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Comparison of the Effects of Hexanic Extract of Serenoa repens (Permixon) and Tamsulosin on Inflammatory Biomarkers in the Treatment of Benign Prostatic Hyperplasia-Related Lower Urinary Tract Symptoms
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文摘
Chronic prostatic inflammation appears to have a key role in the pathogenesis and progression of benign prostatic hyperplasia (BPH). The PERMIN study compared the effects of hexanic extract of Serenoa repens (Permixon; Pierre Fabre, Castres, France) and tamsulosin on inflammation-related biomarkers secreted in urine of patients with BPH-related lower urinary tract symptoms (LUTS).

Objective

To review key features of the PERMIN study as they relate to treatment effects on the messenger RNA expression of selected inflammation-related genes and proteins.

Evidence acquisition

This article is based primarily on material presented at a satellite symposium entitled, “Inflammation and Prostatic Diseases: From Bench to Bedside,” held during the 2015 annual meeting of the European Association of Urology in Madrid, Spain. Current data regarding the link between inflammation and BPH were reviewed.

Evidence synthesis

Permixon showed a more pronounced effect than tamsulosin on selected inflammation-related genes and proteins. Among the 15 most frequently expressed genes in patients at baseline, 73% were favourably affected by Permixon versus 27% with tamsulosin, as indicated by the combination of downregulation and fewer upregulation effects. Expression of inflammatory proteins (CCL2/MCP-1, CXCL10/IP-10, macrophage migration inhibitory factor [MIF]) was downregulated in a higher percentage of patients and upregulated in a lower percentage of patients treated with Permixon compared with tamsulosin. In Permixon-treated patients, greater improvement in the International Prostate Symptom Score was observed at 3 months in those who overexpressed MIF protein at baseline compared with those who did not (−6.4 vs −4.5).

Conclusions

Downregulation of inflammation-related genes and proteins by Permixon brought meaningful symptomatic improvement in patients with moderate to severe LUTS. Patients with high chronic prostatic inflammation may benefit from early treatment with Permixon.

Patient summary

Downregulation of inflammation-related genes and proteins by Serenoa repens (Permixon) was associated with meaningful symptomatic improvement in patients with moderate to severe lower urinary tract symptoms. Patients with high chronic prostatic inflammation may benefit from early treatment with Permixon.

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