Combinations of natural products have a number of benefits. We investigated the inhibitory effect of a combination of 50% ethanol extracts of Cervus elaphus antler (CEE), Glycyrrhiza uralensis (GUE), and Angelica gigas (AGE) on benign prostatic hyperplasia (BPH) using BPH-1 cells and testosterone propionate (TP)-induced BPH rats. The combination, called CGA113, inhibited cell proliferation by decreasing the cell viability of BPH-1 cells up to 72.03% more than the individual extracts. In addition, CGA113 significantly reduced the mRNA expressions of AR and SRD5A2 in BPH-1 cells. Sprague-Dawley rats were subjected to castration surgery to remove endogenous testosterone, and 3 mg/kg testosterone propionate was subcutaneously injected to induce BPH. Subsequently, CGA113 (50 and 200 mg/kg BW/day) was orally administered to the TP-induced BPH rats for 8 weeks. In the CGA113-H group (200 mg/kg of CGA113), the prostate ratio, serum DHT, prostate DHT, and prostate 5α-reductase2 were significantly decreased compared to the BPH group. Histology with H&E staining of the prostate tissue, revealed a reduction in the thickening of the prostate epithelial cells and enlargement of the lumen compared to the BPH group. The mRNA levels of the Bax/Bcl2 ratio in prostate tissue of the CGA113-H group were significantly increased. Overall, the combined extract of CEE, GUE, and AGE, was determined to exert synergistic effects, indicating the potential of the three natural materials as therapeutic agents for alleviation of BPH symptoms.

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This study assessed the effects of mistletoe extract (VA30E) on benign prostatic hyperplasia (BPH) using in vitro and in vivo models. The in vitro study was performed in BPH-1 cells, wherein VA30E treatment at concentrations of 200 μg/mL decreased cell proliferation by 98.97%. VA30E dose-dependently reduced mRNA expression of the androgen receptors. The in vivo study was undertaken with seven-week-old male Sprague-Dawley rats. Surgical castration was conducted to exclude endogenous testosterone (T) and the rats were divided into five groups; control, BPH, VA30E-50 [50 mg/kg of body weight (BW)/d], VA30E-150 (150 mg/kg of BW/d) and saw palmetto (positive control, 100 mg/kg of BW/d). The prostate size of the rats showed a decrease with the administration of VA30E compared to the BPH group. The prostate weight ratio (BW to prostate weight) also decreased in a dose-dependent manner by up to 13.04% in the VA30E-150 group (P<0.05). In addition, T and dihydrotestosterone levels were significantly reduced by 46.01% and 22.26%, respectively, in the VA30E-150 group compared to the BPH group. The 5-alpha reductase 2 levels were also significantly decreased in a dose-dependent manner by the administration of VA30E. Taken together, these results suggest that VA30E could be used as a functional ingredient in the treatment of BPH symptoms.