The Clinical Impact of Hexanic Extract of Serenoa repens in Men with Prostatic Inflammation: A Post Hoc Analysis of a Randomized Biopsy Study.

Michael Samarinas,Stavros Gravas,Vasileios Tzortzis,Anastasios Karatzas

doi:10.3390/jcm9040957

Michael Samarinas, Stavros Gravas + Show 2 more

Open Access

https://doi.org/10.3390/jcm9040957

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Abstract

A randomized biopsy study showed that hexanic Serenoa repens (HESr) treatment resulted in prostatic inflammation reduction. This post-hoc analysis evaluated the clinical impact of HESr and investigated correlations between baseline parameters and treatment response. Patients were randomized to receive HESr 320mg/day for six months or no therapy. Assessment included International Prostate Symptoms Score (IPSS), prostate volume (PV), and maximum flow rate (Qmax). Baseline characteristics were recorded, including body mass index (BMI) and metabolic syndrome (MetS) components. In patients under α1-adrenoceptor antagonists (α1-blockers), the addition of HESr resulted in statistically significant IPSS improvement after 6 months (p = 0.006). IPSS remained stable in patients under a1-blockers only (p = 0.346). Patients treated only with HESr reported a significant IPSS amelioration (p = 0.001). In the control group of naïve patients, no significant IPSS change was detected (p = 0.298). Baseline PV showed fair correlation (r = −0.20) with inflammation reduction in the HESr patients. BMI (r = 0.40), diabetes mellitus (r = 0.40), and PV (r = 0.23) showed fair correlation with Qmax increase but without reaching statistical significance. MetS (p = 0.06) was an influent biomarker for Qmax improvement. Treatment with HESr (as monotherapy or add-on therapy to a-blockers) may improve urinary symptoms in terms of IPSS in patients with prostatic inflammation.

Highlights

Lower urinary tract symptoms (LUTS) have multifactorial etiology, and several urological and non-urological conditions contribute to the development of LUTS [1]
A randomized biopsy study showed that hexanic Serenoa repens (HESr) treatment resulted in prostatic inflammation reduction
Prostatic inflammation seems to play a role in LUTS pathophysiology, since several studies have reported a relationship between the presence of prostatic inflammation, the severity of LUTS and progression of benign prostatic hyperplasia (BPH)

Summary

Introduction

Lower urinary tract symptoms (LUTS) have multifactorial etiology, and several urological and non-urological conditions contribute to the development of LUTS [1]. Prostatic inflammation has been suggested as a candidate link between metabolic syndrome (MetS) and BPH that could explain the association between these two conditions [5]. It was reasonable to explore if therapies that could improve prostatic inflammation might result in a beneficial effect on patients in terms of alleviation of their urinary symptoms. In this context, different drugs classes with potential anti-inflammatory properties were evaluated with varying results. There is a growing interest in the use of natural products in treatment of human pathologies, and studies have shown that plant components may exert antiaging, anticancer, anti-inflammatory, and antioxidant activities through different pathways [6,7]

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