Therapeutic effects of α-adrenergic receptor antagonists on benign prostatic hyperplasia: A network meta-analysis / 中华男科学杂志

<p><b>Objective</b>To investigate the therapeutic effects of commonly used selective α-adrenergic receptor antagonists (α-ARA) on benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>PubMed, Embase and CNKI databases were searched for the literature about selective α-ARAs for the treatment of BPH and the information was extracted on the common adverse reactions in the course of treatment. Multivariate meta-analysis was conducted to investigate the therapeutic effects of different α-ARAs.</p><p><b>RESULTS</b>The total rates of adverse effects of silodosin and tamsulosin were the highest, 51.9% and 34.0% respectively, with the highest incidences of headache (38.3%), weakness (23.6%) and dizziness (17.5%). Besides, tamsulosin ranked the first in inducing sexual dysfunction of the male patients with BPH (70.4%).</p><p><b>CONCLUSIONS</b>Doxazosin is preferable as the first-choice treatment of BPH for its therapeutic effect and improvement of the patient's quality of life. Silodosin and tamsulosin, however, can be selectively used according to the patient's specific tolerance to different adverse effects.</p>

Doxazosin Treatment Attenuates Carbon Tetrachloride-Induced Liver Fibrosis in Hamsters through a Decrease in Transforming Growth Factor beta Secretion

BACKGROUND/AIMS: The development of therapeutic strategies for the treatment of cirrhosis has become an important focus for basic and clinical researchers. Adrenergic receptor antagonists have been evaluated as antifibrotic drugs in rodent models of carbon tetrachloride (CCl4)-induced cirrhosis. The aim of the present study was to evaluate the effects of carvedilol and doxazosin on fibrosis/cirrhosis in a hamster animal model. METHODS: Cirrhotic-induced hamsters were treated by daily administration of carvedilol and doxazosin for 6 weeks. Hepatic function and histological evaluation were conducted by measuring biochemical markers, including total bilirubin, aspartate aminotransferase, alanine aminotransferase and albumin, and liver tissue slices. Additionally, transforming growth factor beta (TGF-beta) immunohistochemistry was analyzed. RESULTS: Biochemical markers revealed that hepatic function was restored after treatment with doxazosin and carvedilol. Histological evaluation showed a decrease in collagen type I deposits and TGF-beta-secreting cells. CONCLUSIONS: Taken together, these results suggest that the decrease in collagen type I following treatment with doxazosin or carvedilol is achieved by decreasing the profibrotic activities of TGF-beta via the blockage of alpha1- and beta-adrenergic receptor. Consequently, a diminution of fibrotic tissue in the CCl4-induced model of cirrhosis is achieved.

Effect of carvedilol on mitochondrial respiratory function of pressure overload induced left ventricular hypertrophy in rats and its mechanism / 医学研究生学报

Objective: To understand the effect of Carvedilol on mitochondrial oxidative phosphorylation function during the development of pressure overload induced left ventricular hypertrophy in rats and its mechanism.Methods: Male SD rats were randomized into 6 groups: 5-and 15-week coarctation of the abdominal aorta(H5,H15),5-and 15-week Carvedilol intervention(HR5,HR15) and 5-and 15-week sham operation(S5,S15).Hemodynamics and ventricular remodeling parameters were measured,and the mitochondrial respiratory function was detected by Clark oxygen electrode.Results: Compared with S5,mitochondrial state 3 and 4 respiration and the oxidative phosphorylation rate(OPR) were increased and the respiratory control rate(RCR) decreased significantly in the H5 group.In comparison with S15,state 3 respiration,OPR and RCR were reduced significantly in the H15group.Carvedilol increased the three parameters and restored them to the level of the S15.Conclusion: Mitochondrial respiratory function decreased during the development of pressure overload induced left ventricular hypertrophy in rats.Carvedilol could protect mitochondrial respiratory function and improve myocardial energy metabolism,which might be a mechanism underlying its protective effect on myocardium.

Analyses of four?-adrenergic receptor antagonists in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) / 中华泌尿外科杂志

Objective To investigate the efficacy and side effects of 4?-adrenergic receptor(?- AR)antagonists in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).Meth- ods Totally,325 patients(mean age,33.2 year;disease history,2.4 years)with CP/CPPS were randomly divided into Prazosin(n=95),Terazosin(n=78),Phenoxybenzamine(n=27),and Doxazosin mesylate controlled release tablets(n=72)groups.Some antibiotics and medications were used for allopathy.In addi- tion,53 cases with no?-AR antagonist treatment served as control group.The efficacy and side effects in all the patients were observed and recorded.The chronic prostatitis symptom index(CPSI)was used to evaluate the efficacy.Results In control group,22(41.5%)patients responded well to the treatment( CPSI mark drop≥5)and 31(58.5%)failed to respond to the treatment(CPSI mark drop＜5).In study group,199 (73.2%)patients responded well to the treatment,and 73(26.8%)failed.The difference in efficacy be- tween?-AR antagonists and placebo treatment was significant(P＜0.01).In study group,specifically,the effective rate was 55.6% in Phenoxybenzamine,78.2% in Terazosin,76.4% in Doxazosin mesylate con- trolled release tablets,and 71.6% in Prazosin groups.The main side effects of?-AR antagonists were postur- al hypotension(a rate of 23.2% for Prazosin,17.9% for Terazosin,22.2% for Phenoxybenzamine,and 8.3% for Doxazosin mesylate controlled release tablets)and dysfunction of ejaculation(only in Phenoxy- benzamine group with a rate of 51.9%).The rates of withdrawing treatment due to side effects were in turn 18.5% of Phenoxybenzamine,7.4% of Prazosin,5.1% of Terazosin,and 0% of Doxazosin mesylate con- trolled release tablets.Conclusions As essential medications for the treatment of CP/CPPS,?-AR antag- onists can relieve the clinical symptoms(dropping NIH-CPSI mark significantly),but some side effects should be considered when some medications are selected.