Wang Yi, Chen Guihua, Li Deng, Zhang Dongliang, Xing Qianwei
Department of Urology, Affiliated Hospital of Nantong University, No.20 West Temple Road, Nantong, Jiangsu Province, 226001, China.
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.85 Wujin Road, Shanghai, 200080, China.
Biol Direct. 2024 Dec 19;19(1):129. doi: 10.1186/s13062-024-00575-x.
No authoritative books or guidelines are currently available for revealing the interrelationships of prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer (PCa). Moreover, no consensus on this issue has been reached among previously published epidemiological studies or meta-analyses.
We first took advantage of Mendelian randomization to clarify this issue and provide clinical implications for these patients' populations.
Bidirectional two-sample and mediator Mendelian randomization were applied to explore the causal relationships among prostatitis, BPH, and PCa. Sensitivity analyses, including phenotype scanning, heterogeneity, pleiotropy, leave-one-out analysis, and the Steiger test, were conducted to evaluate the robustness and reliability of our results.
Our results revealed the interrelationships among prostatitis, BPH, and PCa via Mendelian randomization, confirming that genetic susceptibility to prostatitis or BPH could lead to increased risks of PCa directly or indirectly (P < 0.05). Moreover, mediator Mendelian randomization revealed four potential mediator pathways, including the prostatitis-BPH-PCa, the BPH-PCa-prostatitis, the PCa-prostatitis-BPH, and the PCa-BPH-prostatitis pathways. Based on these, we also provided clinical implications for prostatitis, BPH, and PCa patients' populations, respectively. Interestingly, a total of three vicious circles were revealed by us, including the prostatitis-BPH circle, the BPH-PCa circle, and the prostatitis-BPH-PCa circle. All of these three vicious circles contributed to the progression of benign prostate diseases to malignant diseases.
We successfully clarified the interrelationships among prostatitis, BPH, and PCa, providing clinical implications for these patients' populations. A total of three vicious circles were also revealed by us to provide novel ideas for future drug development and guide clinical decision-making.
目前尚无权威书籍或指南来揭示前列腺炎、良性前列腺增生（BPH）和前列腺癌（PCa）之间的相互关系。此外，先前发表的流行病学研究或荟萃分析在这个问题上尚未达成共识。
我们首次利用孟德尔随机化来阐明这个问题，并为这些患者群体提供临床启示。
应用双向双样本和中介孟德尔随机化来探讨前列腺炎、BPH和PCa之间的因果关系。进行了敏感性分析，包括表型扫描、异质性、多效性、留一法分析和Steiger检验，以评估我们结果的稳健性和可靠性。
我们的结果通过孟德尔随机化揭示了前列腺炎、BPH和PCa之间的相互关系，证实了前列腺炎或BPH的遗传易感性可直接或间接导致PCa风险增加（P<0.05）。此外，中介孟德尔随机化揭示了四条潜在的中介途径，包括前列腺炎-BPH-PCa、BPH-PCa-前列腺炎、PCa-前列腺炎-BPH和PCa-BPH-前列腺炎途径。基于此，我们还分别为前列腺炎、BPH和PCa患者群体提供了临床启示。有趣的是，我们总共揭示了三个恶性循环，包括前列腺炎-BPH循环、BPH-PCa循环和前列腺炎-BPH-PCa循环。这三个恶性循环都促成了良性前列腺疾病向恶性疾病的进展。
我们成功阐明了前列腺炎、BPH和PCa之间的相互关系，为这些患者群体提供了临床启示。我们还揭示了总共三个恶性循环，为未来药物开发提供了新思路并指导临床决策。
Zotero 插件
