Association of polymorphism within the interleukin-28 receptor alpha gene, but not in interleukin-28B, with lower urinary tract symptoms (LUTS) in Chinese.

The aim of this study was to determine the relationship between polymorphisms in the IL-28B and IL-28R genes and lower urinary tract symptoms (LUTS) in Chinese patients. Genomic DNA was extracted from 553 whole blood samples from 233 patients with LUTS resulted from benign prostatic hyperplasia and 320 control subjects. The IL-28B rs12979860 and rs8099917, and IL-28Rα rs10903035 and rs11249006 polymorphisms were genotyped using a polymerase chain reaction-restriction fragment length polymorphism assay. For rs10903035, the frequencies of the "G" allele and the "AG/GG" genotypes in the LUTS group were significantly lower than those in the control group ("G" vs "A": OR = 0.655, 95%CI = 0.506-0.849; AG/GG vs "AA": OR = 0.538, 95%CI = 0.379-0.764, respectively). Combined effects analysis of rs12979860 and rs10903035 showed that the "CC+AG/GG" and "CT+AA" genotypes were significantly less frequent in the LUTS group ("CC+AG/GG" vs "CC+AA": OR = 0.553, 95%CI = 0.381-0.801; "CT+AG/GG" vs "CC+AA": OR = 0.429, 95%CI = 0.198- 0.927, respectively). In addition, the combined effects of the rs8099917 and rs10903035 "TT+AG/GG" and "GT+AG/GG" genotypes were also significantly lower in the LUTS group ("TT+AG/GG" vs "TT+AA": OR = 0.569, 95%CI = 0.395-0.821; "GT+AG/GG" vs "TT+AA": OR = 0.318, 95%CI = 0.128-0.788, respectively). Stratification analysis revealed that the frequencies of the rs11249006 "AG/GG" genotypes in the subgroups of size ≤4.11 and IPSS ≤ 28 were significantly higher than those in the subgroups of size >4.11 and IPSS > 28. Therefore, the IL-28Rαgene polymorphism might be involved in the development of LUTS.

Discovery of novel candidate urinary protein biomarkers for prostate cancer in a multiethnic cohort of South African patients via label-free mass spectrometry.

PURPOSE: Improvement in diagnostic accuracy of prostate cancer (PCa) progression using MS-based methods to analyze biomarkers in our African, Caucasian, and Mixed Ancestry patients can advance early detection and treatment monitoring. EXPERIMENTAL DESIGN: MS-based proteomic analysis of pooled (N = 36) and individual samples (N = 45) of PCa, benign prostatic hyperplasia, normal healthy controls, and patients with other uropathies was used to identify differences in proteomics profile. Samples were analyzed for potential biomarkers and proteome coverage in African, Caucasian, and Mixed Ancestry PCa patients. RESULTS: A total of 1102 and 5595 protein groups and nonredundant peptides, respectively, were identified in the pooling experiments (FDR = 0.01). Twenty potential biomarkers in PCa were identified and fold differences ± 2SD were observed in 17 proteins using intensity-based absolute quantification. Analysis of 45 individual samples yielded 1545 and 9991 protein groups and nonredundant peptides, respectively. Seventy-three (73) proteins groups, including existing putative PCa biomarkers, were found to be potential biomarkers of PCa by label-free quantification and demonstrated ethnic trends within our PCa cohort. CONCLUSION AND CLINICAL RELEVANCE: Urinary proteomics is a promising route to PCa biomarker discovery and may serve as source of ethnic-related biomarkers of PCa.

Comparison of tamsulosin plus serenoa repens with tamsulosin in the treatment of benign prostatic hyperplasia in Korean men: 1-year randomized open label study.

INTRODUCTION: In Korea, increasing attention has recently been given to the use of phytotherapeutic agents to alleviate the symptoms of BPH. Serenoa repens has been shown to have an equivalent efficacy to Finasteride or Tamsulosin in the treatment of BPH in previous studies. The present study was designed to compare the efficacy and safety of Serenoa repens plus tamsulosin with tamsulosin only over 12 months in men with LUTS secondary to BPH. MATERIALS AND METHODS: One hundred forty men with symptomatic BPH (IPSS≥10) were recruited in our hospital for a 12-month, open-label, randomized trial. Patients were randomly assigned to either tamsulosin 0.2 mg/day plus Serenoa repens 320 mg/day (n=60) or tamsulosin 0.2 mg/day only (n=60). Prostate volume and PSA were measured at baseline and at end-point, whereas total IPSS, and its storage and voiding subscores, LUTS-related QoL, Qmax, and PVR were evaluated at baseline and later every 6 months. RESULTS: Total 103 patients were finally available: 50 in the TAM+SR group and 53 in the TAM group. At 12 months, total IPSS decreased by 5.8 with TAM+SR and 5.5 with TAM (p=0.693); the storage symptoms improved significantly more with TAM+SR (-1.7 vs. -0.8 with TAM, p=0.024). This benefit with regard to storage symptom in the TAM+SR group lasts at 12 months (-1.9 vs. -0.9, p=0.024). The changes of voiding subscore, LUTS-related QoL, Qmax, PVR, PSA, and prostate volume showed no significant differences between the TAM+SR and TAM groups. During the treatment period, 8 patients (16.9%) with TAM and 10 (20%) with TAM+SR had drug-related adverse reactions, which included ejaculatory disorders, postural hypotension, dizziness, headache, gastro-intestinal disorders, rhinitis, fatigue and asthenia. CONCLUSIONS: The combination treatment of Serenoa repens and tamsulosin was shown to be more effective than tamsulosin monotherapy in reducing storage symptoms in BPH patients after 6 months and up to 12 months of treatment.

Impact of metabolic syndrome on benign prostatic hyperplasia in elderly Chinese men.

OBJECTIVE: The aim of the present study was to evaluate the impact of metabolic syndrome (MetS) on benign prostatic hyperplasia (BPH) in elderly Chinese men. METHODS: A total of 401 elderly BPH patients were divided into the without or with MetS group to assess the associations of MetS and components of MetS with BPH. Urologic evaluation included prostate volume, International Prostate Symptom Score, serum prostate-specific antigen, duration of concomitant lower urinary tract symptoms (LUTS) and maximum flow rate. RESULTS: Body mass index (BMI), waist circumference, fasting glucose, glycosylated hemoglobin, triglyceride, fasting insulin (FINS), insulin resistance assessed by homeostasis model assessment (HOMA-IR) were greater and high-density lipoprotein cholesterol (HDL-C) was lower in BPH patients with MetS than in those without MetS. The patients with MetS showed a significantly larger prostate volume (p = 0.000) and longer duration of LUTS (p = 0.006) than those without MetS. Prostate volume was positively correlated with BMI (p = 0.000), FINS (p = 0.001), HOMA-IR (p = 0.003) and inversely correlated with HDL-C (p = 0.000). Multiple linear regression analysis showed that prostate volume was significantly correlated with HOMA-IR (p = 0.015). CONCLUSIONS: Our results suggest that MetS, BMI, low HDL-C level, increased serum insulin and especially insulin resistance are considered risk factors for prostate enlargement in elderly Chinese men.

Morbidity and mortality after benign prostatic hyperplasia surgery: data from the American College of Surgeons national surgical quality improvement program.

BACKGROUND AND PURPOSE: With the aging population, it is becoming increasingly important to identify patients at risk for postsurgical complications who might be more suited for conservative treatment. We sought to identify predictors of morbidity after surgical treatment of benign prostatic hyperplasia (BPH) using a large national contemporary population-based cohort. METHODS: Relying on the American College of Surgeons National Surgical-Quality Improvement Program (ACS-NSQIP; 2006-2011) database, we evaluated outcomes after transurethral resection of the prostate (TURP), laser vaporization of the prostate (LVP), and laser enucleation of the prostate (LEP). Outcomes included blood-transfusion rates, length of stay, complications, reintervention rates, and perioperative mortality. Multivariable logistic-regression analysis evaluated the predictors of perioperative morbidity and mortality. RESULTS: Overall, 4794 (65.2%), 2439 (33.1%), and 126 (1.7%) patients underwent TURP, LVP, and LEP, respectively. No significant difference in overall complications (P=0.3) or perioperative mortality (P=0.5) between the three surgical groups was found. LVP was found to be associated with decreased blood transfusions (odds ratio [OR]=0.21; P=0.001), length of stay (OR=0.12; P<0.001) and reintervention rates (OR=0.63; P=0.02). LEP was found to be associated with decreased prolonged length of stay (OR=0.35; P=0.01). Men with advanced age at surgery and non-Caucasians were at increased risk of morbidity and mortality. In contrast, normal preoperative albumin and higher preoperative hematocrit (>30%) levels were the only predictors of lower overall complications and perioperative mortality. CONCLUSIONS: All three surgical modalities for BPH management were found to be safe. Advanced age and non-Caucasian race were independent predictors of adverse outcomes after BPH surgery. In patients with these attributes, conservative treatment might be a reasonable alternative. Also, preoperative hematocrit and albumin levels represent reliable predictors of adverse outcomes, suggesting that these markers should be evaluated before BPH surgery.

Association of metabolic syndrome and benign prostatic hyperplasia in Chinese patients of different age decades.

OBJECTIVES: To evaluate the relationship between metabolic syndrome (MetS) and annual prostate growth rates in Chinese patients of different age decades with benign prostatic hyperplasia (BPH). METHODS: We retrospectively analyzed the clinical data obtained from 1,052 Chinese men with BPH. Overnight fasting venous blood specimens were collected and serum levels of prostate-specific antigen, fasting blood glucose, high-density lipoprotein cholesterol, total cholesterol and triglyceride were recorded. We divided age into four groups: 50 ≤ age ≤ 60, 60 < age ≤ 70, 70 < age ≤ 80 and 80 < age ≤ 90. Pearson's correlation coefficient was used to test the linearity of the relationships between each of the MetS components and prostate volume and annual prostate growth rates generally and in different age decades. RESULTS: The median total prostate volume (69.01 ml) and median annual prostate growth rate (1.92 ml/year) were significantly higher in the MetS group compared with the non-MetS group (57.26 ml and 1.23 ml/year). Significant positive correlations were also found in total prostate volume and different age decades, while negative correlations were seen in annual prostate growth rate and different age decades. CONCLUSIONS: MetS is associated with an increased risk of total volume and annual prostate growth rate in BPH patients of different age decades.

Genetic variants in 2q31 and 5p15 are associated with aggressive benign prostatic hyperplasia in a Chinese population.

BACKGROUND: Benign prostatic hyperplasia (BPH) is a common disease prevalent in elderly men. However, the genetic determinants of BPH remain unclear. Because BPH and prostate cancer (PCa) share some common pathological characteristics, we investigated whether susceptibility loci for PCa contributed to BPH risk and BPH aggressiveness in Chinese men. METHODS: Fourteen SNPs associated with PCa risk in a Chinese population were genotyped in 426 BPH cases (184 aggressive and 242 non-aggressive BPH cases) and 1,008 controls. The association between the SNPs and BPH risk/aggressiveness was estimated using logistic regression analysis. In addition, effects of the 14 SNPs on BPH related clinical traits, including International Prostate Symptom Score (IPSS), prostate volume, total PSA, and free PSA were evaluated using linear regression analysis. RESULTS: Two SNPs, rs12621278 in ITGA6 at 2q31 (OR = 0.82, P = 0.05) and rs339331 in RFX6 at 6q22 (OR = 1.22, P = 0.04) were significantly associated with BPH. In addition, rs12621278 (OR = 0.73, P = 0.05) and rs12653946, 13 kb upstream of IRX4 at 5p15 (OR = 1.40, 0.03), were significantly associated with aggressive BPH. Moreover, the risk allele of rs12621278 (G) and rs12653946 (T) for aggressive BPH were significantly associated with elevated IPSS after treatment (P = 0.01). CONCLUSIONS: This is the first systematic investigation on the contributions of PCa susceptibility loci to risk and aggressiveness of BPH. Our findings advance our understanding of the genetic basis of BPH, especially aggressive BPH. In addition, our results provide new insights into the genetic determinants shared between BPH and PCa.

Elevated polycyclic aromatic hydrocarbon-DNA adducts in benign prostate and risk of prostate cancer in African Americans.

Carcinogen-DNA adducts, a marker of DNA damage, are capable of inducing mutations in oncogenes and tumor suppressor genes, resulting in carcinogenesis. We have shown previously that polycyclic aromatic hydrocarbon (PAH)-DNA adduct levels in prostate cancer cases vary by cellular histology and that higher adduct levels are associated with biochemical recurrence. A nested case-control study was conducted in a historical cohort of 6692 men with histopathologically benign prostate specimens. PAH-DNA adduct levels were determined by immunohistochemistry in benign prostate specimens from 536 prostate cancer case-control pairs (59% White and 41% African American). We estimated the overall and race-stratified risk of subsequent prostate cancer associated with higher adduct levels. Prostate cancer risk for men with elevated adduct levels (defined as greater than control group median) was slightly increased [odds ratio (OR) = 1.28, 95% confidence interval (CI) = 0.98-1.67, P = 0.07]. After race stratification, elevated adduct levels were significantly associated with increased risk in African American men (OR = 1.56, CI = 1.00-2.44, *P = 0.05) but not White men (OR = 1.14, CI = 0.82-1.59, P = 0.45). Elevated PAH-DNA adduct levels were significantly associated with 60% increased risk of prostate cancer among cases diagnosed 1-4 years after cohort entry (OR = 1.60, CI = 1.07-2.41) with a greater risk observed in African Americans within the first 4 years of follow-up (OR = 4.71, CI = 1.97-11.26, ***P = 0.0005). Analyses stratified by age or tumor grade revealed no additional significant heterogeneity in risk. Increased prostate cancer risk associated with high PAH-DNA adduct levels in benign prostate was found only in African Americans; risk was greatest within 4 years of follow-up, possibly reflecting a carcinogenic process not yet histologically detectable.

An overview of prostate diseases and their characteristics specific to Asian men.

In this paper, we reviewed the features of common prostate diseases, such as benign prostatic hyperplasia (BPH), prostate cancer (PCa) and chronic prostatitis (CP) that are specific to Asian men. Compared to the Westerners, Asians exhibit particular characteristics of prostate diseases. Through summarizing the epidemiology, symptomatology, diagnostics and therapeutics of these diseases, we find that Asians have a lower incidence of PCa than whites, but the incidences of BPH and CP are similar. Asian men with CP often suffer from fewer disease sites, but have a higher frequency of pain during urination rather than after sexual climax. Prostate-specific antigen (PSA) is a widely used marker for the diagnosis of PCa in both Asian and Western countries. Although the PSA level may be lower in Asians, the threshold used is based on whites. After reviewing the treatments available for these diseases, we did not find a fundamental difference between Asians and whites. Furthermore, the selection for the most appropriate treatment based on the individual needs of patients remains a challenge to urologists in Asia. After considering the traits of prostate diseases that are specific to Asian men, we hope to pave the way for the development of specific diagnostic and therapeutic strategies targeted specifically to Asian men.

Lower urinary tract symptoms have negative associations with glomerular filtration rate irrespective of prostate volume in Korean men.

OBJECTIVE: To understand the relationship between lower urinary tract symptoms (LUTS) and renal function by prostate volume (PV) in Korean men. LUTS can be related to early renal dysfunction, irrespective of bladder outlet obstructive lesions, few studies have been conducted. METHODS: We conducted a cross-sectional survey of 3713 men, aged≥40 years, who received routine comprehensive health evaluations, including transrectal ultrasonography and the International Prostate Symptom Score questionnaire. We used the estimated glomerular filtration rate (GFR) for the assessment of renal function and the IPSS for LUTS severity. We compared LUTS and GFR using multivariate regression analysis after adjusting for age and/or PV. RESULTS: An increasing severity of LUTS, especially voiding LUTS, was associated with a decreasing GFR in the older age group (≥55 years). In a stratified analysis by PV of 30 cm3, voiding LUTS showed a negative association with GFR, irrespective of the PV (P for trend<.01 and P for trend<.02), but total LUTS did so only in the small PV group. CONCLUSION: In men without known urinary tract disease, LUTS and renal function had a negative association, especially in older men with a normal PV. Although the underlying mechanism is uncertain, physicians who treat patients with moderate or severe LUTS should monitor renal function, even in patients with a normal PV.

The relationship between prostate volume and international prostate symptom score in Africans with benign prostatic hyperplasia.

OBJECTIVE: To determine the relationship between prostate volume and international prostate symptom score (IPSS) in Africans with benign prostatic hyperplasia (BPH). PATIENTS AND METHOD: This was a prospective study of 120 men aged between 45 to 85 years, who were referred to the urology outpatient facility for treatment of clinical BPH between July 2007 and October 2008 in Jos University Teaching Hospital. These patients were properly evaluated; a digital rectal examination was done to estimate the prostate size. The pre-treatment IPSS of the patient was also obtained. The prostate volume of each patient was then estimated by transabdominal ultrasound. RESULTS: The mean prostate volume was 72.79 +/- 44.38cm3. The mean values for the different diameters of the prostate were 5.63 +/- 1.17cm (longitudinal diameter), 4.48 +/- 0.95cm (anterior posterior diameter), 4.97 +/- 1.06cm (transverse diameter). The Pearson's correlation between pre-treatment International prostate symptom score and prostate volume was -0.0035 (P > 0.05). CONCLUSION: This study has shown that there is no significant relationship between international prostate symptom score and prostate volume in Africans. This is e with similar studies done in other parts of the world.

Diabetes treatment and progression of benign prostatic hyperplasia in community-dwelling black and white men.

OBJECTIVE: To conduct a study to determine whether diabetes treatment is associated with benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and progression in black and white men. Diabetes has been associated with BPH and LUTS in aging men. METHODS: Using the Olmsted County Study of Urinary Symptoms and Health Status among Men and the Flint Men's Health Study, we examined how the use of medical therapy (eg, insulin regimens, oral hypoglycemics) related to changes in LUTS severity, maximal urinary flow rate measured by uroflowmetry, prostate volume determined by transrectal ultrasonography, and serum prostate-specific antigen concentrations. RESULTS: Of the 2226 men participating in the Olmsted County Study of Urinary Symptoms and Health Status among Men and the Flint Men's Health Study, 186 men reported a history of diabetes, 76.9% of whom were treated with medical therapy. Overall, the men with diabetes had significantly greater odds of moderate/severe LUTS (age- and race-adjusted odds ratio 1.37, 95% confidence interval 1.00-1.87) compared with those without diabetes. However, among the diabetic men, those not taking medication had greater odds of moderate/severe LUTS than those taking medication. This association among men not taking medication was seen for 5 of the 7 individual symptoms. The prostate volume and prostate-specific antigen level were not significantly associated with diabetes treatment. No significant differences were observed for the annual change in BPH characteristics by diabetes treatment status. CONCLUSION: These findings suggest that the presence of diabetes and subsequent poor glycemic control might be less related to prostate growth and more to the dynamic components of lower urinary tract function. Additional evaluations of the associations between glycemic control and BPH progression are warranted.

Finasteride adherence-associated factors in Chinese benign prostatic hyperplasia patients.

OBJECTIVES: Medication noncompliance is a recognized problem worldwide. This study evaluated the factors associated with compliance, discontinuation and switching of finasteride among Chinese benign prostatic hyperplasia patients. MATERIALS AND METHODS: A retrospective cohort study was conducted with 682 outpatients newly diagnosed with benign prostatic hyperplasia and prescribed with finasteride from January 2008 to December 2009, taken from a database. We evaluated their compliance by medication possession ratios, discontinuation and switching rate after the prescription for an average observation period of 15 months. Multiple association factors were identified and evaluated using multivariate logistic regression analyses. RESULTS: The crude compliance level, discontinuation and switching rates were 29.3, 60.6 and 10.1%, respectively. Older age (≥60 years), combination therapy, medical insurance and chronic comorbidities were positively associated with good compliance. Younger age was significantly associated with drug discontinuation or switching. Those patients on finasteride monotherapy and without medical insurance were significantly associated with discontinuation of drugs. CONCLUSIONS: Patients <60 years of age, on monotherapy and without medical insurance were less likely to be compliant with their newly initiated finasteride treatment. Consequently, more efforts should be made among this group to increase treatment adherence.

Genetic polymorphism of the glutathione-S-transferase P1 gene (GSTP1) and susceptibility to prostate cancer in the Kashmiri population.

Glutathione-S-transferase P1 (GSTP1) is a critical enzyme of the phase II detoxification pathway. One of the common functional polymorphisms of GSTP1 is A→G at nucleotide 313, which results in an amino acid substitution (Ile105Val) at the substrate binding site of GSTP1 and reduces catalytic activity of GSTP1. To investigate the GSTP1 Ile105Val genotype frequency in prostate cancer cases in the Kashmiri population, we designed a case-control study, in which 50 prostate cancer cases and 45 benign prostate hyperplasia cases were studied for GSTP1 Ile105Val polymorphism, compared to 80 controls taken from the general population, employing the PCR-RFLP technique. We found the frequency of the three different genotypes of GSTP1 Ile105Val in our ethnic Kashmir population, i.e., Ile/Ile, Ile/Val and Val/Val, to be 52.4, 33.3 and 14.3% among prostate cancer cases, 48.5, 37.5 and 14% among benign prostate hyperplasia cases and 73.8, 21.3 and 5% in the control population, respectively. There was a significant association between the GSTP1 Ile/Val genotype and the advanced age group among the cases. We conclude that GSTP1 Ile/Val polymorphism is involved in the risk of prostate cancer development in our population.

Prostate-specific antigen 1.5-4.0 ng/mL: a diagnostic challenge and danger zone.

UNLABELLED: What's known on the subject? and What does the study add? Large population screening trials like the ERSPC, PCPT and PLCO have noted that men with seemingly low PSA (even as low as 0.5 ng/dL) still can have prostate cancer. Despite these findings, PSA is still predominantly used as a current indicator for possible presence of prostate cancer rather than also serving as a prognostic marker. This study examines a larger number of men in a diverse US population to determine the prognostic value of a man's baseline or first PSA. OBJECTIVES: • To assess the value of a PSA threshold of 1.5 ng/mL as a predictor of increased prostate cancer risk over a four-year period based on a man's first PSA test, including racial differences. • To review the risk of progression of benign prostatic hyperplasia (BPH) based on a similar PSA threshold. PATIENTS AND METHODS: • A retrospective review involving 21,502 men from a large Midwestern health system was performed. • Men at least 40 years old with baseline PSA values between 0 and 4.0 ng/mL and at least four years of follow-up after initial PSA test were included. • Optimal PSA threshold and predictive value of PSA for development of prostate cancer were calculated. RESULTS: • Prostate cancer rates were 15-fold higher in patients with PSA ≥1.5 ng/mL vs patients with PSA <1.5 ng/mL (7.85% vs 0.51%). • African American patients with baseline PSA <1.5 ng/mL faced prostate cancer rates similar to the whole study population (0.54% vs 0.51%, respectively), while African American patients with PSA 1.5-4.0 ng/mL faced a 19-fold increase in prostate cancer. CONCLUSION: • Both Caucasian and African American men with baseline PSA values between 1.5 and 4.0 ng/mL are at increased risk for future prostate cancer compared with those who have an initial PSA value below the 1.5 ng/mL threshold. • Based on a growing body of literature and this analysis, it is recommended that a first PSA test threshold of 1.5 ng/mL and above, or somewhere between 1.5 and 4.0 ng/mL, represent the Early-Warning PSA Zone (EWP Zone). • This should serve to inform patients and clinicians alike to future clinical activities with respect to prostate cancer and BPH.

Benign prostatic hyperplasia: racial differences in treatment patterns and prostate cancer prevalence.

OBJECTIVE: • To compare prostate cancer, prostate-related surgery and acute urinary retention rates, as well as associated healthcare resource use over 11 years in African American and Caucasian men with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: • The BPH-related medical and surgical charges and events were determined for 398 African American men and 1656 Caucasian men followed for a mean of 10.2 years within a health maintenance organization. • Racial differences in clinical outcomes were evaluated using time-to-event analysis, stratifying results by baseline prostate-specific antigen (PSA) values. RESULTS: • Risk of a prostate cancer diagnosis was 2.2 times greater in African American than Caucasian men (95% CI 1.48-3.35, P < 0.001) in analyses adjusting for serum PSA level. • Although African Americans were more likely to receive medical therapy for symptoms of BPH than Caucasians (43.5% vs 37.2%, respectively; P= 0.029), there were no clinically meaningful differences with respect to subsequent acute urinary retention or BPH-related surgery between them, or BPH-related medical charges (US $407 vs US $405 per month). CONCLUSION: • As evidenced by this analysis of 'real-world' clinical practice, African Americans with BPH have a much greater risk of developing prostate cancer than similar Caucasian men highlighting the need for education and early detection in this population.

Antioxidant effects of lycopene in African American men with prostate cancer or benign prostate hyperplasia: a randomized, controlled trial.

Consumption of tomato products is associated with a decreased risk of developing prostate cancer, and lycopene, the red carotenoid in the tomato, is a potent antioxidant that might contribute to this chemoprevention activity. A double-blind, randomized, placebo-controlled trial of 105 African American men veterans, recommended for prostate biopsy to detect cancer, was carried out to investigate whether oral administration of lycopene increases lycopene levels in blood and prostate tissue and lowers markers of oxidative stress. Urology patients were randomly assigned to receive 30 mg/d of lycopene as a tomato oleoresin or placebo for 21 days prior to prostate biopsy for possible diagnosis of prostate cancer. A total of 47 men had a diagnosis of prostate cancer, and 58 men had a diagnosis of benign prostate hyperplasia. Diet, smoking, and drinking habits were assessed. For the men receiving lycopene, the mean lycopene concentration increased from 0.74 ± 0.39 to 1.43 ± 0.61 µmol/L in plasma (P < 0.0001) and from 0.45 ± 0.53 to 0.59 ± 0.47 pmol/mg in prostate tissue (P = 0.005). No significant changes in the DNA oxidation product 8-oxo-deoxyguanosine and the lipid peroxidation product malondialdehyde were observed in prostate tissue and plasma, respectively, as a result of lycopene administration.

Proteomics-based signature for human benign prostate hyperplasia and prostate adenocarcinoma.

Prostate adenocarcinoma often presents at a late stage, due to a lack of early clinical symptoms and lack of accurate objective markers. This study aimed to identify and validate proteomics-based biomarkers useful for prostate cancer diagnosis and to establish a marker-panel for prostate cancer and benign prostate hyperplasia (BPH). Global protein expression patterns in fresh tissue specimens from 8 patients with prostate carcinoma and 16 with BPH were analyzed by two-dimensional gel electrophoresis. Differentially expressed proteins were identified by MALDI-TOF mass spectrometry. We compared our results with those of published studies and defined a set of common biomarkers. We identified 22 differentially expressed proteins between BPH and prostate carcinomas. The up-regulated proteins in cancer compared to BPH included protein disulfide-isomerase, 14-3-3-protein, Enoyl CoA-hydrase, prohibitin and B-tubulin ß-2. Keratin-II, desmin, HSP71, ATP-synthase-ß-chain and creatine kinase-ß-chain were down-regulated. Survey of the literature showed that 15 of our 22 identified proteins have been previously reported to differ in their expression levels between BPH and prostate cancer by other laboratories. The expression patterns of these biomarkers could successfully cluster BPH and adenocarcinomas as well as prostate cancer of low and high Gleason scores. This study validates protein-biomarkers that can be useful for accurate diagnosis and prognostic monitoring of prostate adenocarcinoma. Despite varied prevalence of the disease between different ethnic populations (i.e., high in Sweden, low in Saudi Arabia); the biomarkers indicate that BPH and prostate cancers are biologically 'homogeneous' in their protein expression patterns across wide geographical regions.