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前列腺干细胞在良性前列腺增生中的作用及治疗策略

Role of prostate stem cells and treatment strategies in benign prostate hyperplasia.

作者信息

Gangavarapu Kalyan J, Jowdy Peter F, Foster Barbara A, Huss Wendy J

机构信息

Department of Pharmacology and Therapeutics, Roswell Park Comprehensive Cancer Center Buffalo, NY 14263, USA.

Department of Dermatology, Roswell Park Comprehensive Cancer Center Buffalo, NY 14263, USA.

出版信息

Am J Clin Exp Urol. 2022 Jun 15;10(3):154-169. eCollection 2022.

Abstract

Benign prostate hyperplasia (BPH) is a progressive disease with a direct correlation between incidence and age. Since the treatment and management of BPH involve harmful side effects and decreased quality of life for the patient, the primary focus of research should be to find better and longer-lasting therapeutic options. The mechanisms regulating prostate stem cells in development can be exploited to decrease prostate growth. BPH is defined as the overgrowth of the prostate, and BPH is often diagnosed when lower urinary tract symptoms (LUTS) of urine storage or voiding symptoms cause patients to seek treatment. While multiple factors are involved in the hyperplastic growth of the stromal and epithelial compartments of the prostate, the clonal proliferation of stem cells is considered one of the main reasons for BPH initiation and regrowth of the prostate after therapies for BPH fail. Several theories explain possible reasons for the involvement of stem cells in the development, progression, and pathogenesis of BPH. The aim of the current review is to discuss current literature on the fundamentals of prostate development and the role of stem cells in BPH. This review examines the rationale for the hypothesis that unregulated stem cell properties can lead to BPH and therapeutic targeting of stem cells may reduce treatment-related side effects and prevent the regrowth of the prostate.

摘要

良性前列腺增生(BPH)是一种发病率与年龄直接相关的进行性疾病。由于BPH的治疗和管理会给患者带来有害的副作用并降低生活质量,因此研究的主要重点应是寻找更好且更持久的治疗选择。可以利用调节前列腺干细胞发育的机制来减少前列腺生长。BPH被定义为前列腺过度生长,当储尿或排尿症状引起的下尿路症状(LUTS)导致患者寻求治疗时,通常会诊断出BPH。虽然前列腺基质和上皮细胞增生性生长涉及多种因素,但干细胞的克隆增殖被认为是BPH发生以及BPH治疗失败后前列腺再生的主要原因之一。有几种理论解释了干细胞参与BPH发生、发展和发病机制的可能原因。本综述的目的是讨论当前关于前列腺发育基础以及干细胞在BPH中的作用的文献。本综述探讨了以下假设的理论依据:不受调控的干细胞特性可导致BPH,而针对干细胞的治疗可能会减少治疗相关的副作用并防止前列腺再生。

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