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Apoptotic and Proliferative Index after Alpha-1-Adrenoceptor Antagonist and/or Finasteride Treatment in Benign Prostatic Hyperplasia

Introduction: The induction of apoptosis has emerged as a potential target for optimization of the medical management of benign prostatic hyperplasia (BPH), recently. The influence of α1-adrenoceptor antagonist (α1-ARA), 5-α reductase inhibitor and their combination on prostatic cell apoptotic and proliferative indices of benign hyperplastic prostate gland were investigated. Material and Methods: A total of 49 male patients with BPH (mean age: 66.5 years) treated with α1-ARA and/or finasteride were retrospectively evaluated. Patients treated with α1-ARA (doxazosin n = 12 and terazosin n = 10), finasteride (n = 9) and combination of finasteride and α1-ARA (n = 9) were enrolled in the study. Primary antibodies were Ki-67 and proliferating cell nuclear antigen for the evaluation of proliferation in prostate stromal and epithelial cells. In situ apoptotic DNA fragmentation was evaluated using TUNEL assay. Results: All treatment groups had no significant changes in the rate of prostate stromal and epithelial cell proliferation. Epithelial apoptotic index (AI) was not statistically significant for finasteride vs. α1- ARA, α1-ARA vs. finasteride + α1-ARA and finasteride + α1-ARA vs. finasteride groups. While α1-ARA was more effective than finasteride on stromal apoptosis, α1-ARA-induced stromal apoptosis was not significantly different from α1-ARA plus finasteirde treatment. Conclusion: Not only androgen variabilities but also alterations in sympathetic neurotransmission with age could have important implications for pathophysiological prostate growth. The combination of finasteride and α1-ARA is not superior to α1-ARA therapy with their similar epithelial and stromal apoptotic effects with unaffected cell proliferation.