Prostate Tissue Of Patients Research Articles

A Description and Safety Overview of Irreversible Electroporation for Prostate Tissue Ablation in Intermediate-Risk Prostate Cancer Patients: Preliminary Results from the PRESERVE Trial.

The PRESERVE study (NCT04972097) aims to evaluate the safety and effectiveness of the NanoKnife System to ablate prostate tissue in patients with intermediate-risk prostate cancer (PCa). The NanoKnife uses irreversible electroporation (IRE) to deliver high-voltage electrical pulses to change the permeability of cell membranes, leading to cell death. A total of 121 subjects with organ-confined PCa ≤ T2c, prostate-specific antigens (PSAs) ≤ 15 ng/mL, and a Gleason score of 3 + 4 or 4 + 3 underwent focal ablation of the index lesion. The primary endpoints included negative in-field biopsy and adverse event incidence, type, and severity through 12 months. At the time of analysis, the trial had completed accrual with preliminary follow-up available. Demographics, disease characteristics, procedural details, PSA responses, and adverse events (AEs) are presented. The median (IQR) age at screening was 67.0 (61.0-72.0) years and Gleason distribution 3 + 4 (80.2%) and 4 + 3 (19.8%). At 6 months, all patients with available data (n = 74) experienced a median (IQR) percent reduction in PSA of 67.6% (52.3-82.2%). Only ten subjects (8.3%) experienced a Grade 3 adverse event; five were procedure-related. No Grade ≥ 4 AEs were reported. This study supports prior findings that IRE prostate ablation with the NanoKnife System can be performed safely. Final results are required to fully assess oncological, functional, and safety outcomes.

Influence of diabetes on microbiome in prostate tissues of patients with prostate cancer.

Although microbiota in prostatic tissues of patients with prostate cancer have been studied, results of different studies have been inconsistent. Different ethnicity of study subjects, different study designs, and potential contaminations during sample collection and experiments might have influenced microbiome results of prostatic tissues. In this study, we analyzed microbiota and their potential functions in benign and malignant tissues of prostate cancer considering possible contaminants and host variables. A total of 118 tissue samples (59 benign tissues and 59 malignant tissues) obtained by robot-assisted laparoscopic radical prostatectomy were analyzed and 64 negative controls (from sampling to sequencing processes) were included to reduce potential contaminants. Alteration of the microbiome in prostate tissues was detected only in patients with diabetes. Furthermore, the influence of diabetes on microbiome was significant in malignant tissues. The microbiome in malignant tissues of patients with diabetes was influenced by pathologic stages. The relative abundance of Cutibacterium was reduced in the high pathologic group compared to that in the intermediate group. This reduction was related to microbial pathways increased in the high pathologic group. Results of this study indicate that diabetes can influence the progression of prostate cancer with microbiome alteration in prostate tissues. Although further studies are necessary to confirm findings of this study, this study can help us understand tissue microbiome in prostate cancer and improve clinical therapy strategies.

MP15-04 PRESENCE OF HPV IN PROSTATE TISSUE FROM PATIENTS SUBMITTED TO PROSTATE BIOPSY

You have accessJournal of UrologyCME1 Apr 2023MP15-04 PRESENCE OF HPV IN PROSTATE TISSUE FROM PATIENTS SUBMITTED TO PROSTATE BIOPSY Nalisson Pereira, Emerson Martins, Mateus Quintela, Arthur Cunha, and Jaques Waisberg Nalisson PereiraNalisson Pereira More articles by this author , Emerson MartinsEmerson Martins More articles by this author , Mateus QuintelaMateus Quintela More articles by this author , Arthur CunhaArthur Cunha More articles by this author , and Jaques WaisbergJaques Waisberg More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003235.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer (PCa) is the second most common cancer among men. Environmental and hereditary factors are assumed to play crucial roles in prostate carcinogenesis. In addition, increasing epidemiological evidence, along with molecular research, suggests that viral infection would be a potential cofactor for the development of PCa. Recently, it has been estimated that virus infection represents approximately 10% of the worldwide cancer burden. HPV, one of the most important oncogenic viruses. Based on the genomic sequence of L1, the gene encoding the main capsid protein, more than 200 types of HPV have been identified and characterized, with at least 14 high-risk types which may cause cancer. The aim of this study was to evaluate the presence of HPV in prostate tissue in patients undergoing transrectal ultrasound-guided prostate biopsy and its possible relationship with prostate cancer. METHODS: 157 prostate tissue samples were obtained from patients undergoing screening for PCa by transrectal ultrasound guided biopsy, collected at IOM (Instituto de Oncologia e Mastologia de Macapá, Amapá, Brazil) from December 2018 to January 2021. One fragment was placed in a microcentrifuge tube with 1mL of RNAlater. After collection, the vials were stored at -20C until being processed. Total DNA extraction was performed in the Microbiology and Immunology Laboratory of the Federal University of Amapá (UNIFAP). The Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR) method was used for HPV detection. The analysis to investigate the relationship between the presence of HPV and cancer was the extension of Fisher's exact test and the alpha significance level equal to 5% was applied. RESULTS: 157 patients, 95 (60.5%) with PCa, 55 (35.0%) without cancer, and 7 (4.5%) as inconclusive (ASAP). The presence of HPV was 7/95 =(7.4%) in patients with cancer, and 2/55 =(3.6%) in those without evidence of cancer or inconclusive diagnosis ASAP. The inferential results revealed that the presence of HPV was not related to the diagnosis of cancer when the ASAP diagnosis was considered in the analysis (p=0.663) and, also when the ASAP diagnosis was not included (p=0.487). CONCLUSIONS: There was no L1 gene expression and significant levels of HPV L1 in prostate tissue. These findings suggest no oncogenic activity of HPV in PCa. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e192 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nalisson Pereira More articles by this author Emerson Martins More articles by this author Mateus Quintela More articles by this author Arthur Cunha More articles by this author Jaques Waisberg More articles by this author Expand All Advertisement PDF downloadLoading ...

Presence of HPV in prostate tissue from patients submitted to prostate biopsy

Prostate cancer (PCa) is the second most frequent cancer among men in the Western population. Infections, such as the one caused by the human papillomavirus (HPV), have been shown to promote inflammation that can lead to the appearance of neoplasms. This study aimed to verify the presence of HPV in neoplastic and non-neoplastic prostate tissue in patients undergoing prostate biopsy and its possible relationship with PCa. Prostate tissue fragments were collected by prostate biopsy and subjected to polymerase chain reaction with primers for the HPV L1 gene to identify the presence of the virus. Among 162 patients, 10 (6.2%) had HPV and in 152 (93.8%) HPV was not identified in prostate biopsies. HPV was detected in 7/95 (7.4%) of patients with PCa, in 2/55 (3.6%) of patients without PCa, and in no patient with an inconclusive diagnosis of PCa. There was no significant difference (p = 0.487) of HPV presence in the tissue of patients with PCa. There were no significant levels of HPV L1 protein in prostate tissue. The findings suggest the absence of HPV oncogenic activity in the prostate tissue of patients with PCa.

Detection of H. pylori in tissues with benign prostatic hyperplasia isolates from hospitalized patient in Qom, Iran

BackgroundHelicobacter pylori is an important cause of human infections. There is accumulating evidence relating to H. pylori infection to urological diseases. The aim of this study was to investigate the presence of H. pylori infection in prostate tissues of patients with benign prostatic hyperplasia (BPH). Material and methodsIn this descriptive cross-sectional study the number of 160 patients with benign prostatic hyperplasia, referred to Beheshti and Kamkar Hospital between October 2015 and March 2016 were selected using the connivance sampling method. Open surgery with TURP method (transurethral resection of the prostate) was performed on them and their prostate sample was delivered to lab for testing. DNA extraction of all collected tissues was carried out using PCR. Data were analyzed using descriptive and central statistics with spss 23 software. ResultsThe mean age of patients was 67.4 ± 6.28 (range 50–85) years. After DNA extraction of 160 prostate tissue samples, H. pylori was detected only in three specimens (1.83%). ConclusionAccording to the result of the study, H.pylori infection cannot be reported as an effective cause of BPH.

Benign Prostatik Patolojilerde Regülatuvar T Hücrelerinin (Treg) Değerlendirilmesi: Pilot Çalışma

Objective: We aimed to evaluate the number and function of regulatory T (Treg) cells in peripheral blood and prostate tissues of patients with histopathologically diagnosed benign prostate hyperplasia (BPH) and asymptomatic chronic prostatitis.
 Material and Methods: Blood and histopathological data of 19 patients (BPH=10, ACP=9) that underwent transurethral prostate resection were evaluated. Treg cell count in peripheral blood and prostatic tissue with flowcytometry, Forkhead box P3 (FOXP3) expression in prostatic tissue by reverse transcription polymerase chain reaction (PCR), and IL-17 measurement in blood samples with ELISA were performed. 
 Results: Flowcytometric analyses showed that mean CD4+T cell count and mean FOXP3 levels in both peripheral blood (CD4+T, p= 0.752; FOXP3, p= 1.000) and prostate tissue (CD4+T, p= 0.458; FOXP3, p= 0.590) were higher in the BPH group compared to the chronic prostatitis group. However this difference was not statistically significant. Similarly, the mean blood IL-17 levels were also higher in BPH groups, but the difference was not statistically significant (p= 0.870). The PCR analyses showed that mean FOXP3 gene expression in the tissue was higher in the chronic prostate group, but again there was no statistically significant difference between the groups (p= 0.116).
 Conclusion: Since no statistically significant difference was found between BPH and chronic prostatitis in terms of Treg cell number and function in peripheral blood and prostatic tissue, our study supports the thesis that both these pathologies could be autoimmune inflammatory diseases.

Transcript Levels of Aldo-Keto Reductase Family 1 Subfamily C (AKR1C) Are Increased in Prostate Tissue of Patients with Type 2 Diabetes.

Aldo-keto reductase family 1 (AKR1) enzymes play a crucial role in diabetic complications. Since type 2 diabetes (T2D) is associated with cancer progression, we investigated the impact of diabetes on AKR1 gene expression in the context of prostate cancer (PCa) development. In this study, we analyzed benign (BEN) prostate and PCa tissue of patients with and without T2D. Furthermore, to replicate hyperglycemia in vitro, we treated the prostate adenocarcinoma cell line PC3 with increasing glucose concentrations. Gene expression was quantified using real-time qPCR. In the prostate tissue of patients with T2D, AKR1C1 and AKR1C2 transcripts were higher compared to samples of patients without diabetes. In PC3 cells, high glucose treatment induced the gene expression levels of AKR1C1, C2, and C3. Furthermore, both in human tissue and in PC3 cells, the transcript levels of AKR1C1, C2, and C3 showed positive associations with oncogenes, which are involved in proliferation processes and HIF1α and NFκB pathways. These results indicate that in the prostate glands of patients with T2D, hyperglycemia could play a pivotal role by inducing the expression of AKR1C1, C2, and C3. The higher transcript level of AKR1C was furthermore associated with upregulated HIF1α and NFκB pathways, which are major drivers of PCa carcinogenesis.

Systemic effects of the hormonal treatment of male hypogonadism with preliminary indications for the management of COVID-19 patients.

Male hypogonadism, defined as an inadequate production of testosterone (T), is associated with a greater morbidity and mortality. Epidemiological studies identified T deficiency as a risk factor for cardiovascular disease. Also, low serum T levels impact on glucose homeostasis through a worse glucose uptake, utilization, and disposal, and the general negative impact on metabolism. The aim of this review is to provide a comprehensive and updated overview of the effects of T replacement therapy on metabolic and cardiovascular systems and prostate tissue in patients with hypogonadism, including molecular mechanisms through which T exerts its actions. Furthermore, recent findings on novel coronavirus disease (COVID-19) epidemiology have shown a greater mortality in male compared with female patients and a role of T in promoting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection of the host cells has been demonstrated. Hence, the secondary aim of this review is to provide preliminary indications on the management in patients with COVID-19.

Ablation of Prostate Tissue in Patients With Intermediate Risk Localized Prostate Cancer

Ablation of Prostate Tissue in Patients With Intermediate Risk Localized Prostate Cancer

Increased infiltration of CCR4-positive regulatory T cells in prostate cancer tissue is associated with a poor prognosis.

Regulatory T cells (Tregs) play important roles in the suppression of immune responses, including antitumor immune responses. C-C chemokine receptor 4 (CCR4) is highly expressed on effector Tregs, and anti-CCR4 antibody is attracting attention as a novel immunotherapeutic agent for solid tumors. This study aimed to evaluate the expression of CCR4-positive Tregs (CCR4+Tregs) in prostate cancer and estimate the clinical potential of CCR4-targeting therapy for prostate cancer. A total of 15 radical prostatectomy (RP) specimens and 60 biopsy specimens from individuals diagnosed with prostate cancer were analyzed to evaluate the infiltration of CCR4+Tregs in prostate cancer. The relationships between the number of CCR4+Tregs and clinical parameters were investigated in RP and biopsy specimens. Moreover, the total number of Tregs, CCR4+Tregs, and T cells and the ratio of CCR4+Tregs to Tregs and T cells in biopsy specimens were compared between patients with poor prognosis who progressed to castration-resistant prostate cancer (CRPC) within 12 months (n = 13) and those with good prognosis who were stable with hormone-sensitive prostate cancer over 12 months (n = 47). Furthermore, biopsy specimens were divided into two groups: low and high CCR4+Treg expression groups and the prognosis was compared between them. There was a higher expression of CCR4+Tregs in RP specimens with a higher (≥8) Gleason score than in those with a lower (<8) Gleason score (P = .041). In biopsy specimens, 65.9% Tregs were positive for CCR4. The number of CCR4+Tregs positively correlated with clinical stage (P < .001) and Gleason score (P = .006). The total number of Tregs and CCR4+Tregs significantly increased in the poor prognosis group compared with that in the good prognosis group (P = .024 and .01, respectively). Furthermore, patients with lower CCR4+Treg expression levels showed a significantly longer time to progression to CRPC (not reached vs27.3 months; P < .001) and median survival time (not reached vs69.0 months; P = .014) than those with higher expression levels. CCR4+Tregs are highly infiltrated in the prostate tissue of patients with poor prognosis with potential to progress to CRPC. Furthermore, the degree of infiltration of CCR4+Tregs is related to the prognosis of prostate cancer.

Magnetic resonance imaging-guided transurethral ultrasound ablation of prostate tissue in patients with localized prostate cancer: single-center evaluation of 6-month treatment safety and functional outcomes of intensified treatment parameters.

To evaluate the effect of intensified treatment parameters on safety, functional outcomes, and PSA after MR-Guided Transurethral Ultrasound Ablation (TULSA) of prostatic tissue. Baseline and 6-month follow-up data were collected for a single-center cohort of the multicenter Phase I (n = 14/30 at 3 sites) and Pivotal (n = 15/115 at 13 sites) trials of TULSA in men with localized prostate cancer. The Pivotal study used intensified treatment parameters (increased temperature and spatial extent of ablation coverage). The reporting site recruited the most patients to both trials, minimizing the influence of physician experience on this comparison of adverse events, urinary symptoms, continence, and erectile function between subgroups of both studies. For Phase I and TACT patients, median age was 71.0 and 67.0years, prostate volume 41.0 and 44.5ml, and PSA 6.7 and 6.7ng/ml, respectively. All 14 Phase I patients had low-risk prostate cancer, whereas 7 of 15 TACT patients had intermediate-risk disease. Baseline IIEF, IPSS, quality of life, and pad use were similar between groups. Pad use at 1month and quality of life at 3months favored Phase I patients. At 6months, there were no significant differences in functional outcomes or adverse events. TULSA demonstrated acceptable clinical safety in Phase I trial. Intensified treatment parameters in the TACT Pivotal trial increased ablation coverage from 90 to 98% of the prostate without affecting 6-month adverse events or functional outcomes. Long-term follow-up and 12-month biopsies are needed to evaluate oncological safety.

Морфологические доказательства ишемической природы фиброза предстательной железы при классическом синдроме хронической тазовой боли/хроническом простатите IIIБ

To examine the structure of the prostate tissue in patients with III B chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS). The study analyzed transrectal fine-needle biopsy specimens of 10 patients with the verified diagnosis of chronic pelvic pain syndrome/category III B chronic prostatitis (CPPS/IIIB CP) according to the National Institutes of Health classification. Tissues were examined using light and electron microscopy, and immunohistochemical study of the expression of CD31, CD34, NSE and S-100 markers. All biopsy specimens of all patients showed fibroplastic changes of the prostate tissue most markedly pronounced in the stroma and muscle fibers in the form of total fibrosis, myofibril atrophy, and extracellular lipofuscin deposition. The examination revealed a significant reduction in the density of microcirculatory bed vessels and arteriolar luminal stenosis, a reduction in the number of nerve fibers, and compression of their fibrous tissue. No inflammatory changes were found in the prostate. In patients with CPPS/IIIB CP, the changes in the prostate at the microscopic and ultrastructural levels are characteristic of severe chronic tissue hypoxia, which leads to the development of fibrosis resulting in stenosis of microcirculatory bed vessels and degenerative changes in nerve fibers and cells. No signs of an inflammatory reaction in the examined tissue were established. Changes in the prostate tissue in CPPS/IIIB CP suggest the presence of chronic pelvic ischemia and exclude its association with inflammation as the main pathological process.

Oxytocin: its role in benign prostatic hyperplasia via the ERK pathway.

The aim of the present study was to evaluate oxytocin and benign prostatic hyperplasia (BPH), and study the cell signalling mechanism. Investigation was performed in patients about the correlation between oxytocin level and BPH. Mice were injected with oxytocin or oxytocin antagonist for 2weeks and the prostate morphology was studied after their sacrifice. Furthermore, invitro experiments were performed to evaluate the oxytocin effect through the MEK/ERK/RSK pathway. Oxytocin was significantly elevated in the serum and prostate tissue of patients with BPH, and a positive correlation with prostate volume indicated. In the animal experiments, prostate enlargement was observed in the oxytocin-treated group, whereas oxytocin antagonist reduced prostate hyperplasia. The invitro study confirmed this result and also revealed activation of the MEK/ERK/RSK pathway. Oxytocin is highly expressed in the serum and prostate tissue of patients with BPH. In addition, oxytocin aggravates BPH and the oxytocin-induced proliferative effect on prostatic cells is mediated through the MEK/ERK/RSK pathway, at least partly. Thus, the hypothalamic regulation may be involved in development of BPH, which may open a new door to more medications for BPH in the future.

Clinical Significance of the Apparent Diffusion Coefficient Ratio in Prostate Cancer Treatment with Intensity-modulated Radiotherapy.

We aimed to investigate the correlation between biochemical recurrence (BCR) and the pretreatment apparent diffusion coefficient (ADC) ratio of tumor to normal prostate tissue in patients with prostate cancer who underwent intensity-modulated radiotherapy (IMRT). Retrospective analyses were performed for 101 patients diagnosed with localized prostate cancer who underwent IMRT at a dose of 70-78 Gy to the prostate gland and medial part of the seminal vesicles. Before treatment, all patients underwent magnetic resonance imaging including diffusion-weighted imaging of the prostate. BCR was defined as a rising prostate-specific antigen level (the Phoenix criterion). The median follow-up for all patients was 29 months, and BCR occurred in 10 patients (9.9%). ADC ratios and Gleason scores were significant independent prognostic factors of BCR by multivariate analysis. The pretreatment ADC ratio was an independent prognostic factor for BCR in patients with prostate cancer who underwent IMRT.

Magnetic Resonance Imaging–Guided Transurethral Ultrasound Ablation of Prostate Tissue in Patients with Localized Prostate Cancer: A Prospective Phase 1 Clinical Trial

BackgroundMagnetic resonance imaging–guided transurethral ultrasound ablation (MRI-TULSA) is a novel minimally invasive technology for ablating prostate tissue, potentially offering good disease control of localized cancer and low morbidity. ObjectiveTo determine the clinical safety and feasibility of MRI-TULSA for whole-gland prostate ablation in a primary treatment setting of localized prostate cancer (PCa). Design, setting, and participantsA single-arm prospective phase 1 study was performed at three tertiary referral centers in Canada, Germany, and the United States. Thirty patients (median age: 69 yr; interquartile range [IQR]: 67–71 yr) with biopsy-proven low-risk (80%) and intermediate-risk (20%) PCa were treated and followed for 12 mo. InterventionMRI-TULSA treatment was delivered with the therapeutic intent of conservative whole-gland ablation including 3-mm safety margins and 10% residual viable prostate expected around the capsule. Outcome measurements and statistical analysisPrimary end points were safety (adverse events) and feasibility (technical accuracy and precision of conformal thermal ablation). Exploratory outcomes included quality of life, prostate-specific antigen (PSA), and biopsy at 12 mo. Results and limitationsMedian treatment time was 36min (IQR: 26–44) and prostate volume was 44ml (IQR: 38–48). Spatial control of thermal ablation was ±1.3mm on MRI thermometry. Common Terminology Criteria for Adverse Events included hematuria (43% grade [G] 1; 6.7% G2), urinary tract infections (33% G2), acute urinary retention (10% G1; 17% G2), and epididymitis (3.3% G3). There were no rectal injuries. Median pretreatment International Prostate Symptom Score 8 (IQR: 5–13) returned to 6 (IQR: 4–10) at 3 mo (mean change: −2; 95% confidence interval [CI], −4 to 1). Median pretreatment International Index of Erectile Function 13 (IQR: 6–28) recovered to 13 (IQR: 5–25) at 12 mo (mean change: −1; 95% CI, −5 to 3). Median PSA decreased 87% at 1 mo and was stable at 0.8 ng/ml (IQR: 0.6–1.1) to 12 mo. Positive biopsies showed 61% reduction in total cancer length, clinically significant disease in 9 of 29 patients (31%; 95% CI, 15–51), and any disease in 16 of 29 patients (55%; 95% CI, 36–74). ConclusionsMRI-TULSA was feasible, safe, and technically precise for whole-gland prostate ablation in patients with localized PCa. Phase 1 data are sufficiently compelling to study MRI-TULSA further in a larger prospective trial with reduced safety margins. Patient summaryWe used magnetic resonance imaging–guided transurethral ultrasound to heat and ablate the prostate in men with prostate cancer. We showed that the treatment can be targeted within a narrow range (1mm) and has a well-tolerated side effect profile. A larger study is under way. Trial registrationNCT01686958, DRKS00005311.

MP3-03 IMAGE GUIDED ROBOTIC WATERJET ABLATION (AQUABLATION) OF THE PROSTATE: CLINICAL EXPERIENCE OF A NOVEL TECHNOLOGY FOR BPH

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2015MP3-03 IMAGE GUIDED ROBOTIC WATERJET ABLATION (AQUABLATION) OF THE PROSTATE: CLINICAL EXPERIENCE OF A NOVEL TECHNOLOGY FOR BPH Mihir Desai, Abhishek Laddha, Raed A. Azhar, Shashikant Mishra, Mahesh Desai, and Ravindra Ravindra Sabnis Mihir DesaiMihir Desai More articles by this author , Abhishek LaddhaAbhishek Laddha More articles by this author , Raed A. AzharRaed A. Azhar More articles by this author , Shashikant MishraShashikant Mishra More articles by this author , Mahesh DesaiMahesh Desai More articles by this author , and Ravindra Ravindra SabnisRavindra Ravindra Sabnis More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.106AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report the clinical experience in patients with symptomatic BPH undergoing image-guided waterjet ablation of the prostatic adenoma using a novel technology called Aquablation (PROCEPT BioRobotics, Redwood Shores, CA METHODS The Aquablation System delivers a high-velocity saline stream (the AquaBeam®) under precise electromechanical control and live ultrasound guidance to ablate prostatic glandular tissue without the production of heat. Using the real-time transrectal ultrasound image and an integrated planning station, the target region for excision is registered within the prostate and the target tissue contour and depth are programmed by the surgeon. The surgeon guided AquaBeam ablates the prostatic tissue accurately following a preprogrammed routine, and the ablated prostatic tissue is simultaneously collected for post-procedure analysis. To obtain hemostasis if necessary, a low-power blue laser beam is captured in a low-pressure water column to perform surface coagulation of the fossa. In the present study Aquablation was performed in 9 patients with symptomatic BPH (Mean age 68 years, prostate volume 37 cc and median lobe present in 56%). All patients had urodynamic confirmation of bladder outlet obstruction. RESULTS All procedures were technically successful with a mean operative time of 49 minutes and Aquablation time of 12.2 minutes. Waterjet-guided laser fulguration was required in 3 cases. There were no peri-operative complications and no patients had dysuria after catheter removal after 24 hours. Functional outcomes are summarized in the Table. CONCLUSIONS We report a novel robotic image guided technology that provides rapid ablation of prostate tissue in patients with symptomatic BPH. Use of waterjet-guided blue laser technology was determined to be of limited value as this initial clinical experience suggests that Aquablation alone requires minimum hemostasis resulting in no postoperative dysuria. 1, 3, 6 and 12 month follow-up confirm significant improvement in IPSS, QoL and peak flow rates. Clinical trials with larger number of patients are currently ongoing. Table 1. Baseline 1-month 3-months 6-months 1-year % improvement IPSS 22.1 5.9 2.5 4.0 2.3 90% QOL 5.7 1.3 0.6 1.1 0.7 88% Qmax 7.0 15.1 15.1 16.7 14.1 101% © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e20 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mihir Desai More articles by this author Abhishek Laddha More articles by this author Raed A. Azhar More articles by this author Shashikant Mishra More articles by this author Mahesh Desai More articles by this author Ravindra Ravindra Sabnis More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Different Perforin Expression in Peripheral Blood and Prostate Tissue in Patients with Benign Prostatic Hyperplasia and Prostate Cancer

Perforin (P) is a prototypical cytotoxic molecule involved in cell-mediated immunity against various pathogens, alloantigens and particularly different tumours. The purpose of this study was to determine P expression in different lymphocyte subpopulations isolated from peripheral blood and prostate tissue of patients with benign prostatic hyperplasia (BPH) and prostate cancer (PCa) and compare it with the P expression found in the control group. Twenty subjects were recruited in each of the groups. Prostate mononuclear cells of the BPH and PCa tissues were isolated by enzymatic digestion and gradient density centrifugation, whereas peripheral blood mononuclear cells were isolated by gradient density centrifugation alone. Cells and tissue samples were labelled using monoclonal antibodies against P and different surface antigens (CD3, CD4, CD8 and CD56) and analysed by immunofluorescence and flow cytometry. Total P expression in peripheral blood lymphocytes did not differ significantly between BPH/PCa patients and control group, although the BPH and PCa tissue showed lower P expression level. A negative correlation between prostate-specific antigen levels and the overall percentage of P(+), CD3(+) CD56(-) P(+) , and CD3(-) CD56(+) P(+) cells in the prostate tissue was observed only in patients with PCa. Our findings indicate that the low frequency of P(+) lymphocytes, including T, NKT and NK cells, in the prostate tissue of patients with BPH and, particularly, PCa could be the consequence of local tissue microenvironment and one of the mechanisms involved in the pathogenesis of prostate hyperplasia following malignant alteration.

Biomarkers for the diagnosis of prostatic inflammation in benign prostatic hyperplasia

Chronic prostatic inflammation could be a central mechanism in benign prostatic hyperplasia (BPH) progression. Currently, the histological examination of prostate biopsies remains the only way to diagnose prostatic inflammation. Our objective was to find new noninvasive biomarkers for the diagnosis of prostatic inflammation. Ninety BPH samples were investigated in two steps. First, a hypothesis was generated using a profiling procedure with a panel of 96 genes on an initial set of 30 samples. Then, the candidate biomarkers were validated on a large number of samples (n = 90). Gene expression was compared with the histological prostatic inflammation score based on the density and the confluence of lymphoid nodules. Finally, protein transcripts of the candidate biomarkers were investigated in urine samples and compared with clinical data. Of the 96 genes, nine were significantly correlated with the inflammation score on the initial set of patients. Four of them were validated on the complete set of patients: CCR7, CD40LG, CTLA4, and ICOS. ICOS and CTLA4 protein levels were readily measured in urine samples using a conventional ELISA procedure. High-ICOS expression in urine was associated with a higher post-void residual and a lower maximum urinary flow rate. Four genes were significantly upregulated at the mRNA level in the prostate tissue of patients with severe inflammation score. Two proteins were measured in urine samples, and were associated with maximum uroflowmetry and post-void residual. A prospective clinical study is needed to confirm their clinical relevance.

Prevalence of human xenotropic murine leukemia virus‐related gammaretrovirus (XMRV) in dutch prostate cancer patients

The occurrence of the retrovirus xenotropic murine leukemia virus (MLV)-related virus (XMRV) has been reported in prostate tissue of patients with prostate cancer (PrCa). Considering the potential great medical and social relevance of this discovery, we investigated whether this finding could be confirmed in an independent group of Dutch sporadic PrCa cases. We investigated the occurrence of XMRV in fresh-frozen PrCa specimens of 74 PrCa patients from The Netherlands. Total RNA and DNA were isolated, subjected to cDNA synthesis, and analyzed by real-time PCR targeting conserved XMRV sequences. Spiking experiments showed that we were able to detect at least 10 copies of XMRV sequences in 100,000 cells by real-time PCR, demonstrating high sensitivity of the assay. XMRV sequences were detected in 3 out of 74 (i.e., 4%) PrCa specimens. The number of XMRV containing cells was extremely low (1 in 600-7,000 cells). This was corroborated by the fact that XMRV could not be detected in consecutive tissue sections of the initial XMRV-positive cases. XMRV was rarely detected, and at extremely low levels, in sporadic PrCa samples from Dutch patients. When XMRV would play a causal role in prostate carcinogenesis, integration of the provirus could be expected to be present in, at least, a proportion of tumor cells. Therefore, our data do not support the claim that there is an association between XMRV infection and PrCa in Dutch PrCa patients.

Large scale multi-centre randomized placebo controlled clinical study proves the efficacy of pumpkin seed in symptomatic benign prostatic hyperplasia (BPH) – G.R.A.N.U. study

Of all known herbal drugs in the therapy of BPH, pumpkin seed has the longest tradition. The high level of unique delta-7 sterols is discussed as the active principle. This is supported by a former study where prostate tissue of patients taking pumpkin sterols contained much less dihydrotestosterone, compared to the control group [1]. The aim in the treatment of symptomatic BPH is to improve lower urinary tract symptoms (LUTS) and patient's quality of life (QoL) [2]. This study was carried out to confirm the efficacy of pumpkin seed in a design referring to the recommendations of the International Consultation on BPH and WHO criteria. Method: three treatment groups. 1. pumpkin seed extract (2×500mg capsule per day, PROSTA FINK® FORTE), 2. placebo capsule. 3. pumpkin seed (2×5g per day), The pumpkin is a special variety: GRANU FINK® medicinal pumpkin. Treatment period: 12 months. 1431 patients were randomised. A noticeable decrease in the international prostate symptom score (IPSS) by 3 to 4 points was observed after 3 months followed by gradually continuous decrease until month 12. The QoL improved continuously over time with the remarkable improvement by 36% in the pumpkin seed group. Treatment with pumpkin seed results a strong improvement of micturition complaints. Level of IPSS improvement (%) over 12 months is comparable to most prescription medicines in this indication [3]. The symptom relief is accompanied by a clinically significant improvement of Quality-of-Life by 36%. Pumpkin seed is an effective and safe option for the long-term therapy in men with LUTS due to BPH.