Medical treatment of benign prostatic hyperplasia

Discovery of Lignans from the Herbs of Peperomia heyneana with Inhibitory Activities on BPH-1 Cells

Chemical investigation on the whole herb of Peperomia heyneana Miq. resulted in the isolation of six lignans, including two previously undescribed compounds, named peperomianan A and B (1-2), and four known compounds, 1,2-cyclobutanedicarboxylic acid (3), (+)-medioresinol (4), (+)-pinoresinol (5), and (+)-yangambin (6). Their structures were established by extensive spectroscopic analyses. The absolute configuration of compound 1 was determined by comparison of the experimental and calculated electronic circular dichroism (ECD) spectra. Subsequently, the effects of all isolates on BPH-1 cells were evaluated in vitro by MTT assay.

An integrated strategy for deciphering the action mechanism of emplastrum: Prescription analysis- component identification- virtual screening and affinity testing in the case of Yaoshen Gao

ETHNOPHARMACOLOGICAL RELEVANCE

Emplastrum has a long history of use in the clinical practice of traditional Chinese medicine (TCM), valued for its convenient external application and pronounced therapeutic effects. Traditionally, the emplastrum was composed of numerous herbal medicines. The elucidation of their mechanisms of action are of great importance. YaoShen Gao (YSG), as a traditional example of emplastrum, was composed of more than 20 medicinal herbs. Clinically, YSG has been used to treat benign prostatic hyperplasia (BPH). However, the active components and therapeutic targets of YSG remain unclear, requiring further investigation.

AIM OF THE STUDY

To establish an integrated strategy to uncover the mechanisms underlying the potential active ingredients and therapeutic targets in complex TCM emplastra, using YSG for BPH treatment as a case study.

MATERIALS AND METHODS

A BPH rat model was established via castration and testosterone propionate injections. The therapeutic efficacy of YSG was evaluated comprehensively through phenotypic, pathological, physiological, and biochemical analyses. Prescription analysis was conducted based on the principles of "monarch, minister, assistant, and courier," as well as clinical dosage and efficacy. Based on the strategy of representative compounds-single herbal medicine -YSG formulation, the chemical profile of YSG was performed using UPLC-Q Exactive Orbitrap- MS. Network pharmacology identified preliminary targets, while molecular docking and literature mining further narrowed these down. Finally, molecular dynamics simulations and Bio-Layer Interferometry (BLI) were used to validate binding affinities of active components to targets.

RESULTS

The efficacy indicators demonstrated that treatment of YSG significantly reduced prostate wet weight and prostate index in BPH rats, with notable improvements observed in glandular structure. Additionally, YSG inhibited the expression of inflammatory factors (TNF- α, IL- 8) and fibrosis-related proteins (VEGF, TGF-β). Twelve key herbal medicines were identified by prescription analysis from the 20 herbs in YSG, such as Cistanche deserticola, Epimedium sagittatum and so on. High-resolution mass spectrometry (HR-MS) characterized 125 chemical components, and Venn analysis identified 409 common targets between YSG components and BPH. Subsequently, GO and KEGG analyses revealed that these targets are predominantly involved in protein phosphorylation, cellular components, and key signaling pathways. Protein-protein interaction (PPI) analysis identified 10 key targets, suggesting that the therapeutic effects of YSG on BPH are mediated through 39 active compounds and 12 relevant signaling pathways. Molecular docking analysis identified 14 target-compound pairs, and literature supported their relevance in PI3K/AKT, VEGF, TNF, and TGF-β pathways. Molecular dynamics simulations and BLI further validated the strong interactions between representative target-small molecule pairs like AKT1 with bavachalcone (KD = 46.8 μM) and PIK3R1 with apigenin (KD = 47.9 μM).

CONCLUSIONS

A systematic strategy for identifying active ingredients and therapeutic targets in complex TCM emplastra was developed. YSG contains active components, including bavachalcone, apigenin, schisandrin C, liquiritigenin, 8-prenyldaidzein, estrone, isopimpinellin, 8-prenylkaempferol, which act on six key targets, such as AKT1 and PIK3R1, to regulate the AKT/PI3K, AGE-RAGE, AR, VEGF, TGF-β, TNF and others signaling pathways. These pathways further modulate cellular proliferation, fibrosis, inflammation, and angiogenesis, thereby effectively contributing to the treatment of BPH.

Effects of in utero exposure to D-004, a lipid extract from Roystonea regia fruits, in the male rat: a comparison with finasteride

D-004 is a lipid extract obtained from Cuban royal palm fruits, consisting of a mixture of free fatty acids, that prevents prostate hyperplasia induced with testosterone in rodents. This study investigated the possible alterations due to D-004 of androgen-dependent development after exposure in utero and compared them with those due to finasteride. Rats were randomized into five experimental groups: a control group, three groups treated with D-004 at 500, 750, or 1,000 mg/kg/day, respectively, and a group treated with finasteride (10 mg/kg/day). Male rats were treated 10 weeks before and during mating. Female rats were treated for 15 days prior mating, during mating, during pregnancy, and until lactation (day 21) except for those treated with finasteride, which were only administered the drug on gestational days 12-21. All male offspring were monitored individually until necropsy after postnatal day 90. The results of the present study indicate that D-004 induced no alterations in androgen-dependent development after the exposure in utero. Also, the current study demonstrated a permanent reduction in anogenital distance and retention of nipples in adult male rats exposed to finasteride during late gestation. Significant alterations induced by exposure to finasteride were mainly in tissues dependent on dihydrotestosterone during development.

One year oral Toxicity of D-004, a lipid extract from Roystonea regia fruits, in Sprague Dawley rats

D-004, a lipid extract of royal palm (Roystonea regia) fruits that contains a reproducible mixture of fatty acids, has been shown to prevent testosterone and phenylephrine-induced prostate hyperplasia in rodents. This study investigated the long-term oral toxicity of D-004 in rats. Rats from both sexes were randomized into four groups (20 rats sex/group): a control and three treated with D-004 (800, 1500 or 2000 mg/kg/day, respectively). At study completion, rats were sacrificed under anaesthesia. Determinations of blood biochemical and haematological parameters and organ weight were done. Also, necropsy and histopathological studies were performed. Four of 160 rats died before study completion. No clinical signs of toxicity were observed throughout the study. Food and water consumption, bodyweight, blood biochemical and haematological parameters, organ weight ratios and histopathological findings were similar in control and treated groups. The histological lesions found in treated animals are commonly present in this specie and strain according to literature and our historical data. In conclusion, long-term (12 months) oral treatment of rats with D-004 (800-2000 mg/kg/day) did not show evidences of D-004-related toxicity under our conditions. The highest dose tested (2000 mg/kg) was a no-observed adverse effect level in this study.