RESUMO
Benign prostatic hyperplasia (BPH) may decrease patient quality of life and often leads to acute urinary retention and surgical intervention. While effective treatments are available, many BPH patients do not respond or develop resistance to treatment. To understand molecular determinants of clinical symptom persistence after initiating BPH treatment, we investigated gene expression profiles before and after treatments in the prostate transitional zone of 108 participants in the Medical Therapy of Prostatic Symptoms (MTOPS) Trial. Unsupervised clustering revealed molecular subgroups characterized by expression changes in a large set of genes associated with resistance to finasteride, a 5α-reductase inhibitor. Pathway analyses within this gene cluster found finasteride administration induced changes in fatty acid metabolism, amino acid metabolism, immune response, steroid hormone metabolism, and kinase activity within the transitional zone. We found that patients without this transcriptional response were highly likely to develop clinical progression, which is expected in 13.2% of finasteride-treated patients. Importantly, a patient's transcriptional response to finasteride was associated with their pre-treatment kinase expression. Further, we identified novel expression signatures of finasteride resistance among the transcriptionally responded patients. These patients showed different gene expression profiles at baseline and increased prostate transitional zone volume compared to the patients who responded to the treatment. Our work suggests molecular mechanisms of clinical resistance to finasteride treatment that could be potentially helpful for personalized BPH treatment as well as new drug development to increase patient drug response.
Assuntos
Doxazossina , Finasterida , Próstata , Hiperplasia Prostática , Humanos , Finasterida/farmacologia , Finasterida/uso terapêutico , Masculino , Hiperplasia Prostática/tratamento farmacológico , Hiperplasia Prostática/genética , Hiperplasia Prostática/metabolismo , Doxazossina/uso terapêutico , Doxazossina/farmacologia , Doxazossina/administração & dosagem , Próstata/efeitos dos fármacos , Próstata/metabolismo , Próstata/patologia , Idoso , Inibidores de 5-alfa Redutase/farmacologia , Inibidores de 5-alfa Redutase/uso terapêutico , Pessoa de Meia-IdadeRESUMO
The objective of this study was to evaluate the impact of finasteride on the progression of prostate intraepithelial neoplasia and levels of prostate-specific antigen (PSA) in patients. A total of 120 patients with high-grade prostatic intraepithelial neoplasia were included in this study from January 2013 to January 2018. All patients underwent prostate biopsies. Among them, 60 patients were assigned to the observation group and received a daily dosage of 5 mg finasteride for 60 months, while the remaining 60 patients were assigned to the control group and did not receive finasteride. PSA levels were measured every six months, and imaging scans were conducted throughout the five-year study period. Additional biopsies were performed if PSA levels exceeded 10 ng/mL or imaging suggested the presence of prostate cancer. Statistical analysis was applied to the collected data. In total, 25 cases of prostate cancer were identified in this study. Of these cases, 7 patients belonged to the observation group, whereas the remaining 18 patients were from the control group. The observation group exhibited significantly lower levels of total serum PSA (p < 0.001) and Gleason scores (p < 0.001) compared to the control group. Our study, which involved 120 participants, demonstrated that finasteride effectively reduces serum PSA levels and mitigates the severity of prostate cancer. These findings suggest that finasteride holds potential as a treatment option for patients with -high-grade prostatic intraepithelial neoplasia.
Assuntos
Neoplasia Prostática Intraepitelial , Neoplasias da Próstata , Masculino , Humanos , Neoplasia Prostática Intraepitelial/diagnóstico , Neoplasia Prostática Intraepitelial/tratamento farmacológico , Finasterida/farmacologia , Finasterida/uso terapêutico , Antígeno Prostático Específico , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/tratamento farmacológico , Progressão da DoençaRESUMO
OBJECTIVE: To investigate the effects of different concentrations of Rauwolfia extract (RE) on the proliferation of prostate cells in the rat model of benign prostatic hyperplasia (BPH). METHODS: We randomly divided 48 male SD rats into six groups of an equal number, BPH model control, finasteride, low-concentration RE, medium-concentration RE, high-concentration RE and normal control, and established a BPH model in the former five groups by subcutaneous injection of testosterone propionate following castration. We treated the rats of the finasteride and RE groups intragastrically with finasteride solution at 5 mg/kg and RE at 5, 10 and 20 mg/kg respectively, and those of the model control and normal control groups with an equal dose of normal saline, all once a day for 28 consecutive days. Then, we killed all the animals, collected their prostate tissue, obtained the wet weight and volume of the prostate, the prostate index and the contents of serum T and dihydrotestosterone (DHT), observed the morphological changes of the prostate tissue by HE staining, counted the glands in the prostate tissue, measured the intraglandular area, and determined the expressions of PCNA and α-SMA by immunohistochemistry. RESULTS: Compared with the rats of the normal control group, the BPH model controls showed significantly increased wet weight (ï¼»0.923 ± 0.15ï¼½ vs ï¼»1.455 ± 0.52ï¼½ g, P < 0.05), volume (ï¼»1.035 ± 0.29ï¼½ vs ï¼»1.687 ± 0.31ï¼½ ml, P < 0.05) and index of the prostate (ï¼»0.23 ± 0.04ï¼½% vs ï¼»0.37 ± 0.15ï¼½%, P < 0.05), dilation, hyperemia and edema of the prostatic stroma and vessels, and proliferation rate of the prostatic cells, but remarkably decreased number of glands (ï¼»20.35 ± 3.83ï¼½ vs ï¼»12.56 ± 2.58ï¼½, P < 0.05), epithelial thickness (ï¼»39.76 ± 5.20ï¼½ vs ï¼»19.52 ± 1.52ï¼½ µm, P < 0.05) and intraglandular area (ï¼»12.3 ± 1.21ï¼½ vs ï¼»5.96 ± 0.34ï¼½ ×103µm2, P < 0.05). In comparison with the BPH model controls, the animals treated with RE, especially in the high-concentration RE group, exhibited marked decreases in the weight (ï¼»1.455 ± 0.52ï¼½ vs ï¼»0.862 ± 0.31ï¼½ g, P < 0.05), volume ( ï¼»1.687 ± 0.31ï¼½ vs ï¼»0.952 ± 0.28ï¼½ ml, P < 0.05) and index of the prostate (ï¼»0.37 ± 0.15ï¼½% vs ï¼»0.22 ± 0.07ï¼½%, P < 0.05), dramatic improvement in the number of glands (ï¼»12.56 ± 2.58ï¼½ vs ï¼»18.36 ± 1.25ï¼½, P < 0.05), epithelial thickness (ï¼»39.76 ± 5.20ï¼½ vs ï¼»19.04 ± 3.89ï¼½ µm, P < 0.05) and intraglandular area (ï¼»5.96 ± 0.34ï¼½ vs ï¼»10.25 ± 0.98ï¼½ ×103µm2, P<0.05ï¼½, P < 0.05), remarkable down-regulation of the expressions of PCNA and α-SMA, and significant reduction of the contents of serum T (ï¼»19.147 ± 3.214ï¼½ vs ï¼»6.016 ± 1.978ï¼½ ng/ml, P < 0.05) and DHT (ï¼»9.052 ± 0.633ï¼½ vs ï¼»2.532 ± 0.386ï¼½ ng/ml, P < 0.05). CONCLUSION: Rauwolfia extract can inhibit the proliferation of prostate cells and relieve BPH symptoms in a concentration-dependent manner in rats with BPH.
Assuntos
Alcaloides , Hiperplasia Prostática , Rauwolfia , Humanos , Ratos , Masculino , Animais , Próstata/metabolismo , Hiperplasia Prostática/metabolismo , Finasterida/farmacologia , Rauwolfia/metabolismo , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Antígeno Nuclear de Célula em Proliferação/metabolismo , Ratos Sprague-Dawley , Alcaloides/uso terapêutico , Di-Hidrotestosterona , Proliferação de Células , TestosteronaRESUMO
OBJETIVO: Avaliar o impacto na expressão AgNORs e apoptose na próstata do hamster-Mesocricetus auratus (hMa) submetido à aplicação de finasterida. MÉTODOS: Vinte roedores da espécie hMa (n=20), machos foram separados aleatoriamente em grupos de dez animais: grupo-Finasterida (n=10) e grupo-Controle (n=10). No grupo-finasterida foi administrado 7,14 ng/mL de finasterida, subcutâneo (SC), no dorso, três vezes por semana, por 90 dias. Foi avaliada a expressão AgNORs como marcador de proliferação celular e a apoptose como marcador de morte celular. RESULTADOS: A expressão de AgNORs foi menor no grupo-finasterida, 2,846±0,877 versus 3,68 ±1,07 grumos argilófilos por micrômetro ao quadrado (µm²) no grupo-controle, p= < 0,0001. A apoptose foi mais frequente no grupo-finasterida, 53,62±1,389 versus 14,76 ± 2,137 µm² no grupo-controle, p= 0,0408. CONCLUSÃO: Observou-se diminuição da expressão de AgNORs e promoção da apoptose na próstata dos roedores em estudo, que foram submetidos à aplicação de finasterida.
OBJECTIVE: To evaluate the impact on the AgNORs expression and apoptosis in the prostate of the hamster-Mesocricetus auratus (HMA) submitted to the application of finasteride. METHODS: Twenty male rodents of the species HMA (n = 20) were randomly assigned to groups of ten animals: Finasteride group (n = 10) and the Control group (n = 10). In the finasteride group 7.14 ng / mL finasteride was subcutaneously (SC) administered on the back of the animals three times a week for 90 days. AgNOR expression was evaluated as a marker of cell proliferation and apoptosis as a marker of cell death. RESULTS: The expression of AgNORs was lower in the finasteride group, 2.846 ± 0.877 vs. 3.68 ± 1.07 argyrophilic regions per square micrometer (µm2) in the control group, p = <0.0001. Apoptosis was more frequent in the finasteride group, 53.62 ± 1.389 versus 14.76 ± 2.13 per µm2 in the control group, p = 0.0408. CONCLUSION: We observed decreased expression of AgNORs and promotion of apoptosis in the prostate of rodents treated with finasteride.
Assuntos
Animais , Cricetinae , Masculino , /farmacologia , Antígenos Nucleares/biossíntese , Antígenos Nucleares/efeitos dos fármacos , Apoptose/efeitos dos fármacos , Finasterida/farmacologia , Próstata/citologia , Próstata/metabolismo , Mesocricetus , Próstata/efeitos dos fármacosRESUMO
PURPOSE: Evaluate the effects of finasteride on the serum PSA and on the prostate of hamster-Mesocricetus auratus(hMa). METHODS: Twenty hMa male adults were split in groups control and experimental (n=10). Animals of the experimental group received 7.14ng/mL of finasteride, subcutaneously (SC) on the back three times per week, during 90 days. The finasteride dose was equivalent to 5.0mg administered to a 70kg man. At the end of the experiment the mean age for the animals in the control group was 15.2±1.13months and for the experimental group was 17.7±0.67 months. There was a statistically significant difference between mean ages of both groups (t value=5.98; p=0.001). The animals of the control group weighted 129.0±18.8g and the experimental group weighted 145.0±15.5g, t=1.88 e p=0.0514. The serum PSA was assessed through ELISA method. Prostates of those animals were collected and processed to histology and morphometry: the diameter of the acinous glands and the acinous epithelium, apoptosis, AgNORs and cellularity were assessed in both groups. RESULTS: Serum PSA decreased in the experimental group, 0.003ng/mL versus 0.763ng/mL, H= 7.982 e p= 0.0047. Decrease in the acinous area occurred in animals that received finasteride, 238.000±24.600 μm² versus 398.600±55.320 μm²; t= 2.653; p= 0.0122. A remarkable decrease in the area of the acinous epithelium occurred in the animals that received finasteride, 111.900±12.820 μm² versus 160.400±18.430 μm² t= 2.162; p= 0.0361. AgNORs were less expressed in finasteride treated animals, 2.846±0.877 versus 3.68 ±1.07 argyrophilic clusters for μm², p= < 0.0001. Apoptosis was more intense in the experimental group, 53.62±1.389 than in controls, 14.76 ± 2.137, p= 0.0408. However, there was no statistical difference in the cellularity between both groups, 74.75±5.5 cells, in controls versus 65.07±13.24, in treated animals, p=0.5105. CONCLUSIONS: Use of finasteride decreased serum ...
OBJETIVO: Avaliar o efeito da finasterida no PSA sérico e na próstata do hamster-Mesocricetus auratus (hMa). MÉTODOS: 20 hMa adultos machos foram divididos em grupos de 10 animais. No experimento foram administrados 7,14 ng/mL de finasterida, subcutâneo (SC), no dorso, três vezes por semana, por 90 dias, dose equivalente a 5,0 mg usada em homem de 70Kg. Ao final da pesquisa, grupo experimento apresentou idade média de 17,7 ± 0,67 meses. O grupo controle apresentou idade média de 15,2 ± 1,13 meses. O valor de t na comparação das médias das idades entre os dois grupos foi de 5,98 e p=0.0001. Os animais-controle pesaram em média 129,0 ± 18,8g e o experimento 145,0 ± 15,5g; t=1,88 e p=0,0514. Na microscopia óptica de luz e estudo morfométrico: avaliaram-se o diâmetro dos ácinos e epitélio acinar prostáticos, a apoptose, a expressão AgNORs e a celularidade. RESULTADOS: O grupo-experimento apresentou média de PSA de 0,003 ng/mL e o grupo-controle de 0,763 ng/mL, H=7,982 e p=0,0047. A área dos ácinos do grupo-experimento foi de 238,000±24,600 μm² versus 398,600±55,320 μm²; t= 2,653; p= 0,0122. A área do epitélio acinar no grupo-experimento foi de 111,900±12,820 μm² versus 160,400±18,430 μm² t= 2,162; p= 0,0361. A expressão de AgNORs foi menor no grupo-experimento 2,846±0,877 versus 3,68 ±1,07 grumos argilófilos por μm², p= < 0,0001. A apoptose foi mais freqüente no grupo-experimento, 53,62±1,389 versus controle, 14,76 ± 2,137, p= 0,0408. Não houve diferença na celularidade entre os grupos de animais, 74,75±5,5 células no grupo-controle versus 65,07±13,24, no grupo-experimento, p= 0,5105. CONCLUSÕES: A finasterida diminuiu o PSA sérico, a área do lúmen, o epitélio acinar, a expressão de AgNORs e promoveu a apoptose nos ácinos da próstata dos hamsteres experimento e não houve diferença na celularidade acinar entre os animais estudados.
Assuntos
Animais , Cricetinae , Masculino , Inibidores Enzimáticos/farmacologia , Finasterida/farmacologia , Antígeno Prostático Específico/sangue , Próstata/efeitos dos fármacos , Apoptose/efeitos dos fármacos , Inibidores Enzimáticos/administração & dosagem , Finasterida/administração & dosagem , Mesocricetus , Modelos Animais , Região Organizadora do Nucléolo/efeitos dos fármacos , Região Organizadora do Nucléolo/patologia , Próstata/patologia , Distribuição Aleatória , Coloração pela PrataRESUMO
PURPOSE: To study the effect of finasteride on the spermatogenesis of adult Mesocricetus auratus. METHODS: Twenty adult hamsters were evaluated. The animals were one year-older, and were randomly divided in 2 different groups: control group with ten animals (n=10) and experimental group also with ten animals (n=10). The animals in the experimental group were shot 7.14 ng/mL (0.5mL) of finasteride by 100mg/Kg, subcutaneously in the dorsal region three times per week during 90 days. This dose correspondes to 5mg of the drug used in adult men for the treatment of benign prostatic hyperplasia (BPH). After three months, the animals were anesthetized through association of 200mg/kg ketamine chloridrate and 2.5 mg/kg of diazepan and were dead through hypovolemia.. The testis removed along with the whole genitourinary apparel were fixed with 10 percent formalin and submitted to histological analisys by optical microscopy. The hematoxilin-eosin (HE) method was used to stain the slides. RESULTS: The mean weight of animals in the control group before death was 129.0±18.8gr. The mean weight of animals in experimental group was 145.0±15.25gr. The mean age of animals in control group before death was 15.2±1.13 months. The mean age of animals in experimental group before death was 17.16±0.82 months. The mean difference in weight between both groups was not statistical significant (p=0.0514). The totality of animals in control group (100 percent) presented no tubular alterations and showed no disturbancy in the spermatogenesis stages. Four animals (40 percent) in the experimental group showed hypotrophy of the seminiferous tubules and six (60 percent) showed normal spermatogenesis, however reduced compared to control group. There was statiscally significant difference (p=0.043) between the control and experimental group related to testicular alterations. CONCLUSION: The animals that were administered finasteride showed significant...
OBJETIVO: Estudar o impacto da finasterida na espermatogênese do Mesocricetus auratus, adulto. MÉTODOS: Foram avaliados 20 hamsters adultos, com idades superiores a 1 ano, distribuídos em dois grupos: grupo controle com dez animais (n=10) e grupo experimental também com dez animais (n=10). No grupo experimental foi aplicado 7,14ng/mL (0,5mL) de finasterida por 100mg/Kg/peso, subcutâneo (SC), na região dorsal do animal, três vezes por semana por 90 dias, dose correspondente a 5mg da droga usada em homens adultos, para tratamento da hiperplasia benigna da próstata (HBP). No final de três meses, esses Hamsters foram mortos por hipovolemia, após serem anestesiados com cloridrato de quetamina, na dosagem de 200 mg/kg juntamente com diazepam, na dosagem de 2,5 mg/kg. Os testículos foram retirados em monobloco juntamente com todo o aparelho geniturinário, fixados em formalina a 10 por cento e encaminhados à histotécnica para posterior análise histológica em microscópico óptico. Foram usadas para coloração das lâminas a hematoxilina e eosina (HE). RESULTADOS: Quando foram mortos, os Hamsters do grupo de controle pesaram em média 129,0g e desvio padrão (DP) de 18,8g. O grupo de experimento apresentou média de peso de 145,0g e DP de 15,25g. A idade dos animas de controle quando foram mortos apresentou média de 15,2 meses e DP de 1,13 meses. Os animais de experimento apresentaram média de idade de 17,16 meses e DP de 0,82. A diferença das médias de peso entre os dois grupos não teve significado estatístico (p=0,0514). Os animais (100 por cento) do grupo controle não tiveram alterações tubulares e apresentaram todas as etapas da espermatogênese normais. Quatro animais (40 por cento) do grupo de experimento apresentaram hipotrofia dos túbulos seminíferos, e seis (60 por cento) desses animais apresentaram espermatogênese normal, mas diminuída em relação ao grupo controle. Do ponto de vista estatístico houve significância (p=0,043) entre o grupo de...