Inflammation, apoptosis, and BPH: What is the evidence?

Background: Benign prostatic hyperplasia (BPH) is one of the most common diseases of aging men but its aetiology is far from being completely understood. Methods: Data were identified by searching MEDLINE from which 134 records were identified. Full texts were reviewed by to select the most relevant studies. In addition, other significant texts cited in the reference lists of the selected papers were considered. Results: Based on the role played in several models of human pathology, inflammation and apoptosis have been extensively investigated in the last decade. Inflammation is the basic process whereby tissues of the body respond to injury. Detection of injury or the presence of invaders in the tissue leads to a relatively circumscribed set of responses that removes the damaged structures and cells, kills and clears the invaders, and promotes cell and matrix replacement and repair. The role of inflammation in prostate pathologies is suggested by the presence of several kinds of inflammatory cells within the normal gland, as well as in patients with BPH and prostate cancer. Apoptosis (or programmed cell death) refers to the death of cells, which occurs as a normal and controlled part of the growth of an organism. Apoptosis is currently considered a genetically encoded, ubiquitous pathway, enabling cells to undergo highly regulated cell death in response to specific signalling, which have been largely investigated, as well as its intracellular effectors. Both inflammation and apoptosis are of major interest in understanding the aetiology of BPH, as well as the action mechanism of the drugs currently used and, most importantly, the development of new, more efficacious molecules. Conclusion: This review summarises the available evidence concerning the role of inflammation and apoptosis in BPH pathogenesis and treatment. (c) 2006 Elsevier B.V. All rights reserved.