Tag: prostate

Categories : Neurodegenerative Diseases UrogenitalTags :

Could Drugs for Enlarged Prostate also Protect against Lewy Body Dementia?

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Credit: Darryl Leja National Human Genome Research Institute National Institutes Of Health

A new study published in Neurology suggests that certain drugs commonly used to treat enlarged prostate may also decrease the risk for dementia with Lewy bodies (DLB). This observational finding may seem surprising, but it mirrors previous work by the University of Iowa Health Care team that links the drugs to a protective effect in another neurodegenerative condition: Parkinson’s disease. 

The UI researchers think that a specific side effect of the drugs targets a biological flaw shared by DLB and Parkinson’s disease, as well as other neurodegenerative diseases, raising the possibility that they may have broad potential for treating a wide range of neurodegenerative conditions. 

“Diseases like dementia with Lewy bodies, or Parkinson’s disease, or Alzheimer’s disease are debilitating, and we don’t really have any good treatments that can modify the disease progression. We can treat symptoms, but we can’t actually slow the disease,” explains lead study author Jacob Simmering, PhD, UI assistant professor of internal medicine. “One of the most exciting things about this study is that we find that same neuroprotective effect that we saw in Parkinson’s disease. If there is a broadly protective mechanism, these medications could potentially be used to manage or prevent other neurodegenerative diseases.” 

Large observational study links prostate drugs to lower risk of dementia with Lewy bodies

DLB is a neurodegenerative disease that causes substantial and rapid cognitive decline and dementia. It affects about one in 1000 people per year, accounting for 3 to 7% of all dementia cases. 

For the new study, the UI researchers used a large database of patient information to identify more than 643 000 men with no history of DLB who were newly starting one of six drugs used to treat benign prostatic hyperplasia (enlarged prostate). 

Three of the drugs, terazosin, doxazosin, and alfuzosin (Tz/Dz/Az), have an unexpected side effect; they can boost energy production in brain cells. Preclinical studies suggest that this ability may help slow or prevent neurodegenerative diseases like PD and DLB.  

The other drugs, tamsulosin and two 5-alpha-reductase inhibitors (5ARIs) called finasteride and dutasteride, do not enhance energy production in the brain and therefore provide a good comparison to test the effect of the Tz/Dz/Az drugs. 

The team then followed the data on these men from when they started taking the medication until they left the database or developed dementia with Lewy bodies, whichever happened first. On average, the men were followed for about three years. 

Because all the participants were selected to start a drug that treats the same condition, the researchers reasoned that the men were likely similar to each other at the outset of the treatment. The men were all propensity score-matched for characteristics like age, year of medication start, and other illnesses they had before starting the treatment, to further reduce the differences between the groups. 

“We found that men who took Tz/Az/Dz drugs were less likely to develop a diagnosis of dementia with Lewy bodies,” Simmering says. “Overall, men taking terazosin-type medications had about a 40% lower risk of developing a DLB diagnosis compared to men taking tamsulosin, and about a 37% reduction in risk compared to men taking five alpha reductase inhibitors.” 

Meanwhile, there was no statistically significant difference in risk between men taking tamsulosin and alpha reductase inhibitors. 

Approved drugs show potential

Since this was an observational study, causation cannot be established, only an association. In addition, the study only included men because the drugs are prescribed for prostate problems, which means that the researchers don’t know if the findings would apply to women. However, Simmering and his colleagues are excited by the potential of these drugs, which are already FDA approved, inexpensive, and have been used safely for decades. 

“If terazosin and these similar medications can help slow this progression – if not outright preventing the disease – this would be important to preserving cognitive function and quality of life in people with DLB,” Simmering says. 

Source: University of Iowa Carver College of Medicine

Categories : Cardiovascular DiseaseTags :

Common Hair Loss and Prostate Drug may also Cut Cardiovascular Risk

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Photo by Brett Sayles on Unsplash

The drug finasteride, also known as Propecia or Proscar, treats male pattern baldness and enlarged prostate in millions of men worldwide. But a new study published in the Journal of Lipid Research suggests that the drug may also possess a surprising, life-saving benefit: lowering cholesterol and reducing the overall risk of cardiovascular disease.

The study, led by University of Illinois Urbana-Champaign, found significant correlations between finasteride use and lower cholesterol levels in men taking part in the National Health and Nutrition Examination Survey between 2009 and 2016. In mice taking high finasteride doses, the researchers found reductions in total plasma cholesterol, delayed atherosclerosis progression, lower inflammation in the liver, and related benefits.

“When we looked at the men taking finasteride in the survey, their cholesterol levels averaged 30 points lower than men not taking the drug. I thought we’d see the opposite pattern, so it was very interesting,” said lead study author Jaume Amengual, assistant professor at U. of I.

As exciting as the survey results were, they had their limitations. Of nearly 4800 survey respondents meeting general health criteria for inclusion in the analysis, only 155, all men over 50, reported using finasteride. And the researchers couldn’t tell how much or how long men in the survey had taken the drug.

“This was not a clinical study in which you can control everything perfectly,” Amengual said. “It was more of an observation that led us to say, ‘Okay, now we’ve seen this in people. Let’s see what happens in mice.'”

But first, why would a hair loss and prostate drug affect cholesterol? Amengual studies atherosclerosis, the condition in which cholesterol plaques choke arteries, leading to stroke, heart attack, and other forms of cardiovascular disease. Because the disease is far more common in men than premenopausal women, scientists have long suspected the sex hormone testosterone is important in atherosclerosis, though its role isn’t entirely clear.

Finasteride works by blocking a protein found in hair follicles and the prostate gland that activates testosterone. The common thread, testosterone, was enough to pique Amengual’s interest.

“I was reading about this medication one day, and I started to notice that there were not many long-term studies of the implications of the drug. Initially, it was just my own curiosity, based on the fact that hormone levels are known to have an effect on atherosclerosis, hair loss, and prostate issues,” he said. “So, we decided to dig into it.”

After documenting the first-ever link, albeit observational, between finasteride and lower cholesterol in men, Amengual got doctoral student Donald Molina Chaves to see if the pattern held in mice.

Molina Chaves tested four levels of finasteride – 0, 10, 100, and 1000 mg/kg of food – in male mice genetically predisposed to atherosclerosis. The mice consumed the drug, along with a high-fat, high-cholesterol “Western” diet, for 12 weeks. After the experiment, Molina Chaves analysed the levels of cholesterol and other lipids in the mice, along with evidence of atherosclerotic plaques. He also tested gene expression in the liver, looked at bile acid metabolism, and analysed steroids, triglycerides, immune activity, and more.

“Mice that were given a high dose of finasteride showed lower cholesterol levels within the plasma as well as in the arteries,” Molina Chaves said. “There were also fewer lipids and inflammatory markers in the liver.”

Although the effects were only significant at the highest dose, a level Amengual calls outrageous for humans, he explains that mice metabolise finasteride differently than people.

“It’s an incredibly high level of the drug. But we use mice as a model, and they are extremely resistant to things that would kill any of us,” he said. “So it is not that crazy when you think about it that way.”

Humans take 1mg or 5mg doses of finasteride daily for hair loss and enlarged prostate, respectively. The fact that a clear pattern showed up in a survey of men likely taking one of these doses suggests the drug may be lowering cholesterol without the megadoses tested in mice.

The next step is for physicians to start tracking cholesterol in finasteride patients or conduct a clinical trial to verify the effect. Amengual says it may be especially important to understand how finasteride affects trans individuals.

“Over the past decade, doctors have started prescribing this drug for individuals transitioning either from male to female or female to male. In both cases, the hormonal changes can trigger hair loss,” he said. “The interesting thing is that transgender people are also at a higher risk of cardiovascular diseases. So this drug could have a potential beneficial effect to prevent cardiovascular disease not only in cis men, but also in transgender individuals.”

Finally, Amengual notes, like any medication, finasteride is not without risk. People should consult their doctors to learn more.

Source: University of Illinois College of Agricultural, Consumer and Environmental Sciences

Categories : Cancer General InterestTags :

UK’s King Charles Diagnosed with Cancer

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By White House, Public Domain

The UK’s King Charles has been diagnosed with cancer, though reportedly at an early stage. This follows a brief hospital stay where he underwent a procedure for a benign enlarged prostate. For the time being, he will not being public duties, but will continue his private duties.

Speaking to the BBC, UK Prime Minister Rishi Sunak said that the cancer was “caught early”. The nature of the cancer was not disclosed by Buckingham Palace, which is in line with its usual practice of sharing only basic information concerning the health of the royal family. It however noted that it was not connected to his prostate treatment, ruling out prostate cancer.

Well-wishes for the king have come in from around the globe. Mia Mottley, Barbados’ first female PM, wished wishes King Charles a “full and speedy recovery”. Barbados became a republic in 2021, ending the the role of UK monarchs as its Head of State.

Since the UK is a constitutional democracy, his private duties consist of governmental approvals. For example, the king has constitutional duties, such as approving the passing of laws and appoints new judges, ambassadors and prime ministers. Public activities such as charity events and giving honours for public or voluntary service.

It is expected that certain activities such as his weekly meetings with Prime Minister Sunak will continue unless his doctors advise otherwise. Other members of the royal family will be able to stand in for him for ceremonial duties if he is unable to perform them. Recently, 41-year-old Catherine, Princess of Wales,

It is not an unexpected medical condition to occur for the 75-year old monarch – age is a major factor for almost all cancers – just over a quarter of all cancers are diagnosed from age 75 onward. The American Cancer Society now recommends general cancer screenings start at 45.

Categories : COVID UrogenitalTags : Leave a comment

Study Finds Urological Effects of SARS-CoV-2 Infection in Men

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Photo by Help Stay on Unsplash

A study published in the Journal of Internal Medicine indicates that SARS-CoV-2 infection may worsen lower urinary tract symptoms (LUTS) in men. The study researchers found that a enlarged prostate as a result of COVID was involved.

The study included 17 986 men receiving medication for LUTS within the public healthcare system of Hong Kong in 2021–2022, half of whom had SARS-CoV-2 infection. The group with SARS-CoV-2 had significantly higher rates of retention of urine (4.55% versus 0.86%); blood in the urine (1.36% versus 0.41%); clinical urinary tract infection (4.31% versus 1.49%); bacteria in the urine (9.02% versus 1.97%); and addition of 5-alpha reductase inhibitors, which are drugs prescribed for enlarged prostate. (0.50% versus 0.02%). These urological manifestations occurred regardless of COVID severity.

The findings might relate to the presence of certain proteins targeted by SARS-CoV-2 that are known to be expressed in the prostate.

“We are excited to be the first to report the effects of COVID on complications of benign prostatic hyperplasia – or enlarged prostate – and also demonstrate the alarming extent of its urological effects,” said corresponding author Alex Qinyang Liu, MD, of Prince of Wales Hospital, in Hong Kong.

Source: Wiley