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Heme oxygenase levels and metaflammation in benign prostatic hyperplasia patients

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Abstract

Purpose

To investigate the relationship between intra-prostatic levels of heme oxygenase (HO), metaflammation in benign prostatic hyperplasia (BPH) tissue in patients with MetS and moderate–severe lower urinary tract symptoms (LUTS).

Methods

Between January 2012 and June 2013, 132 consecutive patients, who underwent transurethral resection of the prostate for moderate–severe LUTS, secondary to clinical BPH, were enrolled. Prostate samples were investigated for the presence of an inflammatory infiltrate, according to the Irani score, and for HO-1 and HO-2 levels measurements. Patients were evaluated for the presence of metabolic syndrome (MetS) defined by the International Diabetes Federation.

Results

We observed that subjects with MetS exhibited greater Irani score (3.0 vs. 2.0; p < 0.05), Irani grade (2.0 vs. 1.0; p < 0.05) and lower value of HO-1 (4.55 vs. 6.01; p < 0.05) and HO-2 (0.81 vs. 2.66; p < 0.05). HO-1 (3.91 vs. 5.67; p < 0.05) and HO-2 (1.06 vs. 1.37; p < 0.05) were significantly reduced in patients with high intra-prostatic inflammation (Irani score ≥4). At the multivariate logistic regression analysis, HO-1 reduction (OR 0.588; p < 0.01), waist circumference (OR 1.09; p < 0.01), triglycerides (OR 1.013; p < 0.05) and HDL (OR 0.750; p < 0.05) were independent predictors of high intra-prostatic inflammation. We also found that HO-1 reduction (OR 0.598; p < 0.01) and the presence of MetS (OR 34.846; p < 0.01) were associated with Irani score ≥4.

Conclusion

MetS-induced inflammation may play a key role in BPH. In detail, prostate metaflammation is inversely related to intra-prostatic HO-1 levels, serum HDL and positively with triglycerides.

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Authors contribution

Giorgio Ivan Russo had full access to data. Luca Vanella, Tommaso Castelli, Sebastiano Cimino, Giulio Reale, Daniele Urzì, Mauro Gacci, Marco Carini, Fabio Motta, Rosario Caltabiano and Lidia Puzzo collected data. Giorgio Ivan Russo concepted and designed the study, analyzed and interpreted data, performed statistical analysis and drafted the manuscript. Valeria Sorrenti, Rosario Caltabiano, Lidia Puzzo and Giuseppe Morgia supervised for intellectual contents.

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    Authors and Affiliations

    1. Department of Urology, School of Medicine, Policlinico Hospital, University of Catania, Catania, Italy

      Giorgio Ivan Russo, Tommaso Castelli, Sebastiano Cimino, Giulio Reale, Daniele Urzì & Giuseppe Morgia

    2. Department of Drug Science, Biochemistry Section, University of Catania, Catania, Italy

      Luca Vanella, Giovanni Li Volti & Valeria Sorrenti

    3. Department of Urology, Careggi Hospital, University of Florence, Florence, Italy

      Mauro Gacci & Marco Carini

    4. Department G.F. Ingrassia, Section of Anatomic Pathology, University of Catania, Catania, Italy

      Fabio Motta, Rosario Caltabiano & Lidia Puzzo

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    1. Giorgio Ivan Russo
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    2. Luca Vanella
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    Corresponding author

    Correspondence to Giorgio Ivan Russo.

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    Ethical standard

    All participants provided written informed consent before enrollment, and the study was conducted in accordance with regulatory standards of Good Clinical Practice and the Declaration of Helsinki (1996). The study was approved by our institutional research ethics committee.

    Conflict of interest

    Each author declares no conflict of interest.

    Additional information

    Giorgio Ivan Russo and Luca Vanella have contributed equally to this work.

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    Cite this article

    Russo, G.I., Vanella, L., Castelli, T. et al. Heme oxygenase levels and metaflammation in benign prostatic hyperplasia patients. World J Urol 34, 1183–1192 (2016). https://doi.org/10.1007/s00345-015-1736-8

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    • DOI: https://doi.org/10.1007/s00345-015-1736-8

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