Investigation the mechanism of iron overload-induced colonic inflammation following ferric citrate exposure.

Iron overload occurs due to excessive iron intake compared to the body's demand, leading to iron deposition and impairment of multiple organ functions. Our previous study demonstrated that chronic oral administration of ferric citrate (FC) caused colonic inflammatory injury. However, the precise mechanism underlying this inflammatory response remains unclear. The current study aims to investigate the mechanism by which iron overload induced by FC exposure leads to colonic inflammation. To accomplish this, mice were orally exposed to three different concentrations of FC (71 mg/kg/bw (L), 143 mg/kg/bw (M) and 286 mg/kg/bw (H)) for continuous 16 weeks, with the control group receiving ultrapure water (C). Exposure to FC caused disturbances in the excretory system, altered colonic flora alpha diversity, and enriched pathogenic bacteria, such as Mucispirillum, Helicobacter, Desulfovibrio, and Shigella. These changes led to structural disorders of the colonic flora and an inflammatory response phenotype characterized by inflammatory cells infiltration, atrophy of intestinal glands, and irregular thickening of the intestinal wall. Mechanistic studies revealed that FC-exposure activated the NF-κB signaling pathway by up-regulating TLR4, MyD88, and NF-κB mRNA levels and protein expression. This activation resulted in increased production of pro-inflammatory cytokines, further contributing to the colonic inflammation. Additionally, in vitro experiments in SW480 cells confirmed the activation of NF-κB signaling pathway by FC exposure, consistent with the in vivo findings. The significance of this study lies in its elucidation of the mechanism by which iron overload caused by FC exposure leads to colonic inflammation. By identifying the role of pathogenic bacteria and the NF-κB signaling pathway, this study could potentially offer a crucial theoretical foundation for the research on iron overload, as well as provide valuable insights for clinical iron supplementation.

Artemiprinolides A-M, thirteen undescribed sesquiterpenoid dimers from Artemisia princeps and their antihepatoma activity.

Bioassay-guided investigation of the active fraction of Artemisia princeps led to 13 undescribed sesquiterpenoid dimers, artemiprinolides A-M (1-13), together with 11 known ones (14-24). Their structures were elucidated by comprehensive spectroscopic data and absolute configurations were assigned based on single crystal X-ray diffraction data and ECD calculations. Structurally, all compounds were postulated to be derived from the Diels-Alder cycloaddition. The isolated dimers except 11 and 15 were assayed for their cytotoxicity against HepG2, Huh7, and SK-Hep-1 cell lines, of which four compounds (3, 13, 17, 18) exhibited obvious cytotoxicity with IC50 values ranging from 8.8 to 20.1 µM. Interestingly, the most active compounds 1 and 16 manifested significant cytotoxicity on the three tested hepatoma cell lines with IC50 values of 5.4, 4.1 (HepG2), 7.7, 5.6 (Huh7), and 11.8, 15.7 µM (SK-Hep-1), respectively, which were better than sorafenib. Compound 1 dose-dependently inhibited cell migration and invasion, and significantly induced the HepG2 cell arrest in G2/M phase by downregulating cdc2 and pcdc2 and upregulating cyclinB1; and induced apoptosis by downregulating Bcl-2 expression and upregulating Bax level. The molecular docking study implied that the carbonyl at the C-12' of 1 had a strong binding affinity with PRKACA.

Study on Chemical Components from Derris taiwaniana and Their Lung Epithelial Cell Protect Effects.

The ethanol extract of roots of Derris taiwaniana gave two undescribed compounds, 3,3'-dimethoxy-5'-hydroxystilbene-4-O-ß-apiofuranosyl-(1→6)-ß-D-glucopyranoside (1) and 4',5-dihydroxy-3'-methoxyisoflavone-7-O-ß-apiofuranosyl-(1→6)-ß-D-glucopyranoside (2), along with thirty known components. Among them, compounds 14, 16-17, 23, 26-32 were isolated from this genus for the first time. Their structures were established based on physico-chemical properties and spectroscopic data, the lung epithelial cell protective effects were evaluated using NNK-induced MLE-12 cells. Among them, 2α,3α-epoxy-5,7,3',4'-tetrahydroxyflavan-(4ß-8-catechin) (30) showed the best significant protective effect, speculated to be the key component of D. taiwaniana that plays a protective role in lung epithelial cells.

Artemidubolides A-T, cytotoxic unreported guaiane-type sesquiterpenoid dimers against three hepatoma cell lines from Artemisia dubia.

A random bioassay revealed that the EtOH extract and EtOAc fraction of Artemisia dubia Wall. (Asteraceae) exhibited cytotoxic activity against HepG2 cells with inhibitory ratios of 57.1% and 84.2% at a concentration of 100.0 µg/mL. Bio-guided isolation combined by LC-MS-IT-TOF analyses of the active fractions led to the isolation of 20 previously undescribed guaiane-type sesquiterpenoid dimers named artemidubolides A-T (1-20). Their structures and the absolute configurations were determined by comprehensive spectral analyses, comparison of the experimental and calculated ECD spectra, and seven compounds (artemidubolides A, B, D, F, K, O and R) were confirmed unequivocally by single crystal X-ray diffraction analysis. Structurally, artemidubolides A-Q were [4 + 2] Diels-Alder adducts of two monomeric guaianolides, and artemidubolides R-T were linked though an ester bond. All the isolated compounds were evaluated for their hepatomatic cytotoxicity against HepG2, Huh7, and SK-Hep-1 cell lines to demonstrate that 18 compounds exhibited obvious cytotoxicity against three tested hepatoma cell lines with IC50 values in the range of 5.4-87.6 µM. Importantly, artemidubolides B, D, and M exhibited hepatoma cytotoxicity with IC50 values of 5.4, 5.7, and 9.7 (HepG2), 8.2, 4.3, and 12.2 (Huh7), and 13.4, 8.4, and 12.9 µM (SK-Hep-1), respectively. Mechanism investigation in HepG2 cells suggested the most active artemidubolide D dose-dependently inhibited cell migration and invasion, induced G1/M cell cycle arrest by down-regulating proteins CDK4, CDK6 and CyclinD1 and up-regulating the level of protein P21; and induced apoptosis by down-regulated of PARP-1 and BCL-2 expression and up-regulating Bax and cleaved PARP-1 levels.

Antiproliferative Amaryllidaceae alkaloids from the bulbs of Hymenocallis littoralis (Jacq.) Salisb.

Seven undescribed Amaryllidaceae alkaloids classified into four types, including the plicamine-type, secoplicamine-type, belladine-type and pretazettine-type, along with another three alkaloids that have not been isolated from plant material and seven known alkaloids, were isolated from the bulbs of Hymenocallis littoralis (Jacq.) Salisb. The structures were elucidated on the basis of various spectroscopic methods (UV, IR, MS, NMR, ECD). The isolated alkaloids were screened for antiproliferative activity against four human tumour cell lines (HepG2, HeLa, SPC-A-1, FaDu) through MTT assay, and some alkaloids exhibited potent cytotoxicity. Meanwhile, cell morphological assessment, flow cytometric analysis, Western blot analysis, clone formation and scratch wound assays were utilized for an undescribed belladine-type alkaloid and two known alkaloids, which had antiproliferative effects on the HepG2 cell line via induction of apoptosis in a dose-dependent manner. A pair of diastereoisomers of Amaryllidaceae alkaloids exhibited significant differences in antiproliferative activity. In addition, the alkaloids also possessed the potential to inhibit tumour cell migration.

Wu-Zi-Yan-Zong-Wan protects mouse blood-testis barrier from Tripterygium wilfordii Hook. f. multiglycoside-induced disruption by regulating proinflammatory cytokines.

ETHNOPHARMACOLOGICAL RELEVANCE: Wu-Zi-Yan-Zong-Wan (WZYZW) is a classical traditonal Chinese herbal formula and a Chinese patent medicine used to treat male infertility. However, the chemical components of WZYZW and its mechanism are not yet fully clarified. AIM OF THE STUDY: The purpose of this study is to observe the effect and underlying mechanism of WZYZW on ameliorating blood-testis barrier (BTB) dysfunction in mice with spermatogenic dysfunction induced by administration of Tripterygium wilfordii Hook. f. multiglycosides (GTW). MATERIALS AND METHODS: WZYZW was administered by gavage to mice with GTW-induced spermatogenic dysfunction (kidney essence deficiency pattern) for 40 days. Testis tissues were obtained for subsequent histopathological analysis. Biotin tracing was used to evaluate the permeability of Sertoli cell tight junctions. The levels of proinflammatory cytokines including interleukin (IL)-6, IL-17A, IL-1α and tumor necrosis factor (TNF)-α were analyzed by ELISA. The expression levels of proteins related to tight junction including ZO-1, JAM-A and occludin were analyzed by western blotting. The ultrastructures of tight junctions were observed by transmission electron microscopy. RESULTS: WZYZW ameliorated GTW-induced testicular spermatogenic dysfunction. Levels of IL-6, IL-17A, IL-1α, and TNF-α in the groups receiving low, medium, and high doses of WZYZW decreased in a dose-dependent manner. WZYZW impeded a biotin tracer from permeating the BTB, protecting its integrity in GTW-treated mice. In addition, our results showed no significant changes in the protein expressions of ZO-1, JAM-A, and occludin after WZYZW administration compared with the GTW group. Meanwhile, WZYZW exhibited a linear arrangement and restored the typical "sandwich" structure of BTB. No acute poisoning incidences were observed in all groups during the experiment. CONCLUSIONS: Our findings demonstrate that WZYZW may ameliorate some GTW-induced BTB dysfunction, possibly by regulating proinflammatory cytokine levels. In vitro studies on the regulation of BTB permeability by WZYZW and its active components are further required.

Functional assembly of root-associated microbial consortia improves nutrient efficiency and yield in soybean.

Root-associated microbes are critical for plant growth and nutrient acquisition. However, scant information exists on optimizing communities of beneficial root-associated microbes or the mechanisms underlying their interactions with host plants. In this report, we demonstrate that root-associated microbes are critical influencers of host plant growth and nutrient acquisition. Three synthetic communities (SynComs) were constructed based on functional screening of 1,893 microbial strains isolated from root-associated compartments of soybean plants. Functional assemblage of SynComs promoted significant plant growth and nutrient acquisition under both N/P nutrient deficiency and sufficiency conditions. Field trials further revealed that application of SynComs stably and significantly promoted plant growth, facilitated N and P acquisition, and subsequently increased soybean yield. Among the tested communities, SynCom1 exhibited the greatest promotion effect, with yield increases of up to 36.1% observed in two field sites. Further RNA-seq implied that SynCom application systemically regulates N and P signaling networks at the transcriptional level, which leads to increased representation of important growth pathways, especially those related to auxin responses. Overall, this study details a promising strategy for constructing SynComs based on functional screening, which are capable of enhancing nutrient acquisition and crop yield through the activities of beneficial root-associated microbes.

Iron Overload Resulting from the Chronic Oral Administration of Ferric Citrate Impairs Intestinal Immune and Barrier in Mice.

Ferric citrate (FC) is an iron-containing phosphate binder used as a food additive for iron supplementation. To explore the potential effect of ferric citrate on intestinal epithelial function, in the present study, we administered the mice orally for 16 weeks with different doses of iron citrate (2.5 mg/day (1.25%), 5 mg/day (2.5%), and 10 mg/day (5.0%)). We found that the iron levels of serum and tissue significantly increased, which caused the body to be in an iron overload state; meanwhile, the villus height, the ratio of villus height to crypt depth, and the number of intraepithelial lymphocytes and goblet cells in jejunum all decreased. Iron overload upregulated the pro-inflammatory cytokines (IL-1ß, IL-2, IL-6, TNF-ɑ), while downregulated the anti-inflammatory cytokines (IL-4, IL-10) and sIgA. Moreover, iron overload increased serum D-lactate (D-LA) levels and decreased tight junction proteins (claudin-1, occludin, and ZO-1), MUC-2, and TFF3. In addition, iron overload upregulated the content of MDA and protein carbonyl, while downregulated the activity and content of T-AOC, GSH-PX, SOD, CAT, and GSH. To sum up, the present results showed that long-term oral administration of FC resulted in iron overload, which consequently impaired intestinal immune and barrier function in mice. Meanwhile, the effect on intestinal damage may be highly related to the increase of oxidative stress in the jejunum.

Iron overload resulting from the chronic oral administration of ferric citrate induces parkinsonism phenotypes in middle-aged mice.

Iron homeostasis is critical for maintaining normal brain physiological functions, and its mis-regulation can cause neurotoxicity and play a part in the development of many neurodegenerative disorders. The high incidence of iron deficiency makes iron supplementation a trend, and ferric citrate is a commonly used iron supplement. In this study, we found that the chronic oral administration of ferric citrate (2.5 mg/day and 10 mg/day) for 16 weeks selectively induced iron accumulation in the corpus striatum (CPu), substantia nigra (SN) and hippocampus, which typically caused parkinsonism phenotypes in middle-aged mice. Histopathological analysis showed that apoptosis- and oxidative stress-mediated neurodegeneration and dopaminergic neuronal loss occurred in the brain, and behavioral tests showed that defects in the locomotor and cognitive functions of these mice developed. Our research provides a new perspective for ferric citrate as a food additive or in clinical applications and suggests a new potential approach to develop animal models for Parkinson's disease (PD).

Soy Isoflavones Improve the Spermatogenic Defects in Diet-Induced Obesity Rats through Nrf2/HO-1 Pathway.

Soy isoflavones (SIF) are biologically active compounds of non-steroidal and phenolic properties that are richly present in soybeans, which can reduce the body weight and blood lipids of obese animals. Recently, SIF have been reported to affect reproductive ability in obese male rats. However, the specific mechanism has not been well defined. The aim of the current study was to study the possible mechanisms for the effect of SIF administration on obesity induced spermatogenic defects. Obese rats model induced by high-fat diets were established and gavage treated with 0, 50,150 or 450 mg of SIF/kg body weight/day for 4 weeks. Here, our research shows that obesity resulted in spermatogenic degeneration, imbalance of reproductive hormone, testicular oxidative stress and germ cell apoptosis, whereas evidently recovery effects were observed at 150 and 450 mg/kg SIF. We also have discovered that 150 and 450 mg/kg SIF can activate Nrf2/HO-1 pathway in control of Bcl-2, BAX and cleaved caspase-3 expression with implications in antioxidant protection. Our study indicates the potential mechanism of SIF regulating spermatogenic function in obese rats, and provides a scientific experimental basis for the regulation of biological function of obese male reproductive system by SIF.

An aqueous polyphenol extract from Rosa rugosa tea has antiaging effects on Caenorhabditis elegans.

Rosa rugosa aqueous polyphenol (RAP) is a kind of polyphenol from Rosa rugosa flower tea. In this study, the antiaging activities of RAP were studied in the model organism Caenorhabditis elegans. UHPLC-HESI-MS/MS was employed to identify the specific phenolic profile, revealing that there were 23 types of phenolic compounds in RAP and that quercetin glycoside was the principal component. RAP increased the mean lifespan of C. elegans and enhanced the thermotolerance and resistance to oxidative stress of C. elegans in a concentration-dependent manner. Furthermore, RAP showed powerful antioxidant effects in vitro and strong protection against oxidative DNA damage. RAP significantly improved the levels of total superoxide dismutase and total antioxidant capacity of C. elegans. In conclusion, RAP has antiaging effects on C. elegans, which might be related to its powerful antioxidant effects both in vitro and in vivo. PRACTICAL APPLICATIONS: In recent years, chronic diseases associated with aging have had a profound impact on quality of life. Many healthy foods have antiaging properties, especially flower teas, such as those made from Rosa rugosa. Our results indicated that Rosa rugosa tea is good for health and that RAP could potentially be developed as a bioactive product that could be used to combat aging.

[Differentially expressed proteins in the penile tissue of rats with compound stress-induced ED after intervention with Yimusake Tablets: A bioinformatics analysis].

OBJECTIVE: To search for specific protein makers and target proteins for intervention with Yimusake Tablets (YT) in the penile tissue of rats with ED induced by compound cold stress and explore the molecular mechanisms underlying the development and progression of ED. METHODS: Eighty adult male rats were screened and divided into three groups, normal control (n = 10), ED model control (n = 15) and YT intervention (n = 15). The model of compound cold stress-induced ED was established in the latter two groups, and meanwhile the animals in the YT intervention group were treated with oral YT for 2 weeks. After that, proteins were extracted from the penile tissues of the rats for screening and identification by iTRAQ labeling combined with LC-MS-MS proteomics, and the IPA bioinformatics software was used for analysis of differentially expressed proteins. RESULTS: A total of 48 differentially expressed proteins were identified from the penile tissue of the ED model controls, of which 18 were associated with endothelial function, 5 with smooth muscle activity and 4 with inflammation, involving the biological processes of glucose metabolism and alcohol catabolism and the signaling pathways of glucose metabolism, calcium and RXR activation. In comparison, 29 differentially expressed proteins were identified from the rats in the YT intervention group, of which 5 were associated with endothelial function, 1 with smooth muscle activity and 4 with inflammation, involving the biological processes of glucose metabolism, vasodilation and acute-phase response and the signaling pathways glucose metabolism, RXR activation and acute-phase response. Seven ED-associated candidate biomarkers were obtained from the differentially expressed proteins in the ED model control and YT intervention group, including Collagen alpha-1(III) chain（COL3α1）, Collagen alpha-1(I) chain（COL1α1）, Collagen alpha-2(I) chain（COL1α2）, Glyceraldehyde-3-phosphate dehydrogenase（GAPDH）, T-kininogen 1（MAP1）,Biglycan（BGN）, and Myosin-11（MYH11）. CONCLUSIONS: Changes of vascular endothelial and smooth muscle functions in the penile tissue are likely to be the key mechanisms underlying the development and progression of compound stress-induced ED, which is also associated with inflammation as well as the interaction of the identified differentially expressed proteins and their participation in the relevant signaling pathways. The 7 proteins obtained can be used as the markers of compound stress-induced ED in the rat penile tissue, of which MAP1, GAPDH, BGN and MYH11 may serve as target proteins for YT intervention.

Effect of Electroacupuncture on Spermatogenesis in Rats with Oligozoospermia of Insufficiency of Shen (Kidney) Essence Syndrome.

OBJECTIVE: To assess the effect of electroacupuncture (EA) on expression of cytoskeletal proteins from Sertoli cells (SCs) and spermatogenesis in rats with oligozoospermia of insufficiency of Shen (Kidney) essence syndrome (OIKES). METHODS: Twenty healthy male Sprague-Dawley rats were randomly assigned to four groups using a random number table: control, tripterygium glycosides (TG) treatment, sham and EA groups (n=5 in each group). A rat model of OIKES was established by oral gavage with TG. The EA group was treated with TG and received EA at Shenshu (BL 23) and Zusanli (ST 36) acupoints for 20 min, once daily for 30 days, while the sham group received EA at identical acupoints with skin penetration without stimulation. After 30 days, the final body weight and coefficients for the testis and epididymis were calculated and sperm parameters were measured. Immunohistochemical analyses were performed to detect expression of vimentin and α-tubulin in SCs and proliferating cell nuclear antigen (PCNA) immunoreactivity in germ cells. Apoptosis in germ cells was quantified by the transferase biotin-dUTP nick end labeling assay. RESULTS: Compared with the control group, the final body weight and testis/epididymis coefficients of rats in the TG-treated group were not significantly different, but the sperm count and motility were lower (P<0.05). Expressions of vimentin and α-tubulin were also significantly weaker (P<0.01). The PCNA immunoreactivity of germ cells was decreased (P=0.059), whereas the apoptotic index of germ cells was increased significantly (P<0.01). In contrast, EA at BL 23 and ST 36 acupoints significantly improved the final body weight as well as the sperm count, concentration and motility (P<0.01 or P<0.05). EA increased expression of vimentin and α-tubulin in SCs markedly, and significantly enhanced PCNA immunoreactivity with decreased apoptosis in germ cells (P<0.01 or P<0.05). CONCLUSIONS: EA at BL 23 and ST 36 acupoints has protective effects on spermatogenesis in rats with OIKES. This effect seems to be achieved by attenuating TG-induced disruption of cytoskeletal protein in SCs.

Scalable synthesis enabling multilevel bio-evaluations of natural products for discovery of lead compounds.

Challenges in the development of anti-cancer chemotherapeutics continue to exist, particularly with respect to adverse effects and development of resistance, underlining the need for novel drugs with good safety profiles. Natural products have proven to be a fertile ground for exploitation, and development of anti-cancer drugs from structurally complex natural products holds promise. Unfortunately, this approach is often hindered by low isolation yields and limited information from preliminary cell-based assays. Here we report a concise and scalable synthesis of a series of low-abundance Isodon diterpenoids (a large class of natural products with over 1000 members isolated from the herbs of genus Isodon, which are well-known folk medicines for the treatment of inflammation and cancer), including eriocalyxin B, neolaxiflorin L and xerophilusin I. These scalable syntheses enable multilevel bio-evaluation of the natural products, in which we identify neolaxiflorin L as a promising anti-cancer drug candidate.

Effects of brucine on vascular endothelial growth factor expression and microvessel density in a nude mouse model of bone metastasis due to breast cancer.

OBJECTIVE: To study the effects of brucine on vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) in a nude mouse model of bone metastasis due to breast cancer, and to assess the possible antitumor mechanism of brucine. METHODS: A syringe needle was used to directly inject 0.2 mL monoplast suspension (with 2×10(5) human breast cancer cells contained) into the bony femoral cortex of the right hind leg for modeling. Twenty-five nude mice were randomized into five groups and administered with an intraperitoneal injection of saline or drug for 8 consecutive days: model group (0.2 mL normal saline), low-dose brucine group (1.73 mg·kg(-1)), medium-dose brucine group (3.45 mg·kg(-1)), high-dose brucine group (6.90 mg·kg(-1)), and thalidomide group (200 mg·kg(-1)). Diet and activity were recorded, and the tumors were harvested 5 weeks later. The percentage of VEGF-positive cells was determined with hematoxylin and eosin staining and immunohistochemical staining, and MVD expression was determined by optical microscopy. RESULTS: The VEGF expressions in brucine- or thalidomide-treated mice were significantly reduced as compared with mice in the model group (P <0.01). There were no significant difference between the high-dose brucine group and the thalidomide group (P >0.05). Significant difference was between the high- and low-dose brucine group P<0.05). Further, VEGF expression was significantly increased in the low- and medium-dose brucine groups compared with the thalidomide group (P <0.05). The MVD values in the three brucine and thalidomide groups were significantly lower than that in the model group (P <0.01). The MVD values in the medium- and high-dose brucine groups were not significantly different from those in the thalidomide group (P >0.05), while the MVD value showed a significant increase in the low-dose group compared with the thalidomide group (P <0.05). CONCLUSION: Brucine could inhibit the growth of breast cancer to bone metastases, possibly by inhibiting tumor angiogenesis.

Impact of plasmakinetic enucleation of the prostate (PKEP) on sexual function: results of a prospective trial.

INTRODUCTION: Recent data have shown that plasmakinetic enucleation of the prostate (PKEP) is a novel and effective procedure for symptomatic benign prostatic hyperplasia (BPH); however, data on patient sexual function after PKEP remain scarce. AIMS: This study aims to evaluate the impact of PKEP on sexual function in men with lower urinary tract symptoms because of BPH. METHODS: One hundred eighty-six consecutive patients who underwent the PKEP procedure were prospectively enrolled in this study. The International Index of Erectile Function (IIEF-15) and the International Prostate Symptom Score with quality of life scores were completed and compared preoperatively and at 1, 3, 6, and 12 months postoperatively. At each follow-up visit, maximum urinary flow rates, transrectal ultrasound-assessed prostate volume, postvoid residual urine volume, and serum prostate-specific antigen level were also measured and compared with the baseline. MAIN OUTCOME MEASURES: The IIEF global score and its five domains scores were evaluated for each patient, and the Friedman test or chi-square test was used to identify changes from the baseline. RESULTS: There was a slight and nonsignificant increase in the IIEF global score and four of its five domains scores (i.e., erectile function, intercourse satisfaction, sexual desire, and overall satisfaction) at each postoperative assessment (P > 0.05 for all). However, a statistically significant reduction was observed in the orgasmic function domain score of IIEF at 3 months (P = 0.016), 6 months (P < 0.001), and 12 months (P < 0.001), respectively, along with the corresponding retrograde ejaculation rates of 48.7%, 49.4%, and 48.8%. CONCLUSIONS: PKEP has no negative influence on the quality of erections measured by the self-administered IIEF questionnaire, but it significantly lowers the orgasmic function domain score, reflecting probably postoperative retrograde ejaculation. These findings are important in preoperative counseling of the patients undergoing PKEP for symptomatic BPH.

PSCA mRNA expression in preoperatively negative prostate biopsies predicts incidental prostate cancer in patients undergoing transurethral resection of the prostate for benign prostatic hyperplasia.

BACKGROUND: Recent data showed that prostate stem cell antigen (PSCA) mRNA expression is predictive of the subsequent cancer in BPH patients treated with TURP. This study was to determine whether PSCA mRNA expression in preoperatively negative biopsies identified the presence of incidental prostate cancer (IPCa) on TURP tissues analysis. METHODS: PSCA in situ hybridization was performed in preoperatively negative prostatic biopsies taken from 592 enrolled BPH patients. Predictive performance of PSCA mRNA for IPCa was evaluated by the Cox proportional hazards models. RESULTS: PSCA mRNA positivity in negative biopsy specimens was detected in 84 (14.2%) of 592 men. Of those 84 patients, 57 were histopathologically identified as having PCa on their TURP tissues. None of the rest 508 men with negative PSCA mRNA expression were diagnosed with IPCa. Spearman's rank correlation coefficient showed that PSCA mRNA expression levels were correlated significantly and positively with Gleason score (r = 0.80, P < 0.001) and clinical stage (r = 0.86, P < 0.001). A multivariate Cox model demonstrated that only PSCA mRNA positivity was predictive of the IPCa presence on TURP (HR = 4.04; 95% CI: 2.12-5.42; P < 0.001), with the concordance index of 0.878. CONCLUSION: PSCA mRNA positivity in negative biopsies is a promising marker for the presence of IPCa in BPH patients.