is likely to influence reported rates of sexual dysfunction.
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Affiliation(s)
- V Mirone
- Department of Urology, University Federico II of Naples, Naples, Italy.
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Gur S, Kadowitz PJ, Hellstrom WJ. RhoA/Rho‐Kinase as a Therapeutic Target for the Male Urogenital Tract. J Sex Med 2011; 8:675-87. [DOI: 10.1111/j.1743-6109.2010.02084.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Phosphodiesterase Type 5 Inhibitors for Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia. UROLOGICAL SCIENCE 2010. [DOI: 10.1016/s1879-5226(10)60002-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Gur S, Sikka SC, Chandra S, Koka PS, Agrawal KC, Kadowitz PJ, Hellstrom WJ. Alfuzosin attenuates erectile dysfunction in rats with partial bladder outlet obstruction. BJU Int 2008; 102:1651-7. [DOI: 10.1111/j.1464-410x.2008.07914.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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