What do we know about phytotherapy of benign prostatic hyperplasia

OBJECTIVE

To investigate the effect of Pygeum africanum (PA) extract on the proliferation of cultured human prostatic myofibroblasts and fibroblasts; this extract is used for treating urinary disorders associated with benign prostatic hyperplasia (BPH).



MATERIALS AND METHODS

Primary cultures of prostatic stromal cells were obtained from histologically confirmed human BPH by enzymatic digestion. Cell proliferation was measured by 5-bromo2′-deoxy-uridine (BrdU) incorporation assays, and cytotoxicity by luminescent quantification of adenylate kinase activity.



RESULTS

Cultured cells were labelled by an anti-vimentin antibody, and most of them by an α−smooth-muscle-actin antibody, revealing the presence of fibroblasts and myofibroblasts. BrdU incorporation tests showed that proliferation of cultured human stromal cells, stimulated by fetal calf serum, by basic fibroblast growth factor and by epidermal growth factor, was dose-dependently inhibited by PA extract (5–100 µg/mL). Except at 100 µg/mL, no acute cytotoxicity of the extract was detected after 24 h of culture. Similarly, the extract dose-dependently inhibited the proliferation of Madin–Darby canine kidney epithelial cells, but to a lesser extent; whatever the dose of extract, no acute toxicity was evident on this cell line.



CONCLUSION

PA extract inhibits the proliferation of cultured human prostatic myofibroblasts and fibroblasts. We propose that cultured human prostatic cells offer a reliable model for preclinical screening of therapeutic agents, and to study the mechanisms underlying the inhibition of proliferation.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1464-410X.2006.06483.x

Pygeum africanum extract inhibits proliferation of human cultured prostatic fibroblasts and myofibroblasts.

Aims

To investigate the content of hydroxyproline (Hyp) and the expression of transforming growth factor beta1 (TGFβ1) and basic fibroblast growth factor (bFGF) in the bladder 8 weeks after diabetes induction.



Methods

Thirty wistar rats were divided into three groups: control (n = 10), streptozotocin-induced diabetic group (n = 10), TAD group (n = 10; diabetic rats were fed with Tadenan100 mg kg−1 day−1). Eight weeks later, the bladders were dissected. RT-PCR, immunohistochemistry, and ELISA were used to detect the expression of TGFβ1 and bFGF in the bladder. Also hydroxyproline (Hyp) was measured using a method based on alkaline hydrolysis.



Results

The content of hydroxyproline in the diabetic group was greater than that of control group (P < 0.05); we found significantly increased expression of TGFβ1 mRNA and bFGF mRNA in the bladder from the diabetic group compared with the control group; immunohistochemical and ELISA studies showed a statistically significant increased expression of TGFβ1 protein and bFGF protein in the bladder from the diabetic group compared with the control group (P < 0.05). The content of hydroxyproline in TAD group was less than that of diabetic group (P < 0.05); mRNA expression of TGFβ1 and bFGF greatly decreased in TAD group compared with that of the diabetic group; immunohistochemical and ELISA studies showed decreased levels of TGFβ1 protein and bFGF protein in the bladder from TAD group compared with the diabetic group (P < 0.05).



Conclusions

Rats with streptozoticin-induced diabetes mellitus showed significant increase in hydroxyproline, TGFβ1 and bFGF levels in their bladders, which may be an important mechanism inducing diabetic cystopathy. Tadenan could effectively reduce hydroxyproline, TGFβ1, and bFGF levels. Neurourol. Urodynam. 27:254–259, 2008. © 2007 Wiley-Liss, Inc.

Expression of transforming growth factor beta1 gene, basic fibroblast growth factor gene and hydroxyproline in diabetes-induced bladder dysfunction in a rat model.

Benign prostatic hyperplasia (BPH) is one of the most common urologic conditions affecting the elderly male. Current management options for BPH and for lower urinary tract symptoms (LUTS) related to BPH include lifestyle changes, drugs, and surgical treatment. A comprehensive spectrum of drugs for the treatment of LUTS is available, ranging from adrenoceptor antagonists (alpha-blockers), 5-alpha-Reductase inhibitors (5-ARIs), phosphodiesterase type 5 inhibitor (PDE5-i), antimuscarinics, beta-3-adrenoceptor agonist, vasopressin analogs, and phytotherapeutic agents. Phytotherapy is commonly used as one form of treatment. Our concern is that it should be used in patients with mild-to-moderate grade of disease. The agent most widely used nowadays is the Serenoa repens while the other compounds are less used worldwide. Experimental and clinical studies suggest a crucial role for SeR as an alternative therapy (or as a complementary therapy) for the treatment of LUTS due to BPH.

Phytotherapy in Benign Prostatic Hyperplasia

L'hypertrophie benigne de la prostate est une pathologie frequente. Elle touche la moitie des hommes de 60 ans et la quasi-totalite (90%) des hommes de plus de 80 ans. L'adenome de la prostate est une tumeur benigne, dont le retentissement se fait sur l'appareil urinaire, sans qu'il existe de parallelisme entre l'importance des lesions anatomiques et les signes fonctionnels. En cas de symptomes, le risque de complications justifie l'interet du traitement de cette pathologie. Il incombe ici au pharmacien d'officine de jouer pleinement son role d'information. Le medecin aura plusieurs options : l'abstinence-surveillance, les alpha-bloquants, les inhibiteurs de la 5a-reductase, la phytotherapie, et depuis l'etude MTOPS de 2003 il a ete prouve que l'association d'un alpha-bloquant et d'un inhibiteur de la 5a-reductase diminue le risque de retention aigue d'urine et ralentit la progression de l'hypertrophie prostatique de facon plus importance que l'utilisation d'une monotherapie chez certains patients. Nous nous attacherons donc aux divers traitements medicaux, leurs avantages et leurs contrindications.

https://hal.univ-lorraine.fr/hal-01734343/document

L'hypertrophie bénigne de la prostate et son traitement médicamenteux

UNLABELLED On the basis of its fibroblast growth factor (FGF) inhibitory effect we assessed the possible inhibitory anti-inflammatory role of Pygeum Africanum extract (Tadenan) on FGF and transforming growth factor beta (TGF beta 1/LAP) expression of macrophages and neutrophils in broncho-alveolar lavage fluid (BAL) of rats in a bleomycin-induced acute inflammation model. The rats were divided into three groups: 17 untreated controls, 10 bleomycin-instilled rats, receiving NaCl (0.9%), and 10 rats receiving Pygeum Africanum extract. On the 12th (and 15th day) we performed BAL and after labelling of cells expression of FGF and TGF beta 1 (LAP) was measured by flow-cytometry. We made a quantitative analysis of BAL cells as well. One-way ANOVA was used for statistical analysis. We found in Pygeum Africanum extract treated group 1, a significantly decreased number of neutrophil granulocytes (p < 0.05) compared with other groups 2, there was a considerable decrease (not significant) in expression of TGF beta 1(LAP) on BAL macrophages, but not in case of FGF. IN CONCLUSION our results show the possible 1. inhibitory effect of this drug on TGF beta 1 (LAP) expression, 2. anti-inflammatory role on neutrophil granulocytes.

The effect of Pygeum africanum on fibroblast growth factor (FGF) and transforming growth factor beta (TGF beta 1/LAP) expression in animal model.

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The effect of Pygeum africanum on fibroblast growth factor (FGF) and transforming growth factor beta (TGF beta 1/LAP) expression in animal model.