Monti S, Sciarra F, Adamo M V, Toscano V, Trotta M C, Martini C, Lanzara S, Silverio F D
Department of Fisiopatologia Medica, III Endocrinologia, University of Rome La Sapienza, Italy.
J Androl. 1997 Sep-Oct;18(5):488-94.
The aim of the present investigation is to verify whether treatment with Finasteride or Flutamide influences the regional distribution of testosterone (T), dihydrotestosterone (DHT), and epidermal growth factor (EGF) in benign prostatic hyperplasia (BPH) tissue. Thirty seven BPH patients were studied: 15 untreated, 9 treated with Flutamide (750 mg/day for 2 months), and 13 treated with Finasteride (5 mg/day for 3 months). Testosterone and DHT were evaluated by radioimmunoassay (RIA) after purification of the extracts on celite columns, and EGF was evaluated by RIA after purification on Sep-pak C18 cartridges in total tissue and in periurethral, subcapsular, and intermediate zone. In the untreated group, T, DHT, and EGF of the periurethral region are higher than those of the subcapsular zone (P < 0.01 for T and P < 0.001 for DHT and EGF). In the Flutamide group, DHT is not modified, T is increased (P = 0.045), and EGF is decreased in total tissue (P < 0.02) and in the periurethral zone (P < 0.01). In the Finasteride group, T is increased (P < 0.001), and DHT and EGF are decreased (P < 0.001), particularly in the periurethral zone. A positive linear correlation between DHT and EGF is observed in the Finasteride and in the untreated groups. In conclusion, in BPH the production of EGF is a DHT-dependent receptor-mediated function. The reduction of this growth factor during both treatments, associated with a fall of DHT in only the Finasteride group, is particularly evident in the periurethral zone. Since Finasteride reduces prostatic volume, mainly of the periurethral zone, we can speculate that DHT is responsible, either directly or indirectly through growth factors such as EGF for the enlargement of this region and thus responsible for urinary obstruction.
本研究的目的是验证非那雄胺或氟他胺治疗是否会影响良性前列腺增生（BPH）组织中睾酮（T）、双氢睾酮（DHT）和表皮生长因子（EGF）的区域分布。对37例BPH患者进行了研究：15例未治疗，9例接受氟他胺治疗（750毫克/天，持续2个月），13例接受非那雄胺治疗（5毫克/天，持续3个月）。在硅藻土柱上对提取物进行纯化后，通过放射免疫测定（RIA）评估睾酮和双氢睾酮，在Sep-pak C18柱上对全组织以及尿道周围、包膜下和中间区域进行纯化后，通过RIA评估表皮生长因子。在未治疗组中，尿道周围区域的T、DHT和EGF高于包膜下区域（T为P < 0.01，DHT和EGF为P < 0.001）。在氟他胺组中，DHT未改变，T升高（P = 0.045），全组织（P < 0.02）和尿道周围区域（P < 0.01）的EGF降低。在非那雄胺组中，T升高（P < 0.001），DHT和EGF降低（P < 0.001），特别是在尿道周围区域。在非那雄胺组和未治疗组中观察到DHT与EGF之间呈正线性相关。总之，在BPH中，EGF的产生是一种依赖DHT受体介导的功能。两种治疗期间这种生长因子的减少，仅在非那雄胺组中与DHT的下降相关，在尿道周围区域尤为明显。由于非那雄胺主要减少尿道周围区域的前列腺体积，我们可以推测DHT直接或通过诸如EGF等生长因子间接导致该区域增大，从而导致尿路梗阻。
