Serenoa Repens, Lycopene and Selenium: A Triple Therapeutic Approach to Manage Benign Prostatic Hyperplasia

Abstract

Benign prostatic hyperplasia (BPH) is a major health concern that is likely to have an increasing impact in line with the gradual aging of the population. BPH is characterized by smooth muscle and epithelial proliferation primarily within the prostatic transition zone that can cause a variety of problems for patients, the most frequent are the lower urinary tract symptoms. BPH is thought to involve in disruption of dihydrotestosterone (DHT)-supported homeostasis between cell proliferation and cell death, and, as a result, proliferative processes predominate and apoptotic processes are inhibited. Phytotherapeutic supplements, mainly based on Saw Palmetto-derived Serenoa Repens (SeR), are numerous and used frequently. Serenoa Repens reduces inflammation and decreases in vivo the androgenic support to prostatic cell growth. Furthermore, SeR stimulates the apoptotic machinery; however, data supporting efficacy is limited, making treatment recommendations difficult. Besides SeR, selenium (Se), an essential trace element mainly functioning through selenoproteins and able to promote an optimal antioxidant/oxidant balance, and lycopene (Ly), a dietary carotenoid synthesized by plants, fruits, and microorganisms with a strong antioxidant activity, has been shown to exert beneficial effects in prostate disease. SeR is frequently associated with Ly and Se, in order to increase its therapeutic activity in benign prostatic hyperplasia (BPH). It has been shown that the Ly-Se-SeR association has a greater and enhanced antiinflammatory activity that might be of particular interest in the treatment of BPH. The Ly-Se-SeR association is also more effective than SeR alone in reducing prostate weight and hyperplasia, in augmenting the pro-apoptotic Bax and caspase-9 and blunting the anti-apoptotic Bcl-2 mRNA. In addition, Ly-Se-SeR more efficiently suppresses the EGF and Vascular Endothelial Growth Factor (VEGF) expressions in hyperplastic prostates. Therefore, SeR particularly when combined with Se and Ly may have a greater potential for the management of benign prostate hyperplasia.

Kinetin inhibits apoptosis of aging spleen cells induced by D-galactose in rats

“…In aging cells, the expression of Bcl-2 is decreased and the expression of Bax is elevated [13,17]. Our study showed that D-gal significantly decreased Bcl-2 expression in the aging group while Kn administration restored Bcl-2 expression.…”

Phytotherapy of Benign Prostatic Hyperplasia. A Minireview

“…see Minutoli et al, 2013). All these results suggest that selenium and lycopene increase saw palmetto efficacy in BPH.…”

“…This association is also more effective than saw palmetto in reducing prostate hyperplasia, in enhancing the pro‐apoptotic B ascx and caspase‐9 and suppressing the epidermal growth factor and vascular endothelial growth factor expressions in BPH (for ref. see Minutoli et al ., ). All these results suggest that selenium and lycopene increase saw palmetto efficacy in BPH.…”

Apoptotic Pathways Linked to Endocrine System as Potential Therapeutic Targets for Benign Prostatic Hyperplasia

“…SeR, an extract from the berry of the American saw palmetto or dwarf palm plant [118,119,120,121], induces evident LUTS relief. Its proposed mechanisms of action are the following: (i) antiestrogenic and antiandrogenic effects [122] by weakly inhibiting the conversion of T to DHT [123]; (ii) modulation of apoptosis [78,124]; (iii) inhibition of 5-ARIs in the stroma and epithelium of the prostate [125]; and (iv) relaxation of smooth muscle cells of the detrusor through interaction with α1-adrenergic receptors [126].…”

“…Also growth factors, such as vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), were inhibited by treatment with Se-Ly-SeR combination [113,120] (Figure 1). …”