Shibata Y, Fukabori Y, Ito K, Suzuki K, Yamanaka H
Department of Urology, Gunma University School of Medicine, Maebashi, Japan.
J Urol. 2001 Jan;165(1):289-93. doi: 10.1097/00005392-200101000-00081.
Chlormadinone acetate and finasteride are androgen suppressive agents clinically used for benign prostatic hyperplasia but their mechanism for inducing prostatic atrophy differs. We investigated the effect of these androgen suppressive agents on prostatic histology and apoptosis using the spontaneous canine benign prostatic hyperplasia model.
Animals were treated with oral chlormadinone acetate or finasteride for 25 weeks. The prostatic volumes were analyzed every 5 weeks. Prostatic androgen and estrogen concentrations, histological composition and apoptosis were determined at the end of treatment. Apoptosis was measured by in situ labeling of 3' hydroxy ends of the DNA breaks using the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling method.
There was a similar volume reduction effect with 0.3 mg./kg. chlormadinone acetate daily and 1 mg./kg. finasteride daily. Chlormadinone acetate decreased testosterone and dihydrotestosterone but finasteride decreased only dihydrotestosterone in the prostate gland. The concentration ratio of estradiol-to-total androgen in the prostate was significantly increased in finasteride treated canines. Chlormadinone acetate and finasteride decreased the epithelial and stromal components. The extent of apoptosis observed in the prostate was significantly higher in the chlormadinone acetate group compared to that of the control and finasteride groups.
Although a similar effect of chlormadinone acetate and finasteride was observed in the induction of prostatic regression and composition of the histological components, the sustained increase in apoptosis was observed only in chlormadinone acetate treated canines. We suggest that different intraprostatic endocrine environments created by chlormadinone acetate or finasteride, which have different intraprostatic testosterone levels and estradiol-to-androgen ratios, may be responsible for the different outcomes in the extent of apoptosis.
醋酸氯地孕酮和非那雄胺是临床上用于治疗良性前列腺增生的雄激素抑制药物,但它们诱导前列腺萎缩的机制不同。我们使用自发性犬良性前列腺增生模型研究了这些雄激素抑制药物对前列腺组织学和细胞凋亡的影响。
动物口服醋酸氯地孕酮或非那雄胺治疗25周。每5周分析前列腺体积。在治疗结束时测定前列腺雄激素和雌激素浓度、组织学组成及细胞凋亡情况。细胞凋亡通过末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸缺口末端标记法对DNA断裂的3'羟基末端进行原位标记来测定。
每日0.3mg/kg醋酸氯地孕酮和每日1mg/kg非那雄胺具有相似的体积缩小效果。醋酸氯地孕酮可降低睾酮和双氢睾酮,但非那雄胺仅降低前列腺中的双氢睾酮。在非那雄胺治疗的犬中,前列腺中雌二醇与总雄激素的浓度比显著升高。醋酸氯地孕酮和非那雄胺均可减少上皮和基质成分。与对照组和非那雄胺组相比,醋酸氯地孕酮组前列腺中观察到的细胞凋亡程度显著更高。
虽然在诱导前列腺消退和组织学成分组成方面观察到醋酸氯地孕酮和非那雄胺有相似的效果,但仅在醋酸氯地孕酮治疗的犬中观察到细胞凋亡的持续增加。我们认为,醋酸氯地孕酮或非那雄胺所产生的不同前列腺内内分泌环境,其前列腺内睾酮水平和雌二醇与雄激素的比例不同,可能是导致细胞凋亡程度不同结果的原因。