Background: A close interaction between androgens, in particular dihydrotestosterone (DHT), and prostate tissue is universally recognised. The continuous biologic effects of this hormone are fundamental during the normal development and maintenance of the gland, as well as in the case of hyperplasic growth of the organ. Methods: This article reviews the association between androgens and benign prostatic hyperplasia. Results: The bioavailability of DHT within prostate tissue depends on the correct functioning of a complex hormonal signalling axis that mainly includes the synthesis of testosterone in testes and adrenal glands, the peripheral conversion of this precursor to DHT operated by 5-alpha-reductase, and finally the transport to target sites. The real function of DHT consists in promoting the expression of specific genes through a fine molecular mechanism, leading to synthesis of growth-stimulating or growth-inhibiting factors that modulate cell proliferation and function. The complete pattern of molecular factors involved in this mechanism is not yet completely defined. However, it is generally accepted that DHT, which controls the expression of specific molecular mediators, maintains a constant balance between proliferative and apoptotic processes in the prostate tissue during the normal development and growth of the gland. With advancing age, and for processes not entirely understood, this homeostatic equilibrium between proliferative and apoptotic processes is disrupted, all of which leads to progressive growth and enlargement of the prostate, mainly based on expansion of the epithelial compartment. A complex series of tissue modifications is then activated, especially in the periurethral zone of the gland where a higher sensitivity to androgens is registered, thereby explaining how BPH leads to bladder outlet obstruction. Conclusion: DHT is instrumental in the development of BPH. Under normal conditions, and in the presence of normal circulating and intraprostatic levels of androgens and estrogens, an homeostatic equilibrium between proliferative and apoptotic processes is present. (c) 2006 Elsevier B.V. All rights reserved.

Androgens and benign prostatic hyperplasia

Fusco F;
2006

Abstract

Background: A close interaction between androgens, in particular dihydrotestosterone (DHT), and prostate tissue is universally recognised. The continuous biologic effects of this hormone are fundamental during the normal development and maintenance of the gland, as well as in the case of hyperplasic growth of the organ. Methods: This article reviews the association between androgens and benign prostatic hyperplasia. Results: The bioavailability of DHT within prostate tissue depends on the correct functioning of a complex hormonal signalling axis that mainly includes the synthesis of testosterone in testes and adrenal glands, the peripheral conversion of this precursor to DHT operated by 5-alpha-reductase, and finally the transport to target sites. The real function of DHT consists in promoting the expression of specific genes through a fine molecular mechanism, leading to synthesis of growth-stimulating or growth-inhibiting factors that modulate cell proliferation and function. The complete pattern of molecular factors involved in this mechanism is not yet completely defined. However, it is generally accepted that DHT, which controls the expression of specific molecular mediators, maintains a constant balance between proliferative and apoptotic processes in the prostate tissue during the normal development and growth of the gland. With advancing age, and for processes not entirely understood, this homeostatic equilibrium between proliferative and apoptotic processes is disrupted, all of which leads to progressive growth and enlargement of the prostate, mainly based on expansion of the epithelial compartment. A complex series of tissue modifications is then activated, especially in the periurethral zone of the gland where a higher sensitivity to androgens is registered, thereby explaining how BPH leads to bladder outlet obstruction. Conclusion: DHT is instrumental in the development of BPH. Under normal conditions, and in the presence of normal circulating and intraprostatic levels of androgens and estrogens, an homeostatic equilibrium between proliferative and apoptotic processes is present. (c) 2006 Elsevier B.V. All rights reserved.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11591/434865
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