Apoptotic and proliferative index after Alpha-1-adrenoceptor antagonist and/or finasteride treatment in benign prostatic hyperplasia.
BACKGROUND
The induction of apoptosis has emerged as a potential target for optimization of the medical management of benign prostatic hyperplasia (BPH), recently. The influence of alpha1-adrenoceptor antagonist (alpha1-ARA), 5-alpha reductase inhibitor and their combination on prostatic cell apoptotic and proliferative indices of benign hyperplastic prostate gland were investigated.


METHODS
A total of 49 male patients with BPH (mean age: 66.5 years) treated with alpha1-ARA and/or finasteride were retrospectively evaluated. Patients treated with alpha1-ARA (doxazosin n = 12 and terazosin n = 10), finasteride (n = 9) and combination of finasteride and alpha1-ARA (n = 9) were enrolled in the study. Primary antibodies were Ki-67 and proliferating cell nuclear antigen for the evaluation of proliferation in prostate stromal and epithelial cells. In situ apoptotic DNA fragmentation was evaluated using TUNEL assay.


RESULTS
All treatment groups had no significant changes in the rate of prostate stromal and epithelial cell proliferation. Epithelial apoptotic index (AI) was not statistically significant for finasteride vs. alpha1- ARA, alpha1-ARA vs. finasteride + alpha1-ARA and finasteride + alpha1-ARA vs. finasteride groups. While alpha1-ARA was more effective than finasteride on stromal apoptosis, alpha1-ARA-induced stromal apoptosis was not significantly different from alpha1-ARA plus finasteirde treatment.


CONCLUSIONS
Not only androgen variabilities but also alterations in sympathetic neurotransmission with age could have important implications for pathophysiological prostate growth. The combination of finasteride and alpha1-ARA is not superior to alpha1-ARA therapy with their similar epithelial and stromal apoptotic effects with unaffected cell proliferation.
Erdoğru
Tibet
T
Department of Urology, Faculty of Medicine, Akdeniz University, Antalya, Turkey. drtibet@netone.com.tr
Ciftcioglu
M Akif
MA
Emreoglu
Ibrahim
I
Usta
Mustafa F
MF
Koksal
Turker
T
Ozbilim
Gülay
G
Gulkesen
K Hakan
KH
Baykara
Mehmet
M
D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects*; D002455:Cell Division / Q000187:drug effects; D017292:Doxazosin / Q000008:administration & dosage; D004791:Enzyme Inhibitors / Q000008:administration & dosage; D018120:Finasteride / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000473:pathology*; D012189:Retrospective Studies
D000317:Adrenergic alpha-Antagonists; D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors; D018120:Finasteride; C041226:Terazosin; D017292:Doxazosin; D011224:Prazosin