Research Database -
International Updates

Prostate

Issue 19

CARRARO and colleagues, Perre Fabre Medicament, La Chartreuse, Castres, France, noting the controversy regarding the relative efficacy of treatments for the relief of symptoms of benign prostatic hyperplasia (BPH), compared the use of 320 mg plant extract Permixon with 5 mg finasteride, a 5-alpha-reductase inhibitor, in the treatment of BPH. METHODS: The authors conducted a 6-month double-blind randomised study with more than 1000 men with moderate BPH, using the criteria of the International Prostate Symptom Score (IPSS) as the primary end-point. RESULTS: Both Permixon and finasteride decreased the IPSS (-37% and -39%) , improved the quality of life (38% and 41%) and increased peak urinary flow rate (+25% and +30%). Finasteride markedly decreased prostate volume (-18%) and serum PSA levels (-41%). Permixon improved symptoms with little effect upon volume (-6%) and no change in PSA levels. Permixon was superior to finasteride in a sexual function questionnaire and give rise to fewer complaints of decreased libido and impotence. CONCLUSIONS: Both treatments relieve BPH treatments in two-thirds of patients. Permixon, unlike finasteride, has little effect upon so-called androgen-dependent parameters, suggesting that other pathways may also be involved in BPH symptomatology.
Carraro JC et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 29(4): 231-40. Oct 1996.

PASQUALI and colleagues, V and M McLean Department of Biochemistry, Baylor College of Medicine, Houston Texas USA, note that very little is known regarding the physiological role of Vitamin A (retinol) and its derivatives, the retinoids, in the prostate. RESULTS: The authors show that normal prostate, benign prostate hyperplasia (BPH) and prostage cancer tissues contain endogenous retinol and its biologically active metabolite retinoic acid. Compared with normal or cancer prostate tissues, retinol concentration was raised 2-fold in BPH. In contrast, prostate cancer tissue had 5-8 times less retinoic acid than either normal prostate or BPH. Prostate tissue expresses dehydrogenases capable of converting retinol to retinoic, with retinaldehyde as an intermediate. The formation of retinal from retinol occurs in microsomes; that of retinal to retinoic acid in the cytosol. The nuclear retinoic acid receptors alpha, beta and gamma are expressed in normal and tumour samples. CONCLUSIONS: These studies establish a role for retinoids in prostate physiology and possibly in prostate cancer pathophysiology.
Pasquali D et al. Abnormal level of retinoic acid in prostte cancer tissues. J Clin Endocrinol Metab 81(6): 2186-91. Jun 1996.

COMMENTS: Considering that a majority of men suffer from some degree of BPH as they age, it is interesting to note that the research being reported is of such a basic and fundamental nature, reflecting the infancy of effective treatments using conventional approaches. Considering that the herbal treatment was as effective in controlling symptoms, but had fewer side effects, would research using acupuncture and/or homoeopathy be as effective. For you clinicians and researchers out there, about to write your grant proposals, a sterling opportunity of a research topic.