Evaluation of apoptosis indexes in currently used oral alpha-blockers in prostate: a pilot study

Vol. 44 (3): 600-607, May – June, 2018

doi: 10.1590/S1677-5538.IBJU.2017.0668


ORIGINAL ARTICLE

Mehmet Demir 1, Yigit Akin 1, 2, Kubra Asena Kapakin Terim 3, Mehmet Gulum 4, Evren Buyukfirat 5, Halil Ciftci 1, Ercan Yeni 1
1 Department of Urology, Harran University School of Medicine, Sanliurfa, Turkey; 2 Department of Urology, Izmir Katip Celebi University School of Medicine, Izmir, Turkey; 3 Department of Pathology, Ataturk University School of Veterinary Medicine, Erzurum, Turkey; 4 Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey; 5 Department of Anaesthesiology, Harran University School of Medicine, Sanliurfa, Turkey

 

ABSTRACT

Objectives: Apoptosis effect of oral alpha-blockers is known in the prostate. Apoptosis index of silodosin has not been proved, yet. Aims are to present apoptosis index of silodosin in prostate and to compare this with other currently used alpha-blocker’s apoptosis indexes together with their clinical effects.

Materials and Methods: Benign prostatic hyperplasia (BPH) patients were enrolled among those admitted to urology outpatient clinic between June 2014 and June 2015. Study groups were created according to randomly prescribed oral alpha-blocker drugs as silodosin 8mg (Group 1; n=24), tamsulosin 0.4mg (Group 2; n=30), alfuzosin 10mg (Group 3; n=25), doxazosin 8mg (Group 4; n=22), terazosin 5mg (Group 5; n=15). Pa­tients who refused to use any alpha-blocker drug were included into Group 6 as control group (n=16). We investigated apoptosis indexes of the drugs in prostatic tissues that were taken from patient’s surgery (transurethral resection of prostate) and/or prostate biopsies. Immunochemical dyeing, light microscope, and Image Processing and Analy­sis in Java were used for evaluations. Statistical significant p was p<0.05.

Results: There were 132 patients with mean follow-up of 4.2±2.1 months. Pathologist researched randomly selected 10 areas in each microscope set. Group 1 showed statisti­cal significant difference apoptosis index in immunochemical TUNEL dyeing and im­age software (p<0.001). Moreover, we determined superior significant development in parameters as uroflowmetry, quality of life scores, and international prostate symptom score in Group 1.

Conclusions: Silodosin has higher apoptosis effect than other alpha-blockers in pros­tate. Thus, clinic improvement with silodosin was proved by histologic studies. Besides, static factor of BPH may be overcome with creating apoptosis.

Keywords: Prostate; Prostatic Hyperplasia; 5-alpha Reductase Inhibitors

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