Schally Andrew V, Theodoropoulos George, Sha Wei, Vidaurre Irving, Wangpaichitr Medhi
Endocrine and Polypeptide Institute, Veterans Affairs Healthcare System, Miami, FL, USA.
Department of Veterans Affairs, Miami VA Healthcare System, Research Service, Miami, FL, USA.
NPJ Aging. 2025 May 23;11(1):41. doi: 10.1038/s41514-025-00231-2.
Recent research underscores the crucial role of hormone regulation in benign prostatic hyperplasia (BPH) and the therapeutic promise of growth hormone-releasing hormone (GH-RH) antagonists. BPH incidence in aging men doubled over three decades, driven by prostatic enlargement and lower urinary tract symptoms (LUTS). Aging-related changes in GH-RH and luteinizing hormone-releasing hormone (LH-RH) biology promote BPH through hormonal and inflammatory processes. Traditional therapies provide symptomatic relief but often fail to prevent progression. This review explores the 50-year extensive development of LH-RH and GH-RH peptide analogs from discovery to delivery and their potential in BPH treatment. In preclinical studies, GH-RH antagonists reduced prostate volume, improved LUTS, and modulated inflammation mediated by NF-κB and IGF-I. Clinical trials are needed to validate antagonist efficacy and safety. Given BPH's public health impact among the aged, and especially among aging Veterans, integrating GH-RH antagonists into management strategies may offer precision-based therapeutic advancements.
近期研究强调了激素调节在良性前列腺增生（BPH）中的关键作用以及生长激素释放激素（GH-RH）拮抗剂的治疗前景。在三十年的时间里，老年男性BPH的发病率翻了一番，这是由前列腺肿大和下尿路症状（LUTS）驱动的。GH-RH和促黄体生成素释放激素（LH-RH）生物学中与衰老相关的变化通过激素和炎症过程促进BPH。传统疗法可缓解症状，但往往无法预防疾病进展。本文综述了LH-RH和GH-RH肽类似物从发现到应用的50年广泛发展历程及其在BPH治疗中的潜力。在临床前研究中，GH-RH拮抗剂可缩小前列腺体积、改善LUTS，并调节由NF-κB和IGF-I介导的炎症。需要进行临床试验以验证拮抗剂的疗效和安全性。鉴于BPH对老年人，尤其是老年退伍军人的公共卫生影响，将GH-RH拮抗剂纳入管理策略可能会带来基于精准医学的治疗进展。
