Heme oxygenase-1 prostatic levels are significantly lower in patients affected by moderate-severe LUTS secondary to benign prostatic hyperplasia: A pilot study

Introductions and Objectives The heme oxygenase-1 (HO-1) is responsible for the removal of reactive oxygene species and for the preventions of apoptosis. Several lines of evidence suggest that the increase in adipose tissue and the related Metabolic Syndrome (MetS) suppress HO-1 expression. The aim of this study was to evaluate the association between prostatic HO1 expression in patients affected by moderate-severe LUTS due clinical BPH. Methods Between January 2012 and June 2013, 132 consecutive patients with IPSS ≥12, PSA < 4 ng/ml or PSA ≥4 ng/ml but a negative prostate biopsy, Qmax < 15 mL/sec, prostate volume ≥ 30 ml but ≤ 80 ml who underwent TURP were enrolled. MetS was defined by the International Diabetes Federation (IDF) criteria. Subjects were divided according to presence of serum HDL cholesterol (HDL-C) and tryglicerids alterations in three group: Group A (HDL-C≥40 mg/dl and tryglicerids <150 mg/dl), Group B (HDL-C<40 mg/dl or tryglicerids ≥ 150 ng/ml) and Group C (HDL-C<40 mg/dl and tryglicerids > 150 ng/ml) with those with one of the previous alteration (Group B) or without both (Group A). Surgical specimens (taken by at least three different randomly selected sites of the adenomatous tissue) were collected with sterile procedure and used for HO1 prostatic levels determination. The protocol was approved by the Internal Institutional Review Board (ID: 578) and an informed written consent was obtained from each men before enrolment. All tests were completed using SPSS v. 19 software (SPSS Inc, IBM Corp, Somers, NY, USA). For all statistical comparisons significance was considered as p <0.05. Results Among all, 75 (56.8%) met the inclusion criteria for the MetS while 57 (43.2%) not. Histological analysis revealed BPH in all patients. When comparing subjects with MetS to the normal, we observed significant differences in HO-1 levels (5.29 vs. 6.28, p=0.04). At the Pearson’s correlation analysis, we observed significant associations between HO-1 and WC (r= -0.22, p<0.05), BMI (r= -0.21, p<0.05) and serum HDL (r= 0.30, p<0.05). All these assocations were also significant at the linear regression analysis. When comparing Group C with Group B and Group A, we demonstrated significant differences in term of HO-1 levels (p<0.01). In fact, Group C had lower levels of HO-1 if compared with Group B (4.7 vs. 5.4, p<0.05) and with Group A (4.7 vs. 6.6, p<0.05). Conclusions Intervention targeted to the improving of the lipid profile and the consequent relief of the MetS related condition could significantly reduce LUTS secondary to BPH.