The development of human benign or malignant prostatic diseases is closely associated with androgens, primarily testosterone （T） and dihydrotestosterone （DHT）. T is converted to DHT by 5-alpha reductase （5-AR） i...The development of human benign or malignant prostatic diseases is closely associated with androgens, primarily testosterone （T） and dihydrotestosterone （DHT）. T is converted to DHT by 5-alpha reductase （5-AR） isozymes. Differential expression of 5-AR isozymes is observed in both human benign and malignant prostatic tissues. 5-AR inhibitors （5-ARI） are commonly used for the treatment of benign prostatic hyperplasia （BPH） and were once promoted as chemopreventive agents for prostate cancer （PCa）. This review discusses the role of the differential expression of 5-AR in the normal development of the human prostate and in the pathogenesis and progression of BPH and PCa.展开更多
Benign prostatic hyperplasia(BPH)is characterized by an enlarged prostate,lower urinary tract symptoms(LUTS),and a decreased urinary flow rate.Common in older men,BPH is a progressive disease that can eventually lead ...Benign prostatic hyperplasia(BPH)is characterized by an enlarged prostate,lower urinary tract symptoms(LUTS),and a decreased urinary flow rate.Common in older men,BPH is a progressive disease that can eventually lead to complications including acute urinary retention(AUR)and the need for BPH-related surgery.Both normal and abnormal prostate growth is driven by the androgen dihydrotestosterone(DHT),which is formed from testosterone under the influence of 5-alpha reductase.Thus,5-alpha reductase inhibitors(5-ARIs)effectively reduce the serum and intraprostatic concentration of DHT,causing an involution of prostate tissue.Two 5-ARIs are currently available for the treatment of BPHdfinasteride and dutasteride.Both have been demonstrated to decrease prostate volume,improve LUTS and urinary flow rates,which ultimately reduces the risk of AUR and BPH-related surgery.Therefore,either alone or in combination with other BPH medications,5-ARIs are a mainstay of BPH management.展开更多
Background: Acne vulgaris is a common skin disease. Its pathogenesis is multifactorial, and therapy can now be directed at many of these factors. Among these factors are androgen hormones which play an important role ...Background: Acne vulgaris is a common skin disease. Its pathogenesis is multifactorial, and therapy can now be directed at many of these factors. Among these factors are androgen hormones which play an important role in the pathogenesis of acne. Accordingly,many antiandrogens have been developed to treat acne by systemic and topical ways. Five-Alpha Avocuta 2% cream is a new topical 5-alpha reductase inhibitor extracted from the tropical fruit “avocado”. Objectives: To evaluate the effectiveness and safety of 5-Alpha Avocuta cream and compare it to tretinoin 0.025% cream, in the treatment of acne vulgaris. Patients& Methods: This single blinded comparative study was done in Department of Dermatology– Baghdad Teaching Hospital - from July 2009 through October 2010. All demographic points related to the disease were obtained from each patient to evaluate severity of acne. Sixty-eight patients with acne were divided into two groups and instructed to apply the drugs for three months. Group A uses 5-Alpha avocuta 2% (Teen-derm K) cream and Group B uses tretinoin (Acretin) 0.025% cream. Severe acne was excluded from the study. The clinical improvement was evaluated by counting the number of inflammatory lesions before and after treatment and compare between them by paired t-test. Results: Fifty-eight patients completed the study, their age ranged from 12 - 30 years with a mean of 18.21 ± 4.64 years. In Group A there was a significant reduction of the mean number of papules from 29.7 before treatment to 15.5 after treatment (p < 0.0001), while the mean number of pustules decreased from 4.9 to 0.6 (p = 0.019). In Group B the mean number of papules was reduced from 28.5 to 14.9 (p < 0.0001), while the mean number of pustules dropped from 5.3 before treatment to 0.7 after treatment (p = 0.009). The mean difference of papules after 14 weeks in Group A was 15.55 ± 6.95 while in Group B, the mean difference was 14.86 ± 6.99. This result was statistically not significant (p = 0.708, t-test). The difference in the mean percentage of reduction of inflammatory lesions at week 14 between the two groups was not statistically significant (P-value = 0.999).The side effect was negligible in Group A and not required stopping the drug while in Group B treatment stopped in 2 patients. Conclusions: Five Alpha avocuta was an effective mode of therapy in treatment of acne vulgaris, and it was comparable to tretinoin, with little side effects.展开更多
目的:比较单用α肾上腺受体阻滞剂与α肾上腺受体阻滞剂联合5α-还原酶抑制剂治疗良性前列腺增生(BPH)的疗效。方法:检索中/英文公开发表的随机对照试验(RCT)。计算机检索Pub Med、EMbase、the Cochrane Central Register of Controlled...目的:比较单用α肾上腺受体阻滞剂与α肾上腺受体阻滞剂联合5α-还原酶抑制剂治疗良性前列腺增生(BPH)的疗效。方法:检索中/英文公开发表的随机对照试验(RCT)。计算机检索Pub Med、EMbase、the Cochrane Central Register of Controlled Trials(CENTRAL)、CNKI、CBM、VIP、万方数据库。检索时间为建库至2015年6月30日。同时,手检纳入文献的参考文献。按纳入排除标准进行RCT的筛选、资料提取和质量评价后,采用Rev Man 5.2软件进行Meta分析。结果:共纳入4个研究,403例患者。Meta分析结果显示:有效性方面,两组在降低IPSS评分[SMD=0.89,95%CI(-0.66,2.45)P=0.26]、提高最大尿流率[SMD=-3.67,95%CI(-8.88,1.54)P=0.17]、减少残余尿量[SMD=0.62,95%CI(-0.97,2.22)P=0.17]上无明显统计学差异;与单用药物相比,联合用药在减少前列腺体积上[SMD=6.94,95%CI(2.06,11.81)P=0.005]效果更好,两组在出现不良反应(头晕[SMD=0.57,95%CI(0.16,1.98)P=0.38]、性功能减退[SMD=0.57,95%CI(0.16,1.98)P=0.38])上无明显统计学差异。结论:单用α肾上腺受体阻滞剂与α肾上腺受体阻滞剂联合5α-还原酶抑制剂相比,两者疗效相似,对于前列腺体积不大的患者,单用α肾上腺受体阻滞剂即可达到很好的疗效,避免了不必要的经济负担;对于前列腺体积较大的患者,则推荐联合用药。对于前列腺具体多大的体积才是单用α肾上腺受体阻滞剂与联合5α-还原酶抑制剂治疗的分界阈值,则需要更多高质量、大样本的RCT进一步论证。展开更多
Objectives To study the expression pattern of 5α-reductase type 2 gene in human male reproductive organsMethods The expression level of 5α-reductase type 2 gene inhuman testis, epididymis and vas deferens tissues wa...Objectives To study the expression pattern of 5α-reductase type 2 gene in human male reproductive organsMethods The expression level of 5α-reductase type 2 gene inhuman testis, epididymis and vas deferens tissues was determined by in situ hybridization using Digoxin labeled 5α-reductase type 2 cRNA probe.Results The brown granules of hybridizing signals distributed in the cytoplasm of Sertoli and Leydig cells of the testis, the principle cells of epididymis and the epithelial cells of vas deferens, but there was no positive signal in the nuclei of above-mentioned cells. No positive signal was observed in germ cells, basement of the testis, interstium of epididymis and basement, as well as smooth muscle of vas deferens. Conclusion This study confirmed that the 5α-reductase type 2 gene expressed in Sertoli , Leydig cells of the testis, and the principle cells of epididymis. The expression pattern of the gene in these cells in human was similar to that of rat and monkey. The presence of 5α-reductase type 2 gene in epithelial cells of the vas deferens suggested it might possess an important physiological role in human reproduction.展开更多
基金This work was supported by the National Natural Science Foundation of China （No. 30973015） and the Beijing Natural Science Foundation （No. 7122074） at Beijing Chaoyang Hospital, Capital Medical University to YNN.
文摘The development of human benign or malignant prostatic diseases is closely associated with androgens, primarily testosterone （T） and dihydrotestosterone （DHT）. T is converted to DHT by 5-alpha reductase （5-AR） isozymes. Differential expression of 5-AR isozymes is observed in both human benign and malignant prostatic tissues. 5-AR inhibitors （5-ARI） are commonly used for the treatment of benign prostatic hyperplasia （BPH） and were once promoted as chemopreventive agents for prostate cancer （PCa）. This review discusses the role of the differential expression of 5-AR in the normal development of the human prostate and in the pathogenesis and progression of BPH and PCa.
文摘Benign prostatic hyperplasia(BPH)is characterized by an enlarged prostate,lower urinary tract symptoms(LUTS),and a decreased urinary flow rate.Common in older men,BPH is a progressive disease that can eventually lead to complications including acute urinary retention(AUR)and the need for BPH-related surgery.Both normal and abnormal prostate growth is driven by the androgen dihydrotestosterone(DHT),which is formed from testosterone under the influence of 5-alpha reductase.Thus,5-alpha reductase inhibitors(5-ARIs)effectively reduce the serum and intraprostatic concentration of DHT,causing an involution of prostate tissue.Two 5-ARIs are currently available for the treatment of BPHdfinasteride and dutasteride.Both have been demonstrated to decrease prostate volume,improve LUTS and urinary flow rates,which ultimately reduces the risk of AUR and BPH-related surgery.Therefore,either alone or in combination with other BPH medications,5-ARIs are a mainstay of BPH management.
文摘Background: Acne vulgaris is a common skin disease. Its pathogenesis is multifactorial, and therapy can now be directed at many of these factors. Among these factors are androgen hormones which play an important role in the pathogenesis of acne. Accordingly,many antiandrogens have been developed to treat acne by systemic and topical ways. Five-Alpha Avocuta 2% cream is a new topical 5-alpha reductase inhibitor extracted from the tropical fruit “avocado”. Objectives: To evaluate the effectiveness and safety of 5-Alpha Avocuta cream and compare it to tretinoin 0.025% cream, in the treatment of acne vulgaris. Patients& Methods: This single blinded comparative study was done in Department of Dermatology– Baghdad Teaching Hospital - from July 2009 through October 2010. All demographic points related to the disease were obtained from each patient to evaluate severity of acne. Sixty-eight patients with acne were divided into two groups and instructed to apply the drugs for three months. Group A uses 5-Alpha avocuta 2% (Teen-derm K) cream and Group B uses tretinoin (Acretin) 0.025% cream. Severe acne was excluded from the study. The clinical improvement was evaluated by counting the number of inflammatory lesions before and after treatment and compare between them by paired t-test. Results: Fifty-eight patients completed the study, their age ranged from 12 - 30 years with a mean of 18.21 ± 4.64 years. In Group A there was a significant reduction of the mean number of papules from 29.7 before treatment to 15.5 after treatment (p < 0.0001), while the mean number of pustules decreased from 4.9 to 0.6 (p = 0.019). In Group B the mean number of papules was reduced from 28.5 to 14.9 (p < 0.0001), while the mean number of pustules dropped from 5.3 before treatment to 0.7 after treatment (p = 0.009). The mean difference of papules after 14 weeks in Group A was 15.55 ± 6.95 while in Group B, the mean difference was 14.86 ± 6.99. This result was statistically not significant (p = 0.708, t-test). The difference in the mean percentage of reduction of inflammatory lesions at week 14 between the two groups was not statistically significant (P-value = 0.999).The side effect was negligible in Group A and not required stopping the drug while in Group B treatment stopped in 2 patients. Conclusions: Five Alpha avocuta was an effective mode of therapy in treatment of acne vulgaris, and it was comparable to tretinoin, with little side effects.
文摘目的:比较单用α肾上腺受体阻滞剂与α肾上腺受体阻滞剂联合5α-还原酶抑制剂治疗良性前列腺增生(BPH)的疗效。方法:检索中/英文公开发表的随机对照试验(RCT)。计算机检索Pub Med、EMbase、the Cochrane Central Register of Controlled Trials(CENTRAL)、CNKI、CBM、VIP、万方数据库。检索时间为建库至2015年6月30日。同时,手检纳入文献的参考文献。按纳入排除标准进行RCT的筛选、资料提取和质量评价后,采用Rev Man 5.2软件进行Meta分析。结果:共纳入4个研究,403例患者。Meta分析结果显示:有效性方面,两组在降低IPSS评分[SMD=0.89,95%CI(-0.66,2.45)P=0.26]、提高最大尿流率[SMD=-3.67,95%CI(-8.88,1.54)P=0.17]、减少残余尿量[SMD=0.62,95%CI(-0.97,2.22)P=0.17]上无明显统计学差异;与单用药物相比,联合用药在减少前列腺体积上[SMD=6.94,95%CI(2.06,11.81)P=0.005]效果更好,两组在出现不良反应(头晕[SMD=0.57,95%CI(0.16,1.98)P=0.38]、性功能减退[SMD=0.57,95%CI(0.16,1.98)P=0.38])上无明显统计学差异。结论:单用α肾上腺受体阻滞剂与α肾上腺受体阻滞剂联合5α-还原酶抑制剂相比,两者疗效相似,对于前列腺体积不大的患者,单用α肾上腺受体阻滞剂即可达到很好的疗效,避免了不必要的经济负担;对于前列腺体积较大的患者,则推荐联合用药。对于前列腺具体多大的体积才是单用α肾上腺受体阻滞剂与联合5α-还原酶抑制剂治疗的分界阈值,则需要更多高质量、大样本的RCT进一步论证。
基金This study was supported by the State Family Planning Committee
文摘Objectives To study the expression pattern of 5α-reductase type 2 gene in human male reproductive organsMethods The expression level of 5α-reductase type 2 gene inhuman testis, epididymis and vas deferens tissues was determined by in situ hybridization using Digoxin labeled 5α-reductase type 2 cRNA probe.Results The brown granules of hybridizing signals distributed in the cytoplasm of Sertoli and Leydig cells of the testis, the principle cells of epididymis and the epithelial cells of vas deferens, but there was no positive signal in the nuclei of above-mentioned cells. No positive signal was observed in germ cells, basement of the testis, interstium of epididymis and basement, as well as smooth muscle of vas deferens. Conclusion This study confirmed that the 5α-reductase type 2 gene expressed in Sertoli , Leydig cells of the testis, and the principle cells of epididymis. The expression pattern of the gene in these cells in human was similar to that of rat and monkey. The presence of 5α-reductase type 2 gene in epithelial cells of the vas deferens suggested it might possess an important physiological role in human reproduction.
