title: Serenoa repens treatment modifies bax/bcl-2 index expression and caspase-3 activity in prostatic tissue from patients with benign prostatic hyperplasia.
abstract: OBJECTIVE
  Permixon is a lipidosterolic extract of Serenoa repens (SR) widely used to treat men with benign prostatic hyperplasia (BPH). We tested the effect of this drug on molecular mechanisms associated with apoptosis, such as the Bax-to-Bcl-2 expression ratio and caspase-3 activity, in prostatic tissue from men with symptomatic BPH treated for 3 months before surgery.
  
  
  METHODS
  An open, multicenter pilot study of 2 parallel groups of patients with BPH was done. They were randomized to be followed for 3 weeks without any treatment before surgery (control group) or to receive 160 mg SR orally twice daily for a 3-month period preceding the same surgery. Surgery was ultimately performed in 17 controls and 12 patients by transurethral prostate resection or retropubic adenomectomy. Bax and Bcl-2 expression, and caspase-3 activity were determined by Western blot in 15 controls and 10 patients, and reported in blinded fashion.
  
  
  RESULTS
  The Bax-to-Bcl-2 ratio, which is used as an apoptotic index, was significantly increased in the prostatic tissue of treated patients. The level of the intact 116 kDa poly (adenosine diphosphate-ribose) polymerase form, an enzyme involved in the cell death apoptotic pathway, was also found to be decreased in prostatic tissue from SR treated patients, suggesting increased caspase 3 activity in the prostate.
  
  
  CONCLUSIONS
  Permixon increased molecular markers involved in the apoptotic process, ie the Bax-to-Bcl-2 expression ratio and caspase-3 activity. This could have clinical relevance due to the improvement in symptoms produced by treatment with this drug.
authors.affiliation: Department of Urology, Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain.
authors.forename: Remigio
authors.initials: R
authors.lastname: Vela-Navarrete
authors.forename: Marta
authors.initials: M
authors.lastname: Escribano-Burgos
authors.forename: Antonio López
authors.initials: AL
authors.lastname: Farré
authors.forename: Juan
authors.initials: J
authors.lastname: García-Cardoso
authors.forename: Felix
authors.initials: F
authors.lastname: Manzarbeitia
authors.forename: Carolina
authors.initials: C
authors.lastname: Carrasco
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D053148:Caspase 3; D020169:Caspases / Q000378:metabolism*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D010936:Plant Extracts / Q000494:pharmacology / Q000627:therapeutic use*; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000378:metabolism*; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis*; D028024:Serenoa; D016037:Single-Blind Method; D051028:bcl-2-Associated X Protein
chemical_list: D000726:Androgen Antagonists; C494826:BAX protein, human; D010936:Plant Extracts; D019253:Proto-Oncogene Proteins c-bcl-2; D051028:bcl-2-Associated X Protein; C505407:CASP3 protein, human; D053148:Caspase 3; D020169:Caspases; C040972:saw palmetto extract