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Luis Heriberto VM, Patrick MS, Elihu CP, Bravo G, Julian ACD. Whole tomato lipidic extract improved sperm quality in obese rats induced by a high-carbohydrate diet. Andrology 2024. [PMID: 39189885 DOI: 10.1111/andr.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 08/05/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Obesity represents a risk in the development of metabolic and oxidative stress (OS), as well as in male infertility. There is still no pharmacological treatment for obesity-induced male infertility, but the use of natural antioxidants has been proposed as a treatment. OBJECTIVE The aim of this work is to evaluate the effect of a whole tomato lipid extract on rats that decreased their fertility and spermatogenesis after being induced obese with a high carbohydrate diet. MATERIALS AND METHODS One hundred fourteen male Wistar rats of 12 weeks of age were used. Two groups were randomly formed non-obese control group (C, n = 54) and obese group (Ob, n = 54) that received 30% w/v sucrose solution for 3 months. Subsequently, the C and Ob group were divided into two groups: vehicle (C-Vh and Ob-Vh) that received corn oil as vehicle and tomato lipid extract (C-Ex and Ob-Ex) that received whole tomato lipid extract. The groups that received a hypercaloric diet had a gain in visceral and retroperitoneal adipose tissue, an increase in total cholesterol and triglyceride levels, increased OS in the testis, and lesions in testicular histology, as well as a reduction in testicular size and sperm quality parameters (motility, viability, and concentration). RESULTS Treatment with whole tomato lipid extract significantly decreased the weight of gonadal adipose tissue and OS, maintained testicular size, showed a significant increase in sperm quality parameters and improved histology of seminiferous tubules. CONCLUSIONS These results demonstrate a greater therapeutic and beneficial effect of the tomato lipid extract on sperm quality parameters in obese rats and therefore on fertility.
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Affiliation(s)
| | - Mailloux Salinas Patrick
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados del IPN, Sede Sur, México
| | - Campos Pérez Elihu
- Departamento de Patología, Hospital General Dra. Matilde Petra Montoya Lafragua, ISSSTE, México
| | - Guadalupe Bravo
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados del IPN, Sede Sur, México
| | - Arias Chávez David Julian
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados del IPN, Sede Sur, México
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El Tabaa MM, Aboud MM, Anis A, Rashad E, Sokar SS. Targeting SRD5A1 and MMP-2/NLRP3/TGF-β1 axis alleviates the amlodipine-induced gingival hyperplasia in rats: Emerging role of saw palmetto and folic acid. Food Chem Toxicol 2024; 189:114731. [PMID: 38740241 DOI: 10.1016/j.fct.2024.114731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/04/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024]
Abstract
Saw palmetto (SAW), the herbal drug used to treat prostatic hyperplasia, exerts its antiproliferative effects by blocking steroid 5 alpha-reductase (SRD5A1) activity, that has also been involved in gingival hyperplasia (GH) pathogenesis. Concurrently, folic acid (FA) could reduce GH prevalence via its antioxidant and anti-inflammatory effects. Thus, this study tended to assess the potential therapeutic efficacy of SAW, alone and along with FA, against amlodipine-induced gingival inflammation and overgrowth in rats. Rats were grouped into (CONT, AIGH, SAW, SAW-treated, FA-treated, and SAW + FA-treated). SAW and FA were administered once daily for 4 weeks. Gingival SRD5A1, CTGF, GSK-3β, and NLRP3 expressions, as well as T, DHT, MDA, TAC, ET-1, and MMP2 levels were determined. In addition, histopathological and immunohistochemical analyses of TNF-α, IL-6, TGF-β1, and α-SMA were documented. Results declared that SAW and FA administration markedly ameliorated amlodipine-associated GH and may be presenting a novel therapeutic avenue in the future.
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Affiliation(s)
- Manar Mohammed El Tabaa
- Pharmacology & Environmental Toxicology, Environmental Studies & Research Institute (ESRI), University of Sadat City, Sadat City, 32897, Menoufia, Egypt.
| | - Mahmoud Moustafa Aboud
- Dental Science, Environmental Studies & Research Institute (ESRI), University of Sadat City, Sadat City, 32897, Menoufia, Egypt.
| | - Anis Anis
- Pathology, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, 32897, Menoufia, Egypt.
| | - Eman Rashad
- Cytology and Histology Department, Faculty of Veterinary Medicine, Cairo University, Egypt.
| | - Samia Salem Sokar
- Pharmacology & Toxicology, Faculty of Pharmacy, Tanta University, Tanta, Egypt.
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Arias‐Chávez DJ, Mailloux‐Salinas P, Ledesma Aparicio J, Campos‐Pérez E, Medina‐Campos ON, Pedraza‐Chaverri J, Bravo G. Selenium in combination with a tomato lipid extract as a therapy for benign prostatic hyperplasia and its alterations in rats with induced BPH. J Cell Mol Med 2023; 27:3147-3156. [PMID: 37726932 PMCID: PMC10568668 DOI: 10.1111/jcmm.17903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/20/2023] [Accepted: 08/01/2023] [Indexed: 09/21/2023] Open
Abstract
Benign prostatic hyperplasia (BPH) is the most common adenoma in old men. Tomatoes are a rich source of bioactive compounds that, as well as selenium (Se), possess antioxidant and antiproliferative activity. The aim was to evaluate the therapeutic effect of Se in combination with a tomato extract in aged rats with BPH. Aged male Wistar rats were divided in the following groups (n = 10 rats/group): Control (C), BPH, BPH + Finasteride (BPH + F), BPH + Tomato Lipidic Extract (BPH + E), BPH + Selenium (BPH + S) and BPH plus E plus S (BPH + E + S). After 4 weeks of treatment, prostate weight, diuresis, antioxidants enzymes, prooxidants and inflammatory markers, growth factors and androgens were determined. BPH + E + S reduced prostate weight by 59.29% and inhibited growth by 99.35% compared to BPH + F which only decreased weight and inhibited growth by 15.31% and 57.54%, respectively. Prooxidant markers were higher with BPH + F (49.4% higher vs. BPH), but BPH + E + S decreased these markers (94.27% vs. BPH) and increased antioxidant activity. Finally, diuresis was higher with the BPH + E + S combination and markers of inflammation and growth factors were significantly lower with respect to BPH + F. Our findings provide a beneficial and protective therapeutic option of E + S directed against androgens, oxidative stress and inflammation that regulates cell proliferation in the prostate gland.
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Affiliation(s)
- David Julian Arias‐Chávez
- Departmento de FarmacobiologíaCentro de Investigación y de Estudios Avanzados del IPN, Sede SurMexico CityMexico
| | - Patrick Mailloux‐Salinas
- Departmento de FarmacobiologíaCentro de Investigación y de Estudios Avanzados del IPN, Sede SurMexico CityMexico
| | - Jessica Ledesma Aparicio
- Departmento de FarmacobiologíaCentro de Investigación y de Estudios Avanzados del IPN, Sede SurMexico CityMexico
| | - Elihu Campos‐Pérez
- Departamento de Patología, ISSSTEHospital General Dra. Matilde Petra Montoya LafraguaMexico CityMexico
- Departamento de PatologíaHospital Ángeles LindavistaMexico CityMexico
| | - Omar Noel Medina‐Campos
- Laboratorio F‐315, Departamento de Biología, Facultad de QuímicaUniversidad Nacional Autónoma de MéxicoMexico CityMexico
| | - José Pedraza‐Chaverri
- Laboratorio F‐315, Departamento de Biología, Facultad de QuímicaUniversidad Nacional Autónoma de MéxicoMexico CityMexico
| | - Guadalupe Bravo
- Departmento de FarmacobiologíaCentro de Investigación y de Estudios Avanzados del IPN, Sede SurMexico CityMexico
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Colado-Velázquez JI, Mailloux-Salinas P, Arias-Chávez DJ, Ledesma-Aparicio J, Gómez-Viquez NL, Cano-Europa E, Sarabia GN, Bravo G. Lipidic extract of whole tomato reduces hyperplasia, oxidative stress and inflammation on testosterone-induced BPH in obese rats. Int Urol Nephrol 2023; 55:529-539. [PMID: 36464759 DOI: 10.1007/s11255-022-03383-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/29/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE Tomato is an important source of lycopene, a carotenoid that has been emerging as a natural preventive agent for prostate disease. Moreover, tomato contains other components with a wide range of physiological properties, but their potential beneficial effects on prostatic hyperplasia (PH) during obesity have not been completely established. In this study, we compared the effect of a lipidic extract of tomato saladette (STE) with Serenoa repens (SR) on obese rats with PH. METHODS Forty-eight Wistar rats were divided in Control (C) and Obese (Ob) treated without (n = 12) and with (n = 36) testosterone enanthate (TE), once a week for 8 weeks to induce PH. After 4 weeks, SR and STE were administered. Biochemical parameters, oxidative stress markers and inflammatory cytokines production were determined. RESULTS TE increased prostate weight and caused prostatic hyperplasia in C group, and these effects were exacerbated by obesity. SR and STE reverted the increase in prostate weight and hyperplasia caused by TE in C and Ob groups. Obesity increased LDL, TGs, NOx and MAD, but decreased HDLc, GSx, SOD and CAT. SR reverted the effects of obesity, but these were significantly reduced and HDLc increased with STE. Obesity and TE increased TNFα, IL-1β and IL-6 levels, but these were partially reverted by STE compared with SR. CONCLUSIONS Excess of fat tissue increases the alterations by PH. STE diminishes these alterations compared with SR, suggesting its beneficial effect to improve prostate function. Whole tomato lipid extract could serve as sole therapy or as an adjunct to pharmacological treatment for PH.
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Affiliation(s)
- Juventino Iii Colado-Velázquez
- Depto. Farmacobiología, Cinvestav-IPN, Calz. de los Tenorios 235, Col. Granjas Coapa, 14330, México, Mexico
- Autonomous University of the West, Unidad Regional Culiacán, Sinaloa, Mexico
| | - Patrick Mailloux-Salinas
- Depto. Farmacobiología, Cinvestav-IPN, Calz. de los Tenorios 235, Col. Granjas Coapa, 14330, México, Mexico
| | - David Julian Arias-Chávez
- Depto. Farmacobiología, Cinvestav-IPN, Calz. de los Tenorios 235, Col. Granjas Coapa, 14330, México, Mexico
| | - Jessica Ledesma-Aparicio
- Depto. Farmacobiología, Cinvestav-IPN, Calz. de los Tenorios 235, Col. Granjas Coapa, 14330, México, Mexico
| | - Norma Leticia Gómez-Viquez
- Depto. Farmacobiología, Cinvestav-IPN, Calz. de los Tenorios 235, Col. Granjas Coapa, 14330, México, Mexico
| | - Edgard Cano-Europa
- Lab. de Metabolismo I, Departamento de Fisiología "Dr. Mauricio Russek Berman", Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, México, Mexico
| | | | - Guadalupe Bravo
- Depto. Farmacobiología, Cinvestav-IPN, Calz. de los Tenorios 235, Col. Granjas Coapa, 14330, México, Mexico.
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Consumption of combined fructose and sucrose diet exacerbates oxidative stress, hypertrophy and CaMKII δ oxidation in hearts from rats with metabolic syndrome. Mol Cell Biochem 2022; 477:1309-1320. [PMID: 35138512 DOI: 10.1007/s11010-022-04364-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/12/2022] [Indexed: 10/19/2022]
Abstract
The prevalence of the metabolic syndrome (MetS) and its cardiac comorbidities as cardiac hypertrophy (CH) have increased considerably due to the high consumption of carbohydrates, such as sucrose and/or fructose. We compared the effects of sucrose (S), fructose (F) and their combination (S + F) on the development of MetS in weaned male Wistar rats and established the relationship between the consumption of these sugars and the degree of cardiac CH development, oxidative stress (OS) and Calcium/calmodulin-dependent protein kinase type II subunit delta oxidation (ox-CaMKIIδ). 12 weeks after the beginning of treatments with S, F or S + F, arterial pressure was measured and 8 weeks later (to complete 20 weeks) the animals were sacrificed and blood samples, visceral adipose tissue and hearts were obtained. Biochemical parameters were determined in serum and cardiac tissue to evaluate the development of MetS and OS. To evaluate CH, atrial natriuretic peptide (ANP), CaMKIIδ and ox-CaMKIIδ were determined by western blot and histological studies were performed in cardiac tissue. Our data showed that chronic consumption of S + F exacerbates MetS-induced CH which is related with a higher OS and ox-CaMKIIδ.
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Paulis G, Paulis A, Perletti G. Serenoa repens and its effects on male sexual function. A systematic review and meta-analysis of clinical trials. Arch Ital Urol Androl 2021; 93:475-480. [PMID: 34933534 DOI: 10.4081/aiua.2021.4.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Serenoa repens (SR) is a plant used to treat benign prostatic hyperplasia and prostatitis. We know that SR act as a 5α-reductase inhibitor, moreover, several studies have proved that SR has anti-inflammatory and antioxidant properties. There is some belief among patients that SR may negatively impact male sexual function. Such belief is circulating in non-medical social networks and is perhaps maintained by patients as a result of incorrect web surfing. However, it is also possible that SR may exert a "nocebo" effect thus negatively impacting on the general well-being of patients. OBJECTIVE The aim of this study is to investigate whether SR is causing negative effects on male sexual function. METHODS To ascertain the effect of SR on male sexual function, we conducted a systematic review and meta-analysis, by performing an electronic database search in accordance with the PRISMA guidelines. RESULTS Out of 20 included papers, 8 papers reported comparisons of SR with placebo, and 7 studies reported comparisons of SR with tamsulosin. The standardized mean difference of changes from baseline scores of sexual function was not significantly different between SR and placebo (SMD: 0.43, 95% CI: 0.18 to 1.05; I^2 = 95%). Similarly, no significant mean differences in the Male Sexual Function-4 (MSF-4) test scores were found between SR and tamsulosin (SMD: -0.31, 95% CI: -0.82 to 0.19; I^2 = 90%). CONCLUSIONS We found no statistically significant differences between negative effects on sexual function in patients treated with SR compared to patients who received placebo. The results of our meta-analysis are similar to those of other systematic reviews. Studies are warranted to ascertain whether any such effects might occur as a result of a nocebo effect.
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Affiliation(s)
- Gianni Paulis
- Department of Uro-Andrology, Castelfidardo Medical Team, Rome.
| | - Andrea Paulis
- Neurosystem Center for applied Psychology and Neuroscience, Janet Clinical Centre, Rome.
| | - Gianpaolo Perletti
- Faculty of Medicine and Medical Sciences, Ghent University, Belgium; Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese.
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Liu M, Yin H, Wang F, Tian Y. The Therapeutic Potential of Saw Palmetto Extract in Urological Disorders. Nat Prod Commun 2021. [DOI: 10.1177/1934578x211059635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Saw palmetto extract (SPE) has been widely used as a therapeutic remedy for urinary dysfunction in western countries. Furthermore, as an herb drug, it can be used as an alternative therapy for benign prostatic hyperplasia (BPH) due to its safety and minimum adverse effects. Reportedly, SPE improves the urinary symptoms, which mainly depend on anti-androgenic effects and effects on autonomic receptors in the lower urinary tract. However, the mechanisms of action responsible for the therapeutic roles of SPE have not been fully elucidated. Relevant studies indicate that SPE has some positive effects on the treatment of urological diseases in animals, and clinical trials are ongoing. In this review, we summarize the pharmacological properties and discuss the possible therapeutic mechanisms of SPE in urological diseases, including anti-androgenic effects, effects on autonomic receptors in the lower urinary tract, anti-inflammatory activity, anti-proliferative and pro-apoptotic effects, and highlight a potential therapeutic approach in the clinical treatment of patients with BPH, prostate cancer, chronic prostatitis (CP) and erectile dysfunction (ED).
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Affiliation(s)
- Meng Liu
- Second Military Medical University, Shanghai, China
| | - Huirong Yin
- Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Fang Wang
- Second Military Medical University, Shanghai, China
| | - Ying Tian
- Hebei Reproductive Hospital, Shijiazhuang, China
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Protective effects of combination of Stauntonia hexaphylla and Cornus officinalis on testosterone-induced benign prostatic hyperplasia through inhibition of 5α- reductase type 2 and induced cell apoptosis. PLoS One 2020; 15:e0236879. [PMID: 32790676 PMCID: PMC7425886 DOI: 10.1371/journal.pone.0236879] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/15/2020] [Indexed: 11/19/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is a progressive pathological condition associated with proliferation of prostatic tissues, prostate enlargement, and lower-urinary tract symptoms. However, the mechanism underlying the pathogenesis of BPH is unclear. The aim of this study was to investigate the protective effects of a combination of Stauntonia hexaphylla and Cornus officinalis (SC extract) on a testosterone propionate (TP)-induced BPH model. The effect of SC extract was examined in a TP-induced human prostate adenocarcinoma cell line. Male Sprague-Dawley rats were randomly divided into 5 groups (n = 6) for in vivo experiments. To induce BPH, all rats, except those in the control group, were administered daily with subcutaneous injections of TP (5 mg/kg) and orally treated with appropriate phosphate buffered saline/drugs (finasteride/saw palmetto/SC extract) for 4 consecutive weeks. SC extract significantly downregulated the androgen receptor (AR), prostate specific antigen (PSA), and 5α-reductase type 2 in TP-induced BPH in vitro. In in vivo experiments, SC extract significantly reduced prostate weight, size, serum testosterone, and dihydrotestosterone (DHT) levels. Histologically, SC extract markedly recovered TP-induced abnormalities and reduced prostatic hyperplasia, thereby improving the histo-architecture of TP-induced BPH rats. SC extract also significantly downregulated AR and PSA expression, as assayed using immunoblotting. Immunostaining revealed that SC extract markedly reduced the 5α-reductase type 2 and significantly downregulated the expression of proliferating cell nuclear antigen. In addition, immunoblotting of B-cell lymphoma 2 (Bcl-2) family proteins indicated that SC extract significantly downregulated anti-apoptotic Bcl-2 and markedly upregulated pro-apoptotic B cell lymphoma-associated X (Bax) expression. Furthermore, SC treatment significantly decreased the Bcl-2/Bax ratio, indicating induced prostate cell apoptosis in TP-induced BPH rats. Thus, our findings demonstrated that SC extract protects against BPH by inhibiting 5α-reductase type 2 and inducing prostate cell apoptosis. Therefore, SC extract might be useful in the clinical treatment of BPH.
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Lamas CA, Kido LA, Hermes TA, Nogueira-Lima E, Minatel E, Collares-Buzato CB, Maróstica MR, Cagnon VHA. Brazilian berry extract (Myrciaria jaboticaba): A promising therapy to minimize prostatic inflammation and oxidative stress. Prostate 2020; 80:859-871. [PMID: 32460430 DOI: 10.1002/pros.24017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/11/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Brazilian berry is a fruit popularly known as "Jaboticaba," rich in bioactive compounds with antioxidant and anti-inflammatory properties. Senescence and overweight are increasing worldwide and are considered risk factors to prostatic pathogenesis mainly due to oxidative and inflammatory processes induction. Thus, this study aimed to evaluate the effect of two increasing doses of the patented jaboticaba peel extract (PJE) on oxidative-stress and inflammation in the prostate of aging or high-fat-fed aging mice. METHODS PJE and/or high-fat diet (HFD) treatments started with 11-month-old mice and lasted 60 days. The levels or the immunoexpression of different inflammatory (nuclear factor κB [NFκB], CD3+, cyclooxygenase 2 [COX-2], toll-like receptor 4 [TLR4], phosphorylated signal transducers and activators of transcription 3 [pSTAT-3], tumor necrosis factor α [TNF-α], interleukin 6 [IL-6], and IL-1β) and oxidative-stress (catalase, superoxide dismutase 2 [SOD2], glutathione reductase [GSR], reduced glutathione, and glutathione peroxidase 3 [GPx3]) related molecules were analyzed by western-blotting, immunohistochemistry, and enzyme-linked immunosorbent assays. RESULTS Both PJE doses reduced the levels of oxidative-stress-related molecules (GPx3, GSR, catalase), lipid peroxidation (4-hydroxynonenal), inflammatory mediators (COX-2, TNF-α, and pSTAT-3) and CD3+ T cells number, which were associated with the maintenance of the glandular morphological integrity in aging and HFD-fed-aging mice. Nevertheless, only the high PJE dose reduced the NFκB and TLR4 levels in aging mice; and SOD2, IL-6, and IL-1β levels in HFD-aging mice. Aging itself promoted an oxidative inflammation in the prostate, interfering in the levels of the different oxidative-stress, lipid peroxidation, and inflammatory mediators evaluated, in association with high incidence of prostate epithelial and stromal damages. The HFD intake intensified aging alterations, showing an unfavorable prostatic microenvironment prone to oxidative and inflammatory damages. CONCLUSIONS PJE exerted a dose-dependent effect controlling inflammation and oxidative-stress in aging and HFD-fed aging mice prostate. This fact contributed to prostate microenvironment balance recovery, preserving the tissue architecture of this gland. Thus, the PJE emerges as a potential therapy to prevent inflammation and oxidative stress in the prostate.
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Affiliation(s)
- Celina A Lamas
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, São Paulo, Brazil
| | - Larissa A Kido
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, São Paulo, Brazil
- Department of Food and Nutrition, School of Food Engineering, University of Campinas, São Paulo, Brazil
| | - Túlio A Hermes
- Department of Morphology and Physiology, ABC Medical School, Santo Andre, São Paulo, Brazil
| | - Ellen Nogueira-Lima
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, São Paulo, Brazil
| | - Elaine Minatel
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, São Paulo, Brazil
| | - Carla B Collares-Buzato
- Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas, São Paulo, Brazil
| | - Mário R Maróstica
- Department of Food and Nutrition, School of Food Engineering, University of Campinas, São Paulo, Brazil
| | - Valéria H A Cagnon
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, São Paulo, Brazil
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El-Zeftawy M, Ali SAEM, Salah S, Hafez HS. The functional nutritional and regulatory activities of calcium supplementation from eggshell for obesity disorders management. J Food Biochem 2020; 44:e13313. [PMID: 32497284 DOI: 10.1111/jfbc.13313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 12/15/2022]
Abstract
The present study was to investigate the effective role of renewable sources of Ca+2 from eggshell (ES) with different doses to restrict obesity disorders. Rats were classified as follows, G1 : normal diet for 26 weeks; G2 : high-fat diet (HFD) for 26 weeks; G3 , G4 , and G5 were supplemented with HFD for 16 weeks and treated with 7.2 g Ca+2 ES/Kg rat chow, 18 g Ca+2 ES/Kg rat chow, and 2% diet containing fat (DCF), respectively, for the remaining 10 weeks. Results revealed a significant effect of the low dose of Ca+2 supplement in form of ES than high dose and 2% DCF; on basis of anthropometric parameters, lipid, leptin, adiponectin, thyroid hormones, Ca+2 , 25-hydroxyl vitamin-D, and oxidative and inflammatory parameters were regulated. Results were confirmed with the histopathological study. Therefore, it was concluded that Ca+2 supplementation can be used as a beneficial source for obesity management with anticholesterol actions. PRACTICAL APPLICATIONS: Obesity represented public health hazards. The eggshell is one of the waste products that contain a high percentage of Ca+2 . The current data exposed using a low dose of ES as a new source of Ca+2 supplement for treatment of HFD rats leads to significant enhancement of lipid profiles, liver enzymes, kidney functions, leptin, adiponectin, Ca+2 , 25(OH)-D, TSH, fT4, and PTH levels. Also, there was a reduction in weight gain, Bwt, BMI, BG, insulin, and HOMA-IR. Moreover, the oxidant-pro-oxidant system was improved in both hepatic and adipose tissues where NO and TBARS concentrations were diminished, and SOD specific activity was elevated. Additionally, TNF-α and ADAM17 expression were downregulated. Hence, it was concluded that there was good evidence that diets supplemented with ES were associated with the reduction of obesity complications especially regulating fat processing and storage in the body.
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Affiliation(s)
- Marwa El-Zeftawy
- Biochemistry Department, Faculty of Veterinary Medicine, New Valley University, New Valley, Egypt.,Biological Screening and Preclinical Trial Lab, Biochemistry Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Samar Abd-El Mohsen Ali
- Nutrition Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Sally Salah
- Nutrition Department, Allied Medical Sciences, Pharos University, Alexandria, Egypt
| | - Hani S Hafez
- Faculty of Science, Zoology Department, Suez University, Suez, Egypt
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Inflammation is a target of medical treatment for lower urinary tract symptoms associated with benign prostatic hyperplasia. World J Urol 2020; 38:2771-2779. [PMID: 32060633 PMCID: PMC7644532 DOI: 10.1007/s00345-020-03106-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/23/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose To review the role of a persistent prostatic inflammatory status (PIS) in the development and progression of benign prostatic hyperplasia (BPH) associated with lower urinary tract symptoms (LUTS) and which medical therapies approved for LUTS/BPH may reduce persistent PIS. Methods Literature search in PubMed up to July 2019. Results The cause of histologically defined persistent PIS or chronic prostatic inflammation is multifactorial. It is evident in many men with LUTS/BPH, particularly in older men and in men with a large prostate volume or more severe (storage) LUTS. Additionally, persistent PIS is associated with an increased risk of acute urinary retention and symptom worsening. Of medical therapies approved for LUTS/BPH, the current evidence for a reduction of persistent PIS is greatest for the hexanic extract of Serenoa repens (HESr). This treatment relieves LUTS to the same extent as α1-adrenoceptor antagonists and short-term 5α-reductase inhibitors. Limited evidence is available on the effect of other mainstream LUTS/BPH treatments on persistent PIS. Conclusions Persistent PIS plays a central role in both the development and progression of LUTS/BPH. In men with LUTS/BPH who have a high chance of harbouring persistent PIS, HESr will not only improve LUTS, but also reduce (underlying) inflammation. Well-designed clinical studies, with a good level of evidence, are required to better evaluate the impact of BPH/LUTS medical therapies on persistent PIS. Electronic supplementary material The online version of this article (10.1007/s00345-020-03106-1) contains supplementary material, which is available to authorized users.
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El-Baz FK, Salama A, Salama RAA. Dunaliella salina Attenuates Diabetic Neuropathy Induced by STZ in Rats: Involvement of Thioredoxin. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1295492. [PMID: 31998774 PMCID: PMC6970482 DOI: 10.1155/2020/1295492] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 12/10/2019] [Indexed: 01/02/2023]
Abstract
Diabetic neuropathy (DN) is a widespread disabling disorder including peripheral nerves' damage. The aim of the current study was to estimate the potential ameliorative effect of Dunaliella salina (D. salina) on DN and the involvement of the thioredoxin. Diabetes was induced by streptozotocin (STZ; 50 mg/kg; i.p). Glimepiride (0.5 mg/kg) or D. salina powder (100 or 200 mg/kg) were given orally, after 2 days of STZ injection for 4 weeks. Glucose, total antioxidant capacity (TAC), superoxide dismutase (SOD), and catalase (CAT) serum levels as well as brain contents of thioredoxin (Trx), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) were measured with the histopathological study. STZ-induced DN resulted in a significant (P < 0.05) rise in glucose blood level and brain contents of TNF-α and IL-6 and produced a reduction in serum TAC, SOD, CAT, and brain Trx levels with irregular islets of Langerhans cells and loss of brain Purkinje cells. Treatment with glimepiride or both doses of D. salina alleviated these biochemical and histological parameters as compared to the STZ group. D. salina has a neurotherapeutic effect against DN via its inhibitory effect on inflammatory mediators and oxidative stress molecules with its upregulation of Trx activity.
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Affiliation(s)
- Farouk K. El-Baz
- Plant Biochemistry Department, National Research Centre (NRC), 33 El Bohouth St. (Former El-Tahrir St.), 12622 Dokki, Giza, Egypt
| | - Abeer Salama
- Pharmacology Department, National Research Centre (NRC), 33 El Bohouth St. (Former El-Tahrir St.), 12622 Dokki, Giza, Egypt
| | - Rania A. A. Salama
- Toxicology and Narcotics Department, National Research Centre (NRC), 33 El Bohouth St. (Former El-Tahrir St.), 12622 Dokki, Giza, Egypt
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13
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Palmitic Acid and β-Hydroxybutyrate Induce Inflammatory Responses in Bovine Endometrial Cells by Activating Oxidative Stress-Mediated NF-κB Signaling. Molecules 2019; 24:molecules24132421. [PMID: 31266188 PMCID: PMC6650895 DOI: 10.3390/molecules24132421] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/24/2019] [Accepted: 06/28/2019] [Indexed: 02/07/2023] Open
Abstract
Ketosis is a nutritional metabolic disease in dairy cows, and researches indicated that ketonic cows always accompany reproductive problems. When ketosis occurs, the levels of non-esterified fatty acids (NEFAs) and β-hydroxybutyrate (BHBA) in the blood increase significantly. Palmitic acid (PA) is a main component of saturated fatty acids composing NEFA. The aim of this study was to investigate whether high levels of PA and BHBA induce inflammatory responses and regulatory mechanisms in bovine endometrial cells (BEND). Using an enzyme-linked immunosorbent assay, quantitative real-time PCR, and western blotting, we evaluated oxidative stress, pro-inflammatory factors, and the nuclear factor (NF)-κB pathway in cultured BEND cells treated with different concentrations of PA, BHBA, pyrrolidinedithiocarbamate (PDTC, an NF-κB pathway inhibitor), and N-acetylcysteine (NAC, an antioxidant). The content of malondialdehyde was significantly higher, the content of glutathione was lower, and antioxidant activity-glutathione peroxidase, superoxide dismutase, catalase, and total antioxidant capacity-was lower in treated cells compared with control cells. PA- and BHBA-induced oxidative stress activated the NF-κB signaling pathway and upregulated the release of pro-inflammatory factors. Moreover, PA- and BHBA-induced activation of NF-κB-mediated inflammatory responses was inhibited by PDTC and NAC. High concentrations of PA and BHBA induce inflammatory responses in BEND cells by activating oxidative stress-mediated NF-κB signaling.
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Paulis G. Inflammatory mechanisms and oxidative stress in prostatitis: the possible role of antioxidant therapy. Res Rep Urol 2018; 10:75-87. [PMID: 30271757 PMCID: PMC6149977 DOI: 10.2147/rru.s170400] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This article focuses on the role that oxidative stress plays in chronic prostatitis, not only with respect to the known impact on symptoms and fertility but also especially in relation to possible prostate cancer development. Prostatitis is the most common urologic disease in adult males younger than 50 years and the third most common urologic diagnosis in males older than 50 years. If the germ-causing acute prostatitis is not eliminated, the inflammatory process becomes chronic. Persistent inflammation causes ongoing production of large quantities of pro-inflammatory cytokines and both oxygen and nitrogen reactive species, with consequent activation of transcription factor nuclear factor-kappa B (NF-κB) and genes encoding for further production of pro-inflammatory cytokines, chemotactic factors, and growth factors. Confirming the role of oxidative stress in chronic prostatitis, several studies have demonstrated the presence of oxidative stress markers in the genital secretions of patients suffering from the disease. Antioxidants can therefore play an essential role in the treatment of chronic bacterial and non-bacterial prostatitis; in the case of bacterial inflammation, they can be associated with antibiotic therapy. Moreover, due to their anti-inflammatory properties, antioxidants hinder the progression of inflammation and the possible development of prostate cancer.
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Affiliation(s)
- Gianni Paulis
- Andrology Center, Villa Benedetta Clinic, Rome, Italy,
- Department of Uro-Andrology, Castelfidardo Medical Team, Rome, Italy,
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15
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Quintero-García M, Delgado-González E, Sánchez-Tusie A, Vázquez M, Aceves C, Anguiano B. Iodine prevents the increase of testosterone-induced oxidative stress in a model of rat prostatic hyperplasia. Free Radic Biol Med 2018; 115:298-308. [PMID: 29248723 DOI: 10.1016/j.freeradbiomed.2017.12.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 12/11/2022]
Abstract
Oxidative stress and inflammation are involved in the development and/or progression of benign prostatic hyperplasia (BPH). Molecular iodine (I2) induces antiproliferative and apoptotic effects in prostate cancer cells, but it is unknown if I2 regulates oxidative stress in the normal and/or tumoral prostate. The purpose of this study was to analyze the effects of I2 and celecoxib (Cxb) on oxidative stress and inflammation in a model of prostatic hyperplasia. Cxb was used as positive control of cyclooxygenase-2 (COX-2) inhibition. Prostatic hyperplasia was induced in male Wistar rats (170g) with testosterone (5mg/kg/week, for three weeks). One week before hyperplasia induction, I2 (25mg/day/rat) or Cxb (1.25mg/day/rat) was supplied for four weeks in the drinking water. Prostatic hyperplasia was evaluated by histological analysis, DNA content, and/or proliferating cell nuclear antigen (PCNA) expression. Lipoperoxidation (malondialdehyde) and nitrite (NO2-) levels were analyzed by colorimetric methods, while nitric oxide synthase (NOS), COX, and myeloperoxidase (MPO) enzymes were analyzed using RT-PCR, immunoblotting, and/or enzymatic assays. Levels of 15-F2t-isoprostanes, prostaglandins (PGE2), leukotrienes (LTB4), and tumor necrosis factor alpha (TNFα) were measured by ELISA. Control testosterone-treated animals exhibited hyperplasia in the dorsolateral prostate, as well as increments in almost all oxidative parameters except for COX-1, TNFα, or MPO. I2 and Cxb prevented epithelial hyperplasia (DNA content) and oxidative stress induction generated by testosterone in almost the same intensity, and the minimum I2 dose required was 2.5mg/rat. The antioxidant capacity of I2 was also analyzed in a cell-free system, showing that this element inhibited the conversion of nitrate (NO3-) to NO2-. I2 did not modify the prostatic oxidative state in testosterone untreated rats. In summary, our data showed that antiproliferative and antioxidant effects of I2 involve the inhibition of NOS and the COX-2 pathway. Further studies are necessary to analyze the therapeutic and/or adjuvant effects of I2 with first-line medications used to treat BPH.
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Affiliation(s)
- Michelle Quintero-García
- Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Campus Juriquilla, 76230 Querétaro, Mexico
| | - Evangelina Delgado-González
- Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Campus Juriquilla, 76230 Querétaro, Mexico
| | - Ana Sánchez-Tusie
- Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Campus Juriquilla, 76230 Querétaro, Mexico
| | - Mario Vázquez
- Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Campus Juriquilla, 76230 Querétaro, Mexico
| | - Carmen Aceves
- Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Campus Juriquilla, 76230 Querétaro, Mexico
| | - Brenda Anguiano
- Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Campus Juriquilla, 76230 Querétaro, Mexico.
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16
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Cordaro M, Impellizzeri D, Siracusa R, Gugliandolo E, Fusco R, Inferrera A, Esposito E, Di Paola R, Cuzzocrea S. Effects of a co-micronized composite containing palmitoylethanolamide and polydatin in an experimental model of benign prostatic hyperplasia. Toxicol Appl Pharmacol 2017; 329:231-240. [DOI: 10.1016/j.taap.2017.06.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 05/30/2017] [Accepted: 06/09/2017] [Indexed: 12/31/2022]
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17
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Ishola IO, Tijani HK, Dosumu OO, Anunobi CC, Oshodi TO. Atorvastatin attenuates testosterone-induced benign prostatic hyperplasia in rats: role of peroxisome proliferator-activated receptor-γ and cyclo-oxygenase-2. Fundam Clin Pharmacol 2017. [PMID: 28636803 DOI: 10.1111/fcp.12301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Diabetes and obesity have been reported to alter sex steroid hormone metabolism. In this study, an attempt was made to investigate the protective effect of atorvastatin (ATR) in combination with celecoxib (CEL) or pioglitazone (PIO) on testosterone-induced BPH in rats. Male Wistar rats (200-250 g) were randomly divided into nine groups (n = 8) and orally treated as follows for 28 consecutive days: group 1: vehicle control (10 mL/kg); group 2: vehicle testosterone (10 mL/kg); groups 3 - 5: ATR (0.5, 2.5, and 5 mg/kg, respectively); group 6: CEL (20 mg/kg); group 7: PIO (20 mg/kg); and groups 8-9: ATR 0.5 mg/kg, and 15 min later, animals were given CEL (20 mg/kg) or PIO (20 mg/kg), respectively. One hour post-treatment, animals in groups 2-9 were given testosterone propionate (3 mg/kg, s.c.). Twenty-four hours after last treatment on day 28, blood was collected for serum testosterone and prostate-specific antigen (PSA) analysis. Prostate was harvested for biochemical and histological assays. Subcutaneous injection of testosterone increased serum levels of testosterone and PSA which was ameliorated by pretreatments of rat with ATR, celecoxib, or pioglitazone. Similarly, testosterone-induced increase in MDA and reduction in the activity of GSH, superoxide dismutase (SOD), and catalase were attenuated by ATR. Conversely, celecoxib or pioglitazone treatment failed to affect the activity of antioxidant enzymes. The histology of the prostate showed significant improvement in prostatic cells of ATR, celecoxib, or pioglitazone treated. Findings from the study showed that atorvastatin attenuated testosterone-induced BPH. Moreover, synergistic effect was observed when atorvastatin was combined with celecoxib.
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Affiliation(s)
- Ismail O Ishola
- Department of Pharmacology, Therapeutics and Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, 234, Lagos, Nigeria
| | - Habeeb K Tijani
- Department of Surgery, Urology Unit, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olufunke O Dosumu
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Charles C Anunobi
- Department of Anatomic and Molecular Pathology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Tolulope O Oshodi
- Department of Pharmacology, Therapeutics and Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, 234, Lagos, Nigeria
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Azab A, Nassar A, Azab AN. Anti-Inflammatory Activity of Natural Products. Molecules 2016; 21:molecules21101321. [PMID: 27706084 PMCID: PMC6274146 DOI: 10.3390/molecules21101321] [Citation(s) in RCA: 216] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 12/13/2022] Open
Abstract
This article presents highlights of the published literature regarding the anti-inflammatory activities of natural products. Many review articles were published in this regard, however, most of them have presented this important issue from a regional, limited perspective. This paper summarizes the vast range of review and research articles that have reported on the anti-inflammatory effects of extracts and/or pure compounds derived from natural products. Moreover, this review pinpoints some interesting traditionally used medicinal plants that were not investigated yet.
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Affiliation(s)
- Abdullatif Azab
- Institute of Applied Research, The Galilee Society, P.O. Box 437, 20200 Shefa-Amr, Israel.
| | - Ahmad Nassar
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84105 Beer-Sheva, Israel.
| | - Abed N Azab
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84105 Beer-Sheva, Israel.
- Department of Nursing, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84105 Beer-Sheva, Israel.
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19
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Russo A, Capogrosso P, La Croce G, Ventimiglia E, Boeri L, Briganti A, Damiano R, Montorsi F, Salonia A. Serenoa repens, selenium and lycopene to manage lower urinary tract symptoms suggestive for benign prostatic hyperplasia. Expert Opin Drug Saf 2016; 15:1661-1670. [PMID: 27232207 DOI: 10.1080/14740338.2016.1190830] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Benign prostatic hyperplasia (BPH) is a disease affecting most of the elderly male. α1-blockers and 5-alpha reductase inhibitors are currently used to target lower urinary tract symptoms (LUTS). Moreover phytotherapeutic agents, including Serenoa Repens (SeR), have shown to have a role in ameliorating BPH/LUTS alone or in combination of other elements like Selenium (Se) and Lycopene (Ly). Areas covered: A literature review was performed using data from articles assessing the role of of SeR+Se+Ly in the management of LUTS secondary to BPH. Diverging evidence on SeR's efficacy is available. On one hand several studies have shown SeR efficacy in treating BPH/LUTS. SeR is effective in reducing prostate size, urinary frequency, dysuria, nocturia and in improving maximum urine flow-rate. On the other hand two long-term trials reported that SeR did not improve prostate size or urinary flow. SeR+Se+Ly in combination with tamsulosin is more effective than single therapies in improving IPSS and increasing maximal urinary flow-rate in patients affected by LUTS/BPH. Expert opinion: Despite great amount of preclinical and clinical studies, the use of SeR in BPH/LUTS is not sustained by clear evidence for a therapeutic efficacy but current data hint higher efficacy of of SeR+Se+Ly compared to SeR alone.
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Affiliation(s)
- Andrea Russo
- a Department of Urology , Università Vita-Salute San Raffaele , Milan , Italy.,b Division of Oncology/Unit of Urology, Urological Research Institute , Department of Urology, IRCCS Ospedale San Raffaele , Milan , Italy
| | - Paolo Capogrosso
- a Department of Urology , Università Vita-Salute San Raffaele , Milan , Italy.,b Division of Oncology/Unit of Urology, Urological Research Institute , Department of Urology, IRCCS Ospedale San Raffaele , Milan , Italy
| | - Giovanni La Croce
- a Department of Urology , Università Vita-Salute San Raffaele , Milan , Italy.,b Division of Oncology/Unit of Urology, Urological Research Institute , Department of Urology, IRCCS Ospedale San Raffaele , Milan , Italy
| | - Eugenio Ventimiglia
- a Department of Urology , Università Vita-Salute San Raffaele , Milan , Italy.,b Division of Oncology/Unit of Urology, Urological Research Institute , Department of Urology, IRCCS Ospedale San Raffaele , Milan , Italy
| | - Luca Boeri
- b Division of Oncology/Unit of Urology, Urological Research Institute , Department of Urology, IRCCS Ospedale San Raffaele , Milan , Italy
| | - Alberto Briganti
- a Department of Urology , Università Vita-Salute San Raffaele , Milan , Italy.,b Division of Oncology/Unit of Urology, Urological Research Institute , Department of Urology, IRCCS Ospedale San Raffaele , Milan , Italy.,c Research Doctorate Program in Urology , Magna Graecia University , Catanzaro , Italy
| | - Rocco Damiano
- c Research Doctorate Program in Urology , Magna Graecia University , Catanzaro , Italy
| | - Francesco Montorsi
- a Department of Urology , Università Vita-Salute San Raffaele , Milan , Italy.,b Division of Oncology/Unit of Urology, Urological Research Institute , Department of Urology, IRCCS Ospedale San Raffaele , Milan , Italy
| | - Andrea Salonia
- a Department of Urology , Università Vita-Salute San Raffaele , Milan , Italy.,b Division of Oncology/Unit of Urology, Urological Research Institute , Department of Urology, IRCCS Ospedale San Raffaele , Milan , Italy
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