Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Urology Reports
Erschienen in: Current Urology Reports 12/2014

01.12.2014 | Benign Prostatic Hyperplasia (K McVary, Section Editor)

The Role of Inflammation in Lower Urinary Tract Symptoms (LUTS) due to Benign Prostatic Hyperplasia (BPH) and Its Potential Impact on Medical Therapy

verfasst von: Vincenzo Ficarra, Marta Rossanese, Michele Zazzara, Gianluca Giannarini, Maria Abbinante, Riccardo Bartoletti, Vincenzo Mirone, Francesco Scaglione

Erschienen in: Current Urology Reports | Ausgabe 12/2014

Einloggen, um Zugang zu erhalten

Abstract

A chronic prostatic inflammation seems to play a crucial role in benign prostatic hyperplasia (BPH) pathogenesis and progression. Therefore, inflammation could represent a new potential target for medical therapy of lower urinary tract symptoms (LUTS) due to BPH (LUTS/BPH). This review article analyzes the evidence supporting the role of inflammation in the onset and progression of BPH, and it assesses the potential impact of previous mechanisms on medical therapy of LUTS/BPH. Literature data support the role of inflammation as a relevant factor in the pathogenesis of BPH. Indeed, several data favour the role of infiltrating lymphocytes in the development and progression of prostate adenoma as an effect of a self-maintaining remodeling process. Although available drugs commonly used in the treatment of LUTS/BPH do not exhibit an anti-inflammatory activity, it seems to be obvious considering the inflammation as a new target in the treatment of LUTS/BPH. Drugs currently investigated for the treatment of prostatic inflammation include the hexanic lipidosterolic extract of Serenoa repens, nonsteroidal anti-inflammatory drugs, and vitamin D receptor agonists.
Literatur
1.
Ribal MJ. The link between benign prostatic hyperplasia and inflammation. Eur Urol Suppl. 2013;12:103–9.CrossRef
2.
Sampson N, Untergasser G, Plas E, Berger P. The ageing male reproductive tract. J Pathol. 2007;211:206–18.PubMedCrossRef
3.
Nickel JC, Roehrborn CG, O’Leary MP, Bostwick DG, Somerville MC, Rittmaster RS. The relationship between prostate inflammation and lower urinary tract symptoms: examination of baseline data from the REDUCE trial. Eur Urol. 2008;54:1379–84.PubMedCentralPubMedCrossRef
4.•
De Nunzio C, Kramer G, Marberger M, et al. The controversial relationship between benign prostatic hyperplasia and prostate cancer: the role of inflammation. Eur Urol. 2011;60:106–17. This is a very comprehensive review article investigating the relationship between inflammation and benign prostatic hyperplasia. The article suggested that chronic prostatic inflammation may be involved in the development and progression of chronic prostatic disease, although there is still no evidence of a causal relation. Inflammation should be considered a new domain in basic and clinical research in patients with BPH.PubMedCrossRef
5.
Steiner GE, Newman ME, Paikl D, et al. Expression and function of proinflammatory interleukin IL-17 and IL-17 receptor in normal, benign hyperplastic, and malignant prostate. Prostate. 2003;56:171–82.PubMedCrossRef
6.
Steiner GE, Stix U, Handisurya A, et al. Cytokine expression pattern in benign prostatic hyperplasia infiltrating T cells and impact of lymphocytic infiltration on cytokine mRNA profile in prostatic tissue. Lab Invest. 2003;83:1131–46.PubMedCrossRef
7.•
Ficarra V, Sekulovic S, Zattoni F, Zazzara M, Novara G. Why and how to evaluate chronic prostatic inflammation. Eur Urol Suppl. 2013;12:110–5. This review describes the recent literature regarding the relationship between prostatic inflammation and BPH and focuses on the clinical perspective of why and how to evaluate prostatic inflammation. The article highlighted the potential role of biomarkers, prostatic calcifications, symptoms severity, and metabolic syndrome to identify clinically patients with suspicious prostatic inflammation.CrossRef
8.
Ficarra V. Is chronic prostatic inflammation a new target in the medical therapy of lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH)? BJU Int. 2013;112:421–2.PubMedCrossRef
9.••
Gandaglia G, Briganti A, Gontero P, et al. The role of chronic prostatic inflammation in the pathogenesis and progression of benign prostatic hyperplasia (BPH). BJU Int. 2013;112:432–41. In this review article, the authors highlighted that although the histological examination of prostatic tissue remains the only available method to diagnose chronic inflammation, different parameters, such as prostatic calcifications, prostate volume, LUTS severity, storage and prostatitis-like symptoms, poor response to medical therapies, and urinary biomarkers, have been shown to be correlated with chronic inflammation.PubMedCrossRef
10.
Robert G, Descazeaud A, Allory Y, Vacherot F, de la Taille A. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia? Eur Urol Suppl. 2009;8:879–86.CrossRef
11.
De Nunzio C, Aronson W, Freedland SJ, Giovannucci E, Parsons JK. The correlation between metabolic syndrome and prostatic diseases. Eur Urol. 2012;61:560–70.PubMedCrossRef
12.
Oelke M, Bachmann A, Descazeaud A, et al. Guidelines on the management of male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO). Eur Assoc Urol. Web site http://​www.​uroweb.​org.
13.
Fullhase C, Chapple C, Cornu JN, et al. Systematic review of combination drug therapy for nonneurogenic male lower urinary tract symptoms. Eur Urol. 2013;64:228–43.PubMedCrossRef
14.
Madersbacher S, Marszalek M, Lackner J, et al. The long-term outcome of medical therapy for BPH. Eur Urol. 2007;51:1522–33.PubMedCrossRef
15.
Christ GJ, Andersson KE. Rho-kinase and effects of Rho-kinase inhibition on the lower urinary tract. Neurourol Urodyn. 2007;26:948–54.PubMedCrossRef
16.
Hennenberg M, Stief CG, Gratzke C. Prostatic α1-adrenoceptors: new concepts of function, regulation, and intracellular signaling. Neurourol Urodyn. 2014;33(7):1074–85.PubMed
17.••
Kwon YK, Choe MS, Seo KW, et al. The effect of intraprostatic chronic inflammation on benign prostatic hyperplasia treatment. Korean J Urol. 2010;51:266–70. This prospective clinical study showed that in patients with high-grade prostatic inflammation the use of alpha-blockers combined with 5-alpha-reductase inhibitors can be insufficient to reduce symptom severity, thus highlighting the need for alternative drugs. 
18.••
de la Taille A. Therapeutic approach: the importance of controlling prostatic inflammation. Eur Urol Suppl. 2013;12:116–23. This review article examined the evidence for the role of inflammation in BPH and the use of various drug classes to reduce and prevent prostatic inflammation, with a particular focus on hexanic lipidosterolic extract of Serenoa repens (Permixon). Scientific evidence supports the conclusion that hexanic extract of Serenoa repens treats BPH through several mechanisms, one of which is reduction of inflammation.CrossRef
19.
Kahokehr A, Vather R, Nixon A, Hill AG. Non-steroidal anti-inflammatory drugs for lower urinary tract symptoms in benign prostatic hyperplasia: systematic review and meta-analysis of randomized controlled trials. BJU Int. 2013;111(2):304–11.PubMedCrossRef
20.
Colli E, Rigatti P, Montorsi F, et al. BXL628, a novel vitamin D3 analog arrests prostate growth in patients with benign prostatic hyperplasia: a randomized clinical trial. Eur Urol. 2006;49:82–6.PubMedCrossRef
21.
Cornu JN, Cussenot O, Haab F, Lukacs B. A widespread population study of actual medical management of lower urinary tract symptoms related to benign prostatic hyperplasia across Europe and beyond official clinical guidelines. Eur Urol. 2010;58:450–6.PubMedCrossRef
22.
Latil A, Libon C, Templier M, Junquero D, Lantoine-Adam F, Nguyen T. Hexanic lipidosterolic extract of Serenoa repens inhibits the expression of two key inflammatory mediators, MCP-1/CCL2 and VCAM-1, in vitro. BJU Int. 2012;110:301–7.CrossRef
23.
Vela Navarrete R, Garcia Cardoso JV, Barat A, Manzarbeitia F, López FA. BPH and inflammation: pharmacological effects of Permixon on histological and molecular inflammatory markers. Results of a double blind pilot clinical assay. Eur Urol. 2003;44:549–55.PubMedCrossRef
24.
Metadaten
Titel
The Role of Inflammation in Lower Urinary Tract Symptoms (LUTS) due to Benign Prostatic Hyperplasia (BPH) and Its Potential Impact on Medical Therapy
verfasst von
Vincenzo Ficarra
Marta Rossanese
Michele Zazzara
Gianluca Giannarini
Maria Abbinante
Riccardo Bartoletti
Vincenzo Mirone
Francesco Scaglione
Publikationsdatum
01.12.2014
Verlag
Springer US
Erschienen in
Current Urology Reports / Ausgabe 12/2014
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-014-0463-9

Weitere Artikel der Ausgabe 12/2014

Current Urology Reports 12/2014 Zur Ausgabe

Invited Commentary

What Is Next in Robotic Urology?

Office Urology (N Shore, Section Editor)

2013-2014 Updates in Peyronie’s Disease Management

Lower Urinary Tract Symptoms & Voiding Dysfunction (H Goldman and G Badlani, Section Editors)

Mixed Incontinence: What Takes Precedence in Its Management?

Benign Prostatic Hyperplasia (K McVary, Section Editor)

Hyperglycemia and Insulin Resistance and the Risk of BPH/LUTS: an Update of Recent Literature

Pediatric Urology (M Castellan and R Gosalbez, Section Editors)

The Surgical Management of Male Epispadias in the New Millennium

Neu im Fachgebiet Urologie

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise