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Chen L, Lin M, Wang Y, Wang X, Qi C, Fan R, Su S, Duan J, Liu F, Guo S, Duan JA. Taraxacum mongolicum total triterpenoids and taraxasterol ameliorate benign prostatic hyperplasia by inhibiting androgen levels, inflammatory responses, and epithelial-mesenchymal transition via the TGFβ1/Smad signalling pathway. JOURNAL OF ETHNOPHARMACOLOGY 2025; 349:119995. [PMID: 40393639 DOI: 10.1016/j.jep.2025.119995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2025] [Revised: 05/16/2025] [Accepted: 05/17/2025] [Indexed: 05/22/2025]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Taraxacum mongolicum Hand.-Mazz. is a well-known plant used both medicinally and as food, commonly used in traditional Chinese medicine prescriptions to alleviate benign prostatic hyperplasia (BPH). However, the material basis and molecular mechanisms of T. mongolicum alone in improving BPH remain unclear. In recent years, triterpenoids have been considered to be a key chemical constituents for T. mongolicum to exert its biological activity. AIM OF THE STUDY To explore the therapeutic efficacy and underlying mechanism of total triterpenoids from T. mongolicum (TTM) and its active constituents against BPH. MATERIALS AND METHODS The chemical components of TTM were determined using UPLC-QTOF-MS analysis. We established a testosterone propionate (TP)-induced rat model of BPH to assess the potential of TTM in vivo. Subsequently, network pharmacology was combined with experimental results from a TGFβ1-stimulated BPH-1 cell model to reveal the molecular mechanism of TTM. The main active ingredient (taraxasterol, TAR) of TTM was screened by evaluating its antiproliferative ability against BPH-1 and WPMY cells. Eventually, RNA-sequencing, RT-qPCR, immunofluorescence, and Western blotting were employed to elucidate the potential molecular targets and signalling pathways of TAR in BPH rats. RESULTS TTM was mainly composed of ten pentacyclic triterpenoids and one phytosterol, including TAR, lupeol, β-amyrin, taraxerol, and their acetates. TTM ameliorated TP-induced BPH by decreasing androgen levels and repressing inflammatory responses and oxidative stress. Furthermore, TTM inhibited epithelial-mesenchymal transition (EMT) and extracellular matrix (ECM) deposition via impeding the TGFβ1/Smad signalling pathway in BPH-1 cells based on the network pharmacology. Among the main chemical components of TTM, TAR exerted the strongest antiproliferative activity in vitro, and inhibited the growth of BPH-1 and WPMY-1 cells in a concentration dependent manner. Importantly, TAR also reduced androgen levels and inflammatory responses to balance proliferation and apoptosis in BPH rats. Transcriptomic analysis showed that TAR attenuated collagen deposition in BPH by inhibiting ECM-receptor interaction pathway. In addition, TAR notably suppressed EMT and the TGFβ1/Smad signalling in BPH rats, as evidenced by reduced the protein levels of collagen I, a-SMA, Snail, TGFβ1, p-Smad2/Smad2, and p-Smad3/Smad3, alongside an increase in E-cadherin expression. CONCLUSIONS TTM or TAR could effectively improve TP-induced BPH by suppressing androgen levels, inflammatory response, and EMT via the TGFβ1/Smad signalling pathway. These findings may present new therapeutic approachs for BPH in clinical settings. Notably, this study is the first to systematically elucidate the therapeutic mechanism of triterpenoids from T. mongolicum in treating BPH.
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Affiliation(s)
- Le Chen
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Ming Lin
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Yuanyuan Wang
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Xuesen Wang
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Chengcheng Qi
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Ruoying Fan
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Shulan Su
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Jialun Duan
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Feng Liu
- Shaanxi Institute of International Trade and Commerce, Xianyang, 710061, China
| | - Sheng Guo
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
| | - Jin-Ao Duan
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
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Abdulrasak M, Someili A, Mohrag M. SGLT2 Inhibitors in Patients with Urogenital Malformations and Urinary Diversions: Risks, Benefits, and Clinical Considerations. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:921. [PMID: 40428879 PMCID: PMC12113410 DOI: 10.3390/medicina61050921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2025] [Revised: 05/14/2025] [Accepted: 05/19/2025] [Indexed: 05/29/2025]
Abstract
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are increasingly used in patients with type 2 diabetes, chronic kidney disease, and heart failure. However, their safety and efficacy in patients with congenital or surgically altered urogenital anatomy remains underexplored. Methods: We conducted a narrative review of current evidence regarding the use of SGLT2i in patients with urinary tract malformations, urinary diversions, and functional voiding disorders. Key risks, clinical considerations, and management strategies were synthesized from the existing literature and case reports. Results: Patients with benign prostatic hyperplasia, vesicoureteral reflux, neurogenic bladder, nephrostomies, and ileal conduits may face increased risks of urinary tract infections, fungal colonization, and therapy-related complications due to persistent glycosuria and altered urinary flow. Nevertheless, these patients may still benefit from SGLT2i's systemic renal and cardiovascular effects. Individualized risk assessment, close monitoring, and multidisciplinary management are essential. Conclusions: Patients with urological abnormalities represent a high-risk but potentially high-reward population for SGLT2i therapy. A cautious, tailored approach is necessary, and future dedicated research is urgently needed to better guide clinical practice.
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Affiliation(s)
- Mohammed Abdulrasak
- Department of Clinical Sciences, Lund University, 22100 Malmo, Sweden
- Department of Gastroenterology and Nutrition, Skane University Hospital, 20502 Malmo, Sweden
| | - Ali Someili
- Department of Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (A.S.); (M.M.)
| | - Mostafa Mohrag
- Department of Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (A.S.); (M.M.)
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Cai T, Ceccato T, Botti S, Kranz J, Verze P, Bonkat G, Aversa A, Racanelli V, Bjerklund Johansen TE. Impact of Lifestyle and the Microbiome on Male Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia. Eur Urol Focus 2025:S2405-4569(25)00090-2. [PMID: 40254491 DOI: 10.1016/j.euf.2025.04.013] [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: 03/19/2025] [Accepted: 04/08/2025] [Indexed: 04/22/2025]
Abstract
Recent studies have facilitated a new understanding of how the microbiome and lifestyle contribute to the pathophysiology of prostatic diseases. This mini review explores evidence on the role of lifestyle, diet, and the microbiome in the development and progression of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). Diet, physical activity, and the gut microbiome may influence LUTS/BPH by modulating systemic inflammation and metabolic processes. Proinflammatory diets, particularly those high in animal-based foods and low in fiber, affect systemic inflammation, leading to LUTS. Changes in the gut microbiota can alter the production of short-chain fatty acids and contribute to insulin resistance and other metabolic disturbances that may exacerbate prostate inflammation and accelerate LUTS progression. BPH development is influenced by a complex interplay of lifestyle factors, the metabolic syndrome, and the composition of the microbiota. More research into the pathophysiology of BPH is warranted to increase the evidence supporting lifestyle-based strategies in BPH prevention and management. PATIENT SUMMARY: There seems to be a link between lower urinary tract symptoms (LUTS) caused by an enlarged prostate and lifestyle, diet, and gut microbes. LUTS can be increased by factors such as a diet rich in red meat and animal protein and poor in fiber, and physical inactivity. Obesity may change the composition of microbes in the gut, which in turn increases inflammation, including in the prostate. Addressing these factors could help in preventing LUTS.
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Affiliation(s)
- Tommaso Cai
- Centre for Medical Sciences, University of Trento, Trento, Italy; Urology Division, Santa Chiara Regional and Teaching Hospital, Provincial Health Care Agency, Trento, Italy.
| | - Tommaso Ceccato
- Urology Division, Santa Chiara Regional and Teaching Hospital, Provincial Health Care Agency, Trento, Italy
| | - Simone Botti
- Urology Division, Santa Chiara Regional and Teaching Hospital, Provincial Health Care Agency, Trento, Italy
| | - Jennifer Kranz
- Department of Urology and Pediatric Urology, RWTH Aachen University, Aachen, Germany; Department of Urology and Kidney Transplantation, Martin Luther University, Halle, Germany
| | - Paolo Verze
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Gernot Bonkat
- Alta Uro AG, Merian Iselin Klinik, Center of Biomechanics & Calorimetry, University of Basel, Basel, Switzerland
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Vito Racanelli
- Centre for Medical Sciences, University of Trento, Trento, Italy; Internal Medicine Division, Santa Chiara Hospital, Provincial Health Care Agency, Trento, Italy
| | - Truls Erik Bjerklund Johansen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Urology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark
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Fu X, Zhang H, Liu J, Li Y, Wang Z, Yang S, Liu D, Zhou Y, Chen P, DiSanto ME, Li H, Zhang X. Midline-1 inhibited high glucose-induced epithelial-mesenchymal transition, fibrosis and inflammation through WNT/β-catenin signaling in benign prostatic hyperplasia. Front Endocrinol (Lausanne) 2025; 16:1543295. [PMID: 40206598 PMCID: PMC11978649 DOI: 10.3389/fendo.2025.1543295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Accepted: 03/07/2025] [Indexed: 04/11/2025] Open
Abstract
Background and objects Benign prostatic hyperplasia (BPH) is a common disease that impairs the life quality of elderly men. The close relationship of BPH and diabetes has been generally established, however, the exact molecular mechanism remains unclear. Midline-1 (MID1) is an E3 ubiquitin ligase belonging to Tripartite Motif family and its involvement in the initiation and progression of many diseases, such as diabetic kidney disease has been well accepted. This study aims to illuminate the potential impact of high glucose (HG) on prostatic cells and elucidate the molecular role of MID1 in the development of BPH. Methods In this work, human prostate specimens and cultured human prostate cell lines (BPH-1 and WPMY-1) were employed. The impact of HG treatment on these two lines was assessed and the expression and localization of MID1, along with its potential downstream target protein phosphatase 2A (PP2A), were determined using multiple experimental methods. MID1-overexpressing cell models were further used to investigate the function of MID1 in regulating inflammation, fibrosis and epithelial-mesenchymal transition (EMT). Results Herein we demonstrate diabetic individuals with BPH had lower expression of MID1 and higher expression of the catalytic subunit of PP2A (PP2Ac), larger prostate volume, higher international prostate symptom score (IPSS) and lower Qmax than non-diabetic groups. On a cellular level, HG treatment inhibited the expression of MID1, thus stimulating cellular proliferation and triggering EMT, fibrosis and inflammation of two prostatic cells via enhanced WNT/β-catenin signaling. Conclusions In general, our novel data demonstrate targeting MID1 might be a promising area of medical treatment for patients with both BPH and diabetes.
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Affiliation(s)
- Xun Fu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Urology, Peking Union Medical Collage Hospital, Beijing, China
| | - Hao Zhang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jiang Liu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yan Li
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhen Wang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shu Yang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Daoquan Liu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yongying Zhou
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ping Chen
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Michael E. DiSanto
- Department of Surgery and Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ, United States
| | - Hongjun Li
- Department of Urology, Peking Union Medical Collage Hospital, Beijing, China
| | - Xinhua Zhang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Li B, Zhang Z, Sun C, Sun Y, Li J, Liu X. Association between TyG-BMI and BPH in a national prospective cohort study. Sci Rep 2025; 15:8743. [PMID: 40082448 PMCID: PMC11906792 DOI: 10.1038/s41598-024-81629-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 11/27/2024] [Indexed: 03/16/2025] Open
Abstract
This study aims to explore the relationship between the Triglyceride Glucose Body Mass Index (TyG-BMI) and the risk of developing benign prostatic hyperplasia (BPH). Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), we included 3301 men aged 45 and above. We analyzed the association between TyG-BMI and the risk of developing BPH using multivariable logistic regression and restricted cubic spline models. During the 4-year follow-up period, 268 cases of BPH were identified. There was a positive correlation between TyG-BMI and the risk of BPH (OR 1.22, 95% CI 1.08-1.38, p < 0.001), with a significant dose-response relationship (P < 0.001). Stratified analyses indicated that the impact of TyG-BMI on BPH risk was consistent across various subgroups. There is a linear positive correlation between TyG-BMI and the risk of developing BPH. Managing TyG-BMI levels may help reduce the risk of BPH.
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Affiliation(s)
- Bing Li
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhiqiang Zhang
- Graduate School of Tianjin Medical University, Tianjin Medical University, Tianjin, China
| | - Chao Sun
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Yaodong Sun
- Department of Cardiovascular surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Junping Li
- Department of Oncology, Zibo City Municipal Hospital, Zibo, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China.
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