Review

The Role of Enflammation as an Etiopathogenetic Mechanism and Treatment Target in Benign Prostatic Hyperplasia

10.4274/uob.258

  • Ali Tekin
  • Alpaslan Yüksel

Received Date: 02.03.2015 Accepted Date: 04.03.2015 Bull Urooncol 2015;14(4):303-307

Despite the etiopathogenesis of benign prostatic hyperplasia (BPH) has not yet been elucidated exactly, current data indicate that the prostatic inflammation may be important in the etiology and it may be a potential for a treatment target. Not only the presence of prostatic inflammation, but also its grade and severity are related to International Prostate Symptom Score and have a capability to predict the progression of BPH (increase in symptom severity, acute urinary retention, and the need for surgery). Although the mechanism of inflammation on the development BPH has not been fully understood, it is probably associated with the weakening of the immune system and hormonal alterations with aging. Subsequent cascade of events including oxidative stress, upregulation of androgen-responsive genes and transforming growth factor β1 cascade genes, decrease of a population of suppressor cells that actively suppresses the recognition of prostatic antigens and an increase in proinflammatory cytokines such as IL-6, IL-8, IL-15 and cyclooxygenase-2 expression may induce the development of BPH. Evidence-based data revealed that non-steroidal anti-inflammatory drugs (NSAID) may prevent prostate enlargement, BPH associated lower urinary tract symptoms, decrease in urinary flow and prostate specific antigen elevation. Furthermore, their anti-inflammatory properties may be responsible for at least some of the beneficial effects of vitamin D agonists, serenoa repens and phosphodiesterase-5 inhibitors in BPH treatment. In conclusion, prostatic inflammation seems to play an important role in the pathogenesis and progression of BPH. In the near future NSAIDs should be expected to take a part in the medical treatment of BPH.

Keywords: Prostatitis, benign prostatic hyperplasia enflammation, anti-enflammatory treatment

Full Text (Turkish)