Furthermore, Jinglou and Hongping in their recent study reported that epigallocatechingallate had protective effects against testosterone induced BPH in rats and against BPH in metabolic syndrome rats.
Another very recent study Ren et al. The mechanistic basis for its anti-BPH activity was reported by the authors to involve stimulation of increased expression of G-protein-coupled estrogen receptor 1 GPER that has been reported to decrease cell proliferation by activating apoptosis in some cells Chimento et al. Until now, the concept of management of BPH using dietary polyphenols has been under debate due to a number of clinical studies that gave contrary results as well as the adverse effects some of these polyphenols could pose following long term exposure.
For instance, in the review by Curtis et al.
Moreover, the double-blind randomized clinical trial conducted by Ghorbanibirgani provided evidence of the efficacy of quercetin in the treatment of BPH. Again, clinical studies conducted on BPH management with resveratrol as reported by Kjaer et al. However, some other clinical studies carried out on BPH management with some dietary polyphenols provided evidence of their usefulness in the management of BPH. For example, in a study carried out on the effects of a low oral dose of equol supplement 6 mg, twice a day with meals for 4 weeks in a total of 18 men 49—60 years old with moderate or severe BPH Lephart, , it was shown that a low dose of equol positively improved moderate to severe BPH symptoms according to the IPSS indices.
In moderately symptomatic men, 5 out of 7 of the IPSS parameters significantly improved by 4 weeks of equol treatment while in severely symptomatic men, all 7 of the IPSS parameters significantly improved with 4 weeks of equol treatment. In a randomized, double-blind, placebo-controlled trial that investigated the effects of lycopene supplementation in elderly men diagnosed with BPH Schwarz et al. Furthermore, the authors Schwarz et al. The finding by these authors with respect to BPH management using this polyphenol was further affirmed by the later experimental study conducted by Ren et al.
Similarly, the double-blind randomized clinical trial conducted by Ghorbanibirgani provided evidence of the efficacy of quercetin in the treatment of BPH as earlier stated. Other clinical studies carried out supported the use of phytotherapies from different plants such as Eviprostat Matsumoto et al. While the contribution of some dietary polyphenols in the management of BPH has been indicated in this review as supported by clinical findings, it must also be emphasized that non-regulated and long-lasting supplementation with some dietary polyphenols could lead to potential harmful effects due to possible interactions with cytochrome P CYP enzymes Mancuso, It has also been shown to be expressed in the prostate, breast, gut, colon, small intestine, and the brain Ferguson and Tyndale, ; Loai and Zohar, In recent times, studies have also suggested possible interactions between dietary polyphenols and CYP 3A4, which could lead to some adverse effects.
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For instance, Mancuso and Barone reported that curcumin and its derivatives inhibit the activity of CYP3A4 and other drug-metabolizing enzymes such as: glutathione- S -transferase and UDP-glucuronosyltransferase. These authors reported that inhibition by curcumin, alone or in combination with piperine, of CYP3A4 could be harmful, especially during prolonged usage.
Kimura et al.
Similarly, the-flavonols kaempferol, quercetin, and galangin were reported to inhibit CYP3A4-mediated metabolism of xenobiotics in vitro Shimada et al. TABLE 1. B Structures of polyphenols with BPH suppressing actions in preclinical studies. While this review does not state emphatically that dietary polyphenols could replace the need for the existing therapies in the management of BPH, it suggests the promise some dietary polyphenols hold in BPH management which could be explored by researchers working in this field.
All authors read and approved the final manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Abd, E. Absorption, tissue distribution and excretion of pelargonidin and its metabolites following oral administration to rats.
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 Medical Management of Benign Prostatic Hyperplasia
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