title: Heme oxygenase levels and metaflammation in benign prostatic hyperplasia patients.
abstract: OBJECTIVE
  To investigate the relationship between intra-prostatic levels of heme oxygenase (HO), metaflammation in benign prostatic hyperplasia (BPH) tissue in patients with MetS and moderate-severe lower urinary tract symptoms (LUTS).
  
  
  METHODS
  Between January 2012 and June 2013, 132 consecutive patients, who underwent transurethral resection of the prostate for moderate-severe LUTS, secondary to clinical BPH, were enrolled. Prostate samples were investigated for the presence of an inflammatory infiltrate, according to the Irani score, and for HO-1 and HO-2 levels measurements. Patients were evaluated for the presence of metabolic syndrome (MetS) defined by the International Diabetes Federation.
  
  
  RESULTS
  We observed that subjects with MetS exhibited greater Irani score (3.0 vs. 2.0; p < 0.05), Irani grade (2.0 vs. 1.0; p < 0.05) and lower value of HO-1 (4.55 vs. 6.01; p < 0.05) and HO-2 (0.81 vs. 2.66; p < 0.05). HO-1 (3.91 vs. 5.67; p < 0.05) and HO-2 (1.06 vs. 1.37; p < 0.05) were significantly reduced in patients with high intra-prostatic inflammation (Irani score ≥4). At the multivariate logistic regression analysis, HO-1 reduction (OR 0.588; p < 0.01), waist circumference (OR 1.09; p < 0.01), triglycerides (OR 1.013; p < 0.05) and HDL (OR 0.750; p < 0.05) were independent predictors of high intra-prostatic inflammation. We also found that HO-1 reduction (OR 0.598; p < 0.01) and the presence of MetS (OR 34.846; p < 0.01) were associated with Irani score ≥4.
  
  
  CONCLUSIONS
  MetS-induced inflammation may play a key role in BPH. In detail, prostate metaflammation is inversely related to intra-prostatic HO-1 levels, serum HDL and positively with triglycerides.
authors.affiliation: Department of Urology, School of Medicine, Policlinico Hospital, University of Catania, Catania, Italy. giorgioivan@virgilio.it.
authors.forename: Giorgio Ivan
authors.initials: GI
authors.lastname: Russo
authors.affiliation: Department of Drug Science, Biochemistry Section, University of Catania, Catania, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Vanella
authors.affiliation: Department of Urology, School of Medicine, Policlinico Hospital, University of Catania, Catania, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Castelli
authors.affiliation: Department of Urology, School of Medicine, Policlinico Hospital, University of Catania, Catania, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cimino
authors.affiliation: Department of Urology, School of Medicine, Policlinico Hospital, University of Catania, Catania, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Reale
authors.affiliation: Department of Urology, School of Medicine, Policlinico Hospital, University of Catania, Catania, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Urzì
authors.affiliation: Department of Drug Science, Biochemistry Section, University of Catania, Catania, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Li Volti
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Gacci
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Carini
authors.affiliation: Department G.F. Ingrassia, Section of Anatomic Pathology, University of Catania, Catania, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Motta
authors.affiliation: Department G.F. Ingrassia, Section of Anatomic Pathology, University of Catania, Catania, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Caltabiano
authors.affiliation: Department G.F. Ingrassia, Section of Anatomic Pathology, University of Catania, Catania, Italy.
authors.forename: Lidia
authors.initials: L
authors.lastname: Puzzo
authors.affiliation: Department of Drug Science, Biochemistry Section, University of Catania, Catania, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Sorrenti
authors.affiliation: Department of Urology, School of Medicine, Policlinico Hospital, University of Catania, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
mesh_terms: D000368:Aged; D006419:Heme Oxygenase (Decyclizing) / Q000032:analysis*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000201:enzymology* / Q000209:etiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000201:enzymology*; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000737:chemistry* / Q000201:enzymology*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000201:enzymology*; D011472:Prostatitis / Q000150:complications / Q000201:enzymology*; D012720:Severity of Illness Index
chemical_list: D006419:Heme Oxygenase (Decyclizing)
keywords: Benign prostatic hyperplasia; Flogosis; HDL; Heme oxygenase; LUTS; Metabolic syndrome; Prostate; Triglycerides