title: An introduction to acinar pressures in BPH and prostate cancer.
abstract: Intra-acinar and peri-acinar pressures in the prostate might be key factors in the evolution of its zonal morphology and the pathogenesis of BPH and cancer. Herein, I hypothesize that intra-acinar pressures lead to a decrease in apoptosis by distending or stretching acinar epithelium and its surrounding stroma. Increased prostatic smooth muscle content and tone might generate peri-acinar pressures, which could, in the long-term, counteract intra-acinar pressures and decrease epithelial stretch. Thus, it is proposed that BPH (characterized by increased prostatic smooth muscle and, therefore, raised peri-acinar pressures) might decrease the risk of prostate cancer progression by counteracting intra-acinar pressures. In the context of this theory, the transition zone might have evolved as a specialized region within the prostate that can mount a concerted stromal-epithelial response to increased urethral and intra-acinar pressures (BPH), and the urethral angulation, anterior stroma and the prostatic capsule have an adjunctive evolutionary role in this phenomenon.
authors.affiliation: The Brooklyn Hospital Center, Department of Surgery, 240 Willoughby Street, Brooklyn, NY 11201, USA. paw9070@nyp.org.
authors.forename: Panikar
authors.initials: P
authors.lastname: Wadhera
mesh_terms: D061354:Acinar Cells / Q000473:pathology*; D000818:Animals; D006801:Humans; D008297:Male; D011312:Pressure / Q000009:adverse effects*; D011470:Prostatic Hyperplasia / Q000175:diagnosis* / Q000453:epidemiology; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology