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ESSM
Today
AUA 2014 Men’s health highlights
by Alejandra Egui
In this issue, we discuss the most outstanding
works in the field of treatment of BPH / LUTS and
recent advances in the field of sexual health,
which were presented at the American Urological
Congress 2014, celebrated in Orlando Florida
(USA) in May, 2014. In order to extend the con-
tent provided, as in previous installments, for
each work commented, the corresponding iden-
tification number is indicated in brackets, to be
able to easily locate it on the conference website.
With respect to the treatment of BPH, highlights
a surge in basic research, which brings two new
natural compounds (phytotherapy) with posible
therapeutic effect on this condition: the Honokiol
and Seroitae. Similarly, research on possible new
therapeutic targets stands as the enzymes Ar-
ginase and Rac.
The first study, discusses the role of Honokiol,
a constituent of Magnolia, on prostatic smooth
muscle (MP19-08). Honokiol and Magnolol
two lignan constituent of Magnolia are used in
traditional Japanese medicine. The aim of this
study was to analyze the effects of these two
components in the contraction of human prostate
tissue and the viability of stromal cells. An in
vitro assay was performed in organ bath stud-
ies with prostate tissue obtained from radical
prostatectomy specimens. Contractions were
induced by noradrenaline, phenylephrine or by
electric field stimulation. Viability was determined
by stromal cells cultures. The authors concluded
Honokiol may interfere with the dynamic compo-
nent of bladder outlet obstruction by inhibition of
prostate smooth muscle contraction, and with
the static component promoting the stromal cell
apoptosis. Randomized placebo-controlled tri-
als needed to determine the potential clinical
applications based Honokiol extract treatments.
The second study evaluates the efficacy Seoritae
extract to reduce the weight and suppress the
proliferation of the prostate (MP19-13). The Se-
oritae (SE) is a variety of soybean and traditional
natural food in Korea. In this paper, an analysis
was performed to determine if the ES has a
beneficial effect on reducing prostate weight a
rat model of BPH.
Sprague-Dawley rats were divided into four
groups: control, BPH, BPH and two groups
were treated with SE (BPH+SE1 and BPH+SE2).
All rats with BPH (BPH / HBP HBP SE1 and SE2)
underwent bilateral orchiectomy and then were
induced prostatic hyperplasia by administra-
tion of testosterone enanthate for 5 weeks.
BPH+ SE groups received daily oral doses of SE
for 5 weeks. Regarding the results, BPH group
showed a marked increase in prostate weight
than in the control group, whereas rats in the
BPH / SE groups showed a decreased prostate
weight. Similarly, the activity of 5-alpha reduc-
tase in serum and prostate were significantly
higher in the BPH group compared to controls
and it was reduced in the groups treated with
HBP / SE. The concentration of caspase-3
(a marker of apoptosis) was significantly increased
in BPH group compared to the control group, and
it was decreased in the groups treated with SE.
These results suggest that SE is effective to re-
duce the volume, and suppressing the prolifera-
tion of the prostate, which may play a role in the
treatment of BPH. However, the most important
limitation of this study is that the work was made
in an animal model.
In respect of novel therapeutic targets, this study
examined the Arginase enzyme as a possible
modulator of nitric oxide (NO) activity (MP19-02).
In the cell, arginase enzymes (Arg) counteract
the production of NO by degrading the amino
acid L-arginine, considered the major substrate
of the nitric oxide synthases (NOS).
Currently, the distribution of Arg in the human
prostate is unknown. This paper, evaluates by
in-vitro immunochemical analysis, the expression
of Arg in the transition zone (TZ) of the prostate.
The results concluded that Arg I (one of the two
types of arginases studied), is located together
with other key proteins in the signaling of cyclic
GMP in the TZ of the human prostate. These
findings support the hypothesis that Arg can
modulate in a negative manner the activity of
the NO system in the TZ and support the role of
signaling via NO-cGMP in the prostate.
Another interesting work regarding possible
future therapeutic targets, it was presented by
Dr Thomas Kunit et al (Munich. Germany) (MP
19-09), where studied the role of compound
NSC23766 (Rac inhibitor monomeric GTPase)
in the regulation of smooth muscle tone of the
periurethral prostate tissue. Rac is a major
regulator of smooth muscle tone outside the
lower urinary tract. This analysis evaluates the
effect of NSC23766 on periurethral prostatic
tissue obtained from patients undergoing radical
prostatectomy (n = 27). The results showed that
NSC23766 inhibited the contraction induced by
phenylephrine and noradrenaline in human pros-
tate samples. In Western blot analysis revealed
bands with the expected size for Rac1 in prostate
tissue, prostatic stroma and glands. Rac1 was
located in smooth muscle cells and epithelial tis-
sue. The results suggest that the pathophysiology
of LUTS may be affected by RAC regulation of
smooth muscle tone in the lower urinary tract,
constituting a potential therapeutic target.
Another topic that has reached interest in the
field of BPH, is the association of this condition
with other entities, specifically with the metabolic
syndrome, which has been implicated in several
diseases. In this sense Russo et al (PD 25-09)
presented a work where the association between
non alcoholic fatty liver disease (NAFLD) and the
risk of moderate/severe LUTS was studied. The
role of insulin resistance (IR) as a predictive factor
of moderate to severe LUTS was also studied. A
cross-sectional study involving 544 patients with
LUTS assessed by IPSS was performed. Diagnosis
María alejandra Egui rojo Md
Department of Urology
Hospital Universitario de
Fuenlabrada
Madrid, Spain
Email:
