title: α-blockade, apoptosis, and prostate shrinkage: how are they related?
abstract: OBJECTIVE
  The α1-adrenoreceptor antagonists, such as terazosin and doxazosin, induce prostate programmed cell death (apoptosis) within prostate epithelial and stromal cells in vitro. This treatment should cause prostate volume decrease, However, this has never been observed in clinical conditions. The aim of this paper is to review the disconnect between these two processes.
  
  
  METHODS
  PubMed and DOAJ were searched for papers related to prostate, apoptosis, and stem cell death. The following key words were used: prostate, benign prostate hyperplasia, programmed cell death, apoptosis, cell death, α1-adrenoreceptor antagonist, α-blockade, prostate epithelium, prostate stroma, stem cells, progenitors, and in vitro models.
  
  
  RESULTS
  We have shown how discoveries related to stem cells can influence our understanding of α-blockade treatment for BPH patients. Prostate epithelial and mesenchymal compartments have stem (progenitors) and differentiating cells. These compartments are described in relation to experimental in vitro and in vivo settings.
  
  
  CONCLUSIONS
  Apoptosis is observed within prostate tissue, but this effect has no clinical significance and cannot lead to prostate shrinkage. In part, this is due to stem cells that are responsible for prostate tissue regeneration and are resistant to apoptosis triggered by α1-receptor antagonists.
authors.affiliation: Department of Urology, Collegium Medicum Jagiellonian University, Kraków, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Chłosta
authors.affiliation: Department of Tissue Engineering, N. Copernicus University, Bydgoszcz, Poland; N. Copernicus Hospital, Toruń, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Drewa
authors.affiliation: Weill Cornell Medical College, Cornell University, New York, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Kaplan
keywords: apoptosis; benign prostate hyperplasia; stem/progenitors cells; α1–receptor antagonists