Cascara Sagrada (Rhamnus purshiana) and Ovarian cancer

Cascara sagrada is a species of buckthorn, genus Rhamnus, belonging to the family Rhamnaceae, native to western North America, it's bark has been used in traditional medicine for gastrointestinal support. and it is thought to have a laxative and natural cleansing, etc.
Ovarian cancer is defined as a condition of abnormal cells growth of ovarian cells as that have become cancerous. It is one of most common cancer in US, according to the statistics adapted from the American Cancer Society's publication, Cancer Facts & Figures 2010, an estimated 21,880 women in the United States will be diagnosed with ovarian cancer and 13,850 deaths

The Ingredients

The chemical constituents of Cascara Sagrada include Aloe-emodin, Anthrquinone glycosides (Barbaloin Cascarosides A, B, C and D ChrysaloinFrangul), Chrysophanol, Emodin, Heterodianthrones palmidin A, B, and C, dianthrones, Oxanthrone, Rhein, Tannins, etc.

The health benefits
Study in combined treatment of emodin and survivin-targeted shRNA (a sequence of RNA) with
sur-shRNA plasmid constructed and transfected into the ovarian cancer cell lines SKOV3 and HO8910, showed positive effect of the shRNA specific for survivin effectively reduced the expression of survivin at the mRNA and protein levels in SKOV3 and HO8910 cells. Combination of emodin and shRNA-mediated knockdown of survivin significantly inhibited cell proliferation, induced apoptosis, and suppressed invasion in SKOV3 and HO8910 cells. Other treatment with concentration of emodin alone or combined with paclitaxel, indicated an effective of emodin induced apoptosis alone at a high concentration and increased paclitaxel-induced apoptosis at a low concentration. These results suggested the possibility of an innovative chemotherapeutic strategy in treating drug resistant ovarian tumor.

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References
(1) The combined effect of survivin-targeted shRNA and emodin on the proliferation and invasion of ovarian cancer cells by Xue H, Chen Y, Cai X, Zhao L, He A, Guo K, Zheng X.(PubMed)
(2) Emodin sensitizes paclitaxel-resistant human ovarian cancer cells to paclitaxel-induced apoptosis in vitro by Li J, Liu P, Mao H, Wanga A, Zhang X.(PubMed)

Phytochemical allicin and anti microbial activity

Allicin is phytochemical containing sulfur in the class of organosulfur compound, found abundantly in onion and garlic.
The immune system is the set of cells and their activity against antigens or infectious agents that comprises of the body's defense system against diseases. The immune system does a great job of keeping people healthy and preventing infections. Beside foods and nutritional supplements, herbs also play a important role in helping the immune system defend against viruses and bacteria attacks.

The health benefits
Allicin, the chemical compound of garlic is found to show a positive effect against infectious diseases caused by Gram-negative and Gram-positive bacteria. In parasite study, allicin inetracted with thiol groups of various enzymes against some major human intestinal protozoan parasites such as Entamoeba histolytica and Giardia lamblia; and iv). In recent publication, garlic extract is found to contain a broad-spectrum antimicrobial activity against many genera of bacteria and fungi. There result indicated that garlic may play an important role in the ecological control of pathogenic microorganisms in nature.


Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

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References
(1) Antimicrobial properties of allicin from garlic by Ankri S, Mirelman D.(PubMed)
(2) Allium sativum (garlic)--a natural antibiotic by Adetumbi MA, Lau BH (PubMed)

Benign prostatic hyperplasia(BPH) in Vitamin E Points of View

Kyle J. Norton

Benign prostatic hyperplasia(BPH) is defined as a condition of increased in the number of cells of prostate gland, causing partial, or sometimes virtually complete obstruction of the urinary tract. According to statistic, BPH commonly starts at age of 30 and symptoms usually can not be realized until age of 50. More than half of men between age of 60-70 are experience symptoms of BPH and only 10% are required treatment.
Vitamin E,  a fat soluble vitamin, consisting eight different variants (alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol) with varying levels of biological activity(2), found abundantly in corn oil, soybean oil, margarine, wheat germ oil, sunflower,safflower oils, etc. plays an important role in neurological functions and inhibition of platelet aggregation, regulation of enzymatic activity, free radical scavenger, etc..
Epidemiological studies, linking vitamin E in reduced risk and treatment of benign prostatic hyperplasia have not been consistent(1)(2)(3).
A composition, consisting cernitin, saw palmetto, B-sitosterol, vitamin E has shown to significantly reduce nocturia and frequency and diminish overall symptomatology of BPH, according to the Georgetown University Medical Center(4). Some researchers suggested that Benign prostatic hypertrophy (BPH) may be associated to the long-term exposure of the prostate to the strong androgen 5alpha-dihydrotestosterone (DHT) due to aging induced conversion of free testosterone. Food supplementation with extracts of Serenoa repens and a combination of the antioxidants selenium, (cis)-lycopene and natural vitamin E, together with fish oil rich in long-chain polyunsaturated essential fatty acids of the omega-3 group may be effective as pharmaceutical 5alpha-reductase inhibitors in partial androgen deficiency correct testosterone substitution(5). Vitamin E, as an antioxidant and free radical scavenger may be effective in reduced oxidative stress as patients with BPH were found with significant decrease in plasma alpha-Toc and Asc level(6)(7). Although diet and dietary supplement intervention appeared to slow BPH progression, over consumption of dietary supplements may be harmful(8).

Taken altogether, without going into reviews, vitamin E may be effective in reduced risk and treatment of patients with BPH. Over doses of vitamin E supplement can cause symptoms of blurred vision, weakness, dizziness, nausea, diarrhea, etc., please make sure you follow the guideline of the Institute of Medicine of the National Academies.



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Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

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References
(1) Preventing diseases of the prostate in the elderly using hormones and nutriceuticals by Comhaire F¹, Mahmoud A.(PubMed)
(2) Diet, micronutrients, and the prostate gland by Thomas JA.(PubMed)
(3) Intake of selected micronutrients and the risk of surgically treated benign prostatic hyperplasia: a case-control study from Italy by Tavani A¹, Longoni E, Bosetti C, Maso LD, Polesel J, Montella M, Ramazzotti V, Negri E, Franceschi S, La Vecchia C.(PubMed)
(4) Randomized trial of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) on symptoms of benign prostatic hyperplasia (BPH) by Preuss HG¹, Marcusen C, Regan J, Klimberg IW, Welebir TA, Jones WA.(PubMed)
(5) Preventing diseases of the prostate in the elderly using hormones and nutriceuticals by Comhaire F¹, Mahmoud A.(PubMed)
(6) Oxidative stress in benign prostate hyperplasia by Aryal M¹, Pandeya A, Gautam N, Baral N, Lamsal M, Majhi S, Chandra L, Pandit R, Das BK(PubMed)
(7) Oxidative stress in patients with benign prostate hyperplasia by Aryal M¹, Pandeya A, Bas BK, Lamsal M, Majhi S, Pandit R, Agrawal CS, Gautam N, Baral N.(PubMed)
(8) Diet and dietary supplement intervention appeared to slow disease progression by Sebastiano C¹, Vincenzo F, Tommaso C, Giuseppe S, Marco R, Ivana C, Giorgio R, Massimo M, Giuseppe M.(PubMed)

Benign prostatic hyperplasia(BPH) in Vitamin D Points of View

Kyle J. Norton

Benign prostatic hyperplasia(BPH) is defined as a condition of increased in the number of cells of prostate gland, causing partial, or sometimes virtually complete obstruction of the urinary tract. According to statistic, BPH commonly starts at age of 30 and symptoms usually can not be realized until age of 50. More than half of men between age of 60-70 are experience symptoms of BPH and only 10% are required treatment.
Vitamin D is a fat-soluble secosteroids found in small amount in few foods, including salmon, mackerel, sardines and tuna. The vitamin plays an important role in modulation of cellular proliferation, apoptosis induction, tumor growth suppression and promotion in absorption of minerals, including calcium, iron, magnesium, phosphate and zinc.
Epidemiological studies, focusing the use of dietary vitamin E in reduced risk of benign prostatic hyperplasia(BPH) have produced inconsistent results(a)(b).
1. Vitamin D receptor(VDR) and BPH
The study of 222 prostate cancer patients, 209 benign prostatic hyperplasia (BPH) patients, 128 male controls who were over 60 years old and without any evidence of prostate cancer or BPH, and 198 female controls in Japanese men to exp;ore the genetic mutation of polymorphism in the VDR gene for risk of prostate cancer and BPH found the positive effect of  BsmI polymorphism in the VDR gene in protection against prostate cancer(1). Other study showed  rs731236(genetic) variant of the vitamin D receptor had a protective effect for LUTS, a common symptoms of men with BPH(2), and VDR Fok I polymorphisms(morphs of the phenotype) may be correlated with BPH complicated by histological prostatitis, the study of Graduate School, South Medical Universit showed(3). In Indian population, Taq-I(a restriction enzyme isolated from the bacterium Thermus aquaticus in 1978) and Bsm-I genetic variants of VDR gene influence susceptibility BPH(4). But in the study of polymorphims with functional significance in the Bsm, Apa 1 and Taq 1 genes were therefore compared in 28 prostate cancer (CaP), 44 benign prostate hyperplasia (BPH) and 30 control cases in Thailand, indicated no significant variation in distribution of these three groups. Of that suggested these variations in the distribution frequencies from country to country and depending to other factors such as sun exposure, dietary and other lifestyle factors(5).

2. The serum of Vitamin D
Some researchers suggested that serum of vitamin D may be an indication of early onset of benign prostatichyoerplasia BPH. According to the study by American Urological Association Education and Research, low levels of 25-OH vitamin D is associated with benign prostatic hyperplasia(6). But a study by Democritus University of Thrace showed no clear relationship between vitamin D and serum levels of PSA or-of f/t-PSA(free/total prostate specific antigen) in PD patients(7).
 
3. The effects
BPH(1). BXL-628. a vitamin D3 analog, showed to decrease prostate growth and BPH symptoms, through inhibition of cell migration and cytoskeleton(a cellular scaffolding or skeleton contained within a cell's cytoplasm) remodeling in altered bladder contractility associated with BPH-induced lower urinary tract symptoms(8). Elocalcitol, a vitamin D3 analog, reduced the static component of BPH by inhibiting the activity of intraprostatic growth factors downstream of the androgen receptor, by targeting the RhoA(regulation and timing of cell division)/ROCK(protein, RhoA, RhoC, and ROCK expression were related to poor tumor differentiation) and NF-kappaB(involved in cellular responses to stimuli such as stress, cytokines, free radicals, ultraviolet irradiation, oxidized LDL, and bacterial or viral antigens.) pathway(9). The New York University School of Medicine study showed increase intake of vitamin D impact an adverse correlation with decreased BPH prevalence(10). Another novel nonsecosteroidal VDR agonist (CH5036249) showed an cell growth inhibitory activity of CH5036249 to be comparable to that of 1alpha,25(OH)2D3(11). Other analogs, including BXL-353, may also be potential for patients with BPH(12).

Taken altogether, serum of vitamin D may not be realizable diagnosis in determination the early onset of BPH, and vitamin D analogs are associated to reduced risk and treatment of Benign prostatic hyperplasia(BPH). As a;ways. all articles written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying.


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References
(a) Dietary patterns, supplement use, and the risk of symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial by Kristal AR¹, Arnold KB, Schenk JM, Neuhouser ML, Goodman P, Penson DF, Thompson IM.(PubMed)
(b) Dietary patterns, supplement use, and the risk of benign prostatic hyperplasia by Poon KS¹, McVary KT.(PubMed)
(c) Vitamin D and benign prostatic hyperplasia -- a review by Espinosa G¹, Esposito R, Kazzazi A, Djavan B.(PubMed)
(1) Association of vitamin D receptor gene polymorphism with prostate cancer and benign prostatic hyperplasia in a Japanese population by Habuchi T¹, Suzuki T, Sasaki R, Wang L, Sato K, Satoh S, Akao T, Tsuchiya N, Shimoda N, Wada Y, Koizumi A, Chihara J, Ogawa O, Kato T.(PubMed)
(2) Systematic Review and Meta-analysis of Candidate Gene Association Studies of Lower Urinary Tract Symptoms in Men by Cartwright R¹, Mangera A², Tikkinen KA³, Rajan P⁴, Pesonen J⁵, Kirby AC⁶, Thiagamoorthy G⁷, Ambrose C⁸, Gonzalez-Maffe J⁹, Bennett PR¹⁰, Palmer T¹¹, Walley A¹², Järvelin MR¹³, Khullar V¹⁴, Chapple C¹⁵(PubMed)
(3) [Relationship between vitamin D receptor gene Fok I polymorphisms and benign prostatic hyperplasia complicated by histological prostatitis].[Article in Chinese] by Ruan L¹, Zhong WD, Li ZM, Hua X.(PubMed)
(4) Association of genetic variants of the vitamin D receptor (VDR) gene (Fok-I, Taq-I and Bsm-I) with susceptibility of benign prostatic hyperplasia in a North Indian population by Manchanda PK¹, Konwar R, Nayak VL, Singh V, Bid HK.(PubMed)
(5) Lack of association of VDR polymorphisms with Thai prostate cancer as compared with benign prostate hyperplasia and controls by Chaimuangraj S¹, Thammachoti R, Ongphiphadhanakul B, Thammavit W.(PubMed)
(6) Low 25-OH vitamin D is associated with benign prostatic hyperplasia by Haghsheno MA¹, Mellström D, Behre CJ, Damber JE, Johansson H, Karlsson M, Lorentzon M, Peeker R, Barret-Connor E, Waern E, Sundh V, Ohlsson C, Hammarsten J.(PubMed)
(7) Serum levels of prostate-specific antigen and vitamin D in peritoneal dialysis patients by Passadakis P¹, Ersoy F, Tam P, Memmos D, Siamopoulos K, Ozener C, Akçiçek F, Camsari T, Ates K, Ataman R, Vlachojannis J, Dombros N, Utas C, Akpolat T, Bozfakioglu S, Wu GG, Karayaylali I, Arinsoy T, Stathakis C, Yavuz M, Tsakiris D, Dimitriades A, Yilmaz ME, Gültekin M, Karayalçin B, Challa A, Polat N, Oreopoulos DG.(PubMed)

(8 BXL-628, a vitamin D receptor agonist effective in benign prostatic hyperplasia treatment, prevents RhoA activation and inhibits RhoA/Rho kinase signaling in rat and human bladder by Morelli A¹, Vignozzi L, Filippi S, Vannelli GB, Ambrosini S, Mancina R, Crescioli C, Donati S, Fibbi B, Colli E, Adorini L, Maggi M.(PubMed)
(9) Vitamin D receptor agonists target static, dynamic, and inflammatory components of benign prostatic hyperplasia by Adorini L¹, Penna G, Fibbi B, Maggi M.(PubMed)
(10) Vitamin D and benign prostatic hyperplasia -- a review by Espinosa G¹, Esposito R, Kazzazi A, Djavan B.(PubMed)
(11) A novel nonsecosteroidal VDR agonist (CH5036249) exhibits efficacy in a spontaneous benign prostatic hyperplasia beagle model by Taniguchi K¹, Katagiri K, Kashiwagi H, Harada S, Sugimoto Y, Shimizu Y, Arakawa H, Ito T, Yamazaki M, Watanabe T, Kato A, Hoshino E, Takahashi T, Esaki T, Suzuki M, Takeda S, Ichikawa F, Harada A, Sekiguchi N, Ishigai M, Kawata H, Yoneya T, Onuma E, Sudoh M, Aoki Y.(PubMed)
(12) Inhibition of spontaneous and androgen-induced prostate growth by a nonhypercalcemic calcitriol analog by Crescioli C¹, Ferruzzi P, Caporali A, Mancina R, Comerci A, Muratori M, Scaltriti M, Vannelli GB, Smiroldo S, Mariani R, Villari D, Bettuzzi S, Serio M, Adorini L, Maggi M.(PubMed)

Benign prostatic hyperplasia(BPH) in Vitamin A Points of View

Benign prostatic hyperplasia(BPH) is defined as a condition of increased in the number of cells of prostate gland, causing partial, or sometimes virtually complete obstruction of the urinary tract. According to statistic, BPH commonly starts at age of 30 and symptoms usually can not be realized until age of 50. More than half of men between age of 60-70 are experience symptoms of BPH and only 10% are required treatment.

Vitamin A is a general term of Vitamin A Retinol, retinal, beta-carotene, alpha-carotene, gamma-carotene, and beta-cryptoxanthin and best known for its functions for vision health and antioxidant scavenger and essential for growth and differentiation of a number of cells and tissues.
Recommended intakes of vitamin A, according to  the Institute of Medicine of the National Academies (formerly National Academy of Sciences) is 600 µg daily as extremely high doses (>9000 mg) can be toxicity as causes of dry, scaly skin, fatigue, nausea, loss of appetite, bone and joint pains, headaches, etc.

1. Retinols
Vitamin A (retinol) and its derivatives, the retinoids concentration was 2-fold elevated in BPH compared with the tissues of normal prostate, and prostate carcinoma tissues of that may be an indication of role of retinoids in the physiology of the prostate and possibly also in the pathophysiology of prostate cancer(1). In human INSL3 in patients with benign prostate hyperplasia (BPH), all-trans-retinoic acid showed to up-regulate LGR8 gene activity in a dose- and time-dependent manner while having no effect on INSL3 gene activity(2). The study of the effects of 9-cis retinoic acid (9cRA) in suppressing prostate cell proliferation (PECP) and carcinogenesis in p27(Kip1) deficient mice, showed that 9cRA suppress prostate intraepithelial neoplasia (PIN) in all three p27(a cell cycle suppressor gene) genotypes through decreased suppress prostate cell proliferation (PECP) and increased cellular senescence(3).

2. Carotenoids(beta-carotene, alpha-carotene, gamma-carotene and beta-cryptoxanthin) Carotenoids, plant pigments, converted to vitamin A after intake, play an important role in prevention and treatment of some diseases through its antioxidant effects. Dietary carotenoids risk of BPH and prostate cancer is associated to age and fat intake. The study of 100 patients with prostate cancer and two different control series [100 benign prostatic hyperplasia (BPH) patients and 100 general hospital patients] showed a risk differentiation of  reduction by dietary beta-carotene and vitamin A was significant in the older men (70-79 years), but not in the younger men (50-69 years) with protective effect against prostate cancer related to the low overall fat intake in Japan(4). According to Johns Hopkins Bloomberg School of Public Health, consumption of fruit and vegetables rich in beta-carotene was inversely related to BPH(5)(6).
The Kyoto University study, in a case-control study of prostatic cancer and BPH, consisted of 100 patients with prostatic cancer, matched for hospital, age (+/- 3 yr) and hospital admission date (+/- 3 months) to patients with benign prostatic hyperplasia (BPH) and hospital controls indicated a correlation of daily intake of beta-carotene (RR = 2.13: 1.20-3.77), as compared with hospital controls, were significantly correlated with prostatic cancer development(7). Lower concentration of of carotenoids, may be an indication of disease progression rather than the systemic inflammatory response in patients with prostate cancer reported by the ¹University Department of Surgery, Royal Infirmary(8). Unfortunately, according to Kyoto Prefectural University of Medicine, serum beta-carotene and smoking are associated to increased risk with the development of BPH(9).

Taken altogether, although controversial, vitamin A may be associated to reduced risk of BPH but further large sample size studies are necessary to clarify its effectiveness. Overdoses can lead to toxic symptoms. Please make sure you follow the guideline of the Institute of Medicine of the National Academies. As always, all articles written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying.



Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

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References
(1) Abnormal level of retinoic acid in prostate cancer tissues by Pasquali D¹, Thaller C, Eichele G.(PubMed)
(2) INSL3 in the benign hyperplastic and neoplastic human prostate gland by Klonisch T¹, Müller-Huesmann H, Riedel M, Kehlen A, Bialek J, Radestock Y, Holzhausen HJ, Steger K, Ludwig M, Weidner W, Hoang-Vu C, Hombach-Klonisch S.(PubMed)
(3) p27(Kip1) deficiency promotes prostate carcinogenesis but does not affect the efficacy of retinoids in suppressing the neoplastic process by Taylor W¹, Mathias A, Ali A, Ke H, Stoynev N, Shilkaitis A, Green A, Kiyokawa H, Christov K.(PubMed)
(4) Dietary beta-carotene and cancer of the prostate: a case-control study in Kyoto, Japan by Ohno Y¹, Yoshida O, Oishi K, Okada K, Yamabe H, Schroeder FH.(PubMed)
(5) Fruit and vegetable consumption, intake of micronutrients, and benign prostatic hyperplasia in US men. by Rohrmann S¹, Giovannucci E, Willett WC, Platz EA.(PubMed)
(6) Intake of selected micronutrients and the risk of surgically treated benign prostatic hyperplasia: a case-control study from Italy by Tavani A¹, Longoni E, Bosetti C, Maso LD, Polesel J, Montella M, Ramazzotti V, Negri E, Franceschi S, La Vecchia C.(PubMed)
(7) A case-control study of prostatic cancer with reference to dietary habits by Oishi K¹, Okada K, Yoshida O, Yamabe H, Ohno Y, Hayes RB, Schroeder FH.(PubMed)
(8) Vitamin antioxidants, lipid peroxidation and the systemic inflammatory response in patients with prostate cancer by Almushatat AS¹, Talwar D, McArdle PA, Williamson C, Sattar N, O'Reilly DS, Underwood MA, McMillan DC.(PubMed)
(9) [Epidemiological study on diet, smoking and alcohol drinking in the relationship to prostatic weight].[Article in Japanese] by Nukui M.(PubMed) 

Benign prostatic hyperplasia(BPH) in Vitamin C Points of View

Kyle J. Norton

Benign prostatic hyperplasia(BPH) is defined as a condition of increased in the number of cells of prostate gland, causing partial, or sometimes virtually complete obstruction of the urinary tract. According to statistic, BPH commonly starts at age of 30 and symptoms usually can not be realized until age of 50. More than half of men between age of 60-70 are experience symptoms of BPH and only 10% are required treatment.

Vitamin C, also known as L-ascorbic acid, is a water-soluble vitamin, found in fresh fruits, berries and green vegetables. It is best known for its free radical scavengers activity and regenerating oxidized vitamin E for immune support.
Epidemiological studies linking dietary vitamin C in reduced risk of Benign prostatic hyperplasia(BPH) may be inconclusive(a)(b)(c).

The study of Vitamin C supplementation for its effect of HIF-1alpha, highly expressed in hyperplasic prostates and prevents prostate cell death by Soul National University College of Medicine indicated that vitamin C effectively prevent prostate hyperplasia through its suppression on HIF-1alpha via prolyl hydroxylation(1). The study of phenol composition and antioxidant capacity of Epilobium species at the ¹Semmelweis University, also support the role vitamin C in reduced risk of BHP through its radical-scavenger activity(2). Some researchers suggested that  free radicals and reactive oxygen species (ROS) are produced more with advancement of age, causing oxidative stress associated with BPH, due to significant decrease in plasma alpha-Toc and Asc level in BPH patients(3). The comparison of the effectiveness of  cimetidine 1 g/day for 4 weeks and 30 received vitamin C 1 g/day for the same period of a total of 60 patients with benign prostatic hypertrophy (BPH) study, showed no significant difference between the 2 groups (mean urinary flow, subjective obstructive or irritative symptoms, or prostate size) but Cimetidine was found to be no more active than vitamin C in treating benign prostatic hypertrophy(4). Regardless how effective the supplements are, some researchers ruled out the use of supplements because over consumption can be harmful(5).



Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Back to Researched articles - Points of view of Vitamins, Foods and Herbs
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References
(a) Fruit and vegetable consumption, intake of micronutrients, and benign prostatic hyperplasia in US men by Rohrmann S¹, Giovannucci E, Willett WC, Platz EA.(PubMed)
(b) Intake of selected micronutrients and the risk of surgically treated benign prostatic hyperplasia: a case-control study from Italy by Tavani A¹, Longoni E, Bosetti C, Maso LD, Polesel J, Montella M, Ramazzotti V, Negri E, Franceschi S, La Vecchia C.(PubMed)
(c) A case-control study of prostatic cancer with reference to dietary habits by Oishi K¹, Okada K, Yoshida O, Yamabe H, Ohno Y, Hayes RB, Schroeder FH.(PubMed)
(1) Vitamin C supplementation prevents testosterone-induced hyperplasia of rat prostate by down-regulating HIF-1alpha by Li SH¹, Ryu JH, Park SE, Cho YS, Park JW, Lee WJ, Chun YS.(PubMed)
(2) Polyphenol composition and antioxidant capacity of Epilobium species byHevesi Tóth B¹, Blazics B, Kéry A.(PubMed)
(3) Oxidative stress in benign prostate hyperplasia by Aryal M¹, Pandeya A, Gautam N, Baral N, Lamsal M, Majhi S, Chandra L, Pandit R, Das BK.(PubMed)
(4) Controlled study of cimetidine in the treatment of benign prostatic hypertrophy by Lindner A¹, Ramon J, Brooks ME.(PubMed)
(5) Dietary patterns and prostatic diseases by Sebastiano C¹, Vincenzo F, Tommaso C, Giuseppe S, Marco R, Ivana C, Giorgio R, Massimo M, Giuseppe M.(PubMed)

Benign prostatic hyperplasia(BPH) in Herbs Points of View

 Kyle J. Norton

Benign prostatic hyperplasia(BPH) is defined as a condition of increased in the number of cells of prostate gland, causing partial, or sometimes virtually complete obstruction of the urinary tract. According to statistic, BPH commonly starts at age of 30 and symptoms usually can not be realized until age of 50. More than half of men between age of 60-70 are experience symptoms of BPH and only 10% are required treatment. Epidemiological studies, linking herbal medicine in reduced risk of benign prostate hyperplasia have produced certain positive results, but multi centers and large sample size studies are necessary to identify the principle ingredients to improve their validations.

1. Serenoa repens (Saw palmetto)
Saw Palmetto, is a small palm like tree of the genus in the genus Serenoa, belonging to the family, native to o southeastern North America. The herb has been used in The North American Seminole Indians for infertility, PMS, reproductive or urinary tract problems, urinary tract infections, stomach aches, indigestion and dysentery, etc. In rat study, a liposterolic extract of saw palmetto  showed to inhibited the contractions of prostate gland consistently with smooth muscle relaxant activity(1). In a total of 297 patients recruited, with 87 into the group TAM, 97 into the group SR and 81 into the group tamsulosin (TAM) + Serenoa repens (SR), SR and TAM treatment of BPH had showed to be efficacy as in alone, a combined therapy (TAM + SR) does not provide extra benefits(2). On the mRNA gene expression profiles of two representative models of BPH,  BPH1 cell line and primary stromal cells derived from BPH, lipidosterolic extract of Serenoa repens (LSESr) significantly altered gene expression patterns, categorized as part of proliferative, apoptotic, and inflammatory pathways(3). Unfortunately, a meta-analysis of two high quality long-term trials (n = 582), conducted by the,  showed no effect of Sere noa repens, at double and triple doses, in improving urinary flow measures or prostate size in men with lower urinary tract symptoms consistent with BPH(4).

2. Cuban royal palm
Cuban royal palm is a genus Roystonea, belonging to the family  Arecoideae, native to southern Florida, Mexico and parts of Central America and the northern
Caribbean. The roots of the tree has been used as a diuretic, and for treatment of diabetes. In rat study, 
D-004, a lipid extract from Cuban royal palm fruits incomparison of Saw palmetto and tamsulosin, a 
selective alpha(1A)-adrenoceptor antagonist, indicated that D-004 was moderately more effective
 than Saw palmetto, a phytotherapeutic standard used to treat BPH, but less effective than tamsulosin, a 
selective alpha(1A)-adrenoceptor antagonist(5).
Other study of the same by the Center of Natural Products from the National Center for Scientific
Research, showed that oral administration of D-004 for 14 days prevented the
increase of prostate size and the testosterone-induced prostate enlargement with in rodents(6)(7).

3. Prunus africana
Prunus africana. also known as Red Stinkwood, is a an evergreen tree,  genus Prunus, belonging to the family Rosaceae, native to the montane regions of Sub-Saharan Africa. The herb has been used in traditional medicine to treat fevers, malaria, wound dressing, arrow poison, stomach pain, purgative, kidney disease, appetite stimulant, gonorrhoea, and insanity(8).
Pygeum africanum extract, in a multicentre trial in central Europe, treatment found to be effective in changes in subjective scores, International Prostate Symptom Score (IPSS) and QoL, after the two-month period the extract also was highly statistically significant with mean improvements of 40% and 31% and with the overall result of a substantial improvement in QoL(9)(10). Although many evidences suggested that P. africanum modestly and significantly, improved urologic symptoms and flow measures, further research is needed using standardized preparations of P. africanum to determine its long-term effectiveness and ability to prevent complications associated with benign prostatic hyperplasia(11).

4. Green tea 
Green tea contains more amount of antioxidants than any drinks or food with the same volume, and is the leaves of Camellia sinensis, undergone minimal oxidation during processing, originated from China. Green tea has been a precious drink in traditional Chinese culture and used exceptional in socialization for more than 4000 thousand years. Because of their health benefits, they have been cultivated for commercial purposes all over the world. The levels or activity of androgen hormones are associated to the risk of BPH, green tea catechin, (-)epigallocatechin-3-gallate, exhibited its modulation of androgenic activity that may be useful for the treatment of various hormone-related abnormalities, such as benign prostatic hyperplasia(12). 5 alpha-reductase activity may be involved in the development of benign prostatic hyperplasia. The Ben May Institute for Cancer Research, and The Tang Center for Herbal Medicine Research study showed that green tea catechin (-)-epigallocatechin gallate (EGCG) is potent inhibition in cell-free and in replacement of the gallate ester in EGCG with long-chain fatty acids produced potent 5 alpha-reductase inhibitors(13). The study by the Oregon State University, also showed that in the study of male noble rats implanted with estradiol and testosterone divided into 4 dietary groups: control, soy, tea, or soy+tea, the combinartion of  soy and tea attenuated prostate malignancy by decreasing prostate hyperplasia(14). Also, green tea catechin, (-)epigallocatechin-3-gallate, according to Dr. Liao S., may be useful for the treatment of various hormone-related abnormalities, such as benign prostatic hyperplasia, due to its modulation of androgenic activity, possibly through increasing in testosterone metabolism, down-regulation of androgen receptors or activation of oestrogen receptors (15).

5. Licorice
Licorice (Glycyrrhiza Glabra) also known as sweetwood, is the genus Glycyrrhiza, belonging to the family Fabaceae, native to the Mediterranean and certain areas of Asia. The herb has been used in traditional medicine to treat skin diseases, coughs, constipation, bronchitis, inflammation, arthritis, etc. Glycyrrhiza glabra extract with doses of 150 and 300 mg/kg showed a significant reduction in prostate weight, total estosterone and VP epithelium/stroma ratio (V/V)(16).

6. Garlic
Garlic is a natural superfood healer for its natural antibiotic with antiviral, antifungal, anticoagulant and antiseptic properties. A multicenter case-control study of 1369 patients with BPH and 1451 controls, indicated an inverse association of intake of garlic related to the risk of BPH, consistent across age strata(17). Other researchers suggested that garlic potential in treating BPH due to its anti-inflammatory, anti-cancer and antioxidant effects as well as its effectiveness for the treatment of prostate cancer and relief of BPH symptoms(18).

7. Epilobium parviflorum
Epilobium parviflorum also known as Smallflower Hairy Willowherb, is a genus Epilobium, belonging to the family Onagraceae. The herb has been used in traditional medicine as an antioxidant and 
antiinflammatory agent and  in treating BPH, bladder and kidney, etc.
According to the study by Farmakognózia Intézet, willow-herb possess remarkable antioxidant and COX-inhibitory action and may be effective in treating benign prostatic hyperplasia (BPH)(19). Other study suggested a protective effect against benign prostatic hyperplasia (BPH), through inhibited oxidative damage, generated in fibroblast cells, decreased the PGE(2) release and inhibited COX-enzyme(20).

8. Urtica dioica
Sting Nettle is a flower plant in the genus Urtica, belonging tothe family Urticaceae, native to Europe, Africa, Asia, and North America.The herb has been used in traditional medicine as diuretic and laxative agent and to treat diarrhea and urinary disorders, to relieve pain, treat arthritis, asthma, bronchitis, sinusitis, etc.
In a 6-month, double-blind, placebo-controlled, randomized, partial crossover, comparative trial with placebo in 620 patients conducted by Shaheed Beheshti University of Medical Sciences, Urtica dioica showed to improve International Prostate Symptom Score (IPSS), the maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR) and prostate size(21). Composition of 160 mg sabal fruit extract WS 1473 and 120 mg urtica root extract WS 1031 per capsule (PRO 160/120) found to improve  the amelioration of LUTS as measured by the I-PSS, obstructive and irritative urinary symptoms and in patients with moderate and severe symptoms of BPH(22)(23). Bazoton uno (459 mg dry extract of stinging nettle roots), in a study of a total of 246 patients, reduced irritative symptoms and BPS-associated complications due to the postulated antiphlogistic and antiproliferative effects(24).

9. Ginseng
Ginseng is a slow-growing perennial plants with fleshy roots, the genus Panax, belonging to the family Araliaceae. Depending to the climate where it grows, ginseng can be classified mainly into Panax ginseng Asian ginseng (root), Red ginseng, wild ginseng, American ginseng (root). Ginseng, one of the most popular herb has been used in human history in treating vary types of diseases. Panax ginseng or Red ginseng water extract and its chemical constituent 20(S)-Rg3 showed to inhibit testosterone-induced cell proliferation, arrested cell cycle by inducing p21 and p27, and induced apoptosis, through inhibition of testosterone-induced expression of human kallikrein-3 mRNA and activation of androgen receptor (AR)(25).

10. Rye (Secale cereal)
Rye (Secale cereal) is a grass in the genus Secale, belonging to the family Poaceae, native to the  central and eastern Turkey, and in adjacent areas. The herb has been used
in folk medicine as laxative due to its fibrous seed coat. Cernilton, isolated
from the rye-grass pollen Secale cereal, in randomized controlled trials or controlled clinical trials
comparing with placebo or other BPH medications in men with BPH showed a modestly
improves overall urologic symptoms including nocturia(26). In a 444 men enrolled in 2
placebo-controlled and 2 comparative trials lasting from 12 to 24 weeks, conducted by Department
of Veterans Affairs Coordinating Center,  Cernilton improved "self rated urinary symptoms", reduced
nocturia, but not improve urinary flow rates, residual volume or prostate size compared to placebo or
the comparative study agents(27). 

Taken altogether, without going into reviews, herbal medicine mentioned above may be effective in
reduced risk and treatment of Benign prostatic hyperplasia(BPH), but further studies are necessary to 
identify the
principle ingredients through comparison with Western medicine in use with large sample size and
multi centers involvement. As always, all articles written by Kyle J. Norton are for information &
education only, please consult your Doctor & Related field specialist before applying



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References
(1) Pharmacological characterization and chemical fractionation of a liposterolic extract of saw palmetto (Serenoa repens): Effects on rat prostate contractility by Chua T¹, Eise NT², Simpson JS³, Ventura S(PubMed)
(2) Does the addition of Serenoa repens to tamsulosin improve its therapeutical efficacy in benign prostatic hyperplasia? byArgirović A¹, Argirović D².(PubMed)
(3) Lipidosterolic extract of serenoa repens modulates the expression of inflammation related-genes in benign prostatic hyperplasia epithelial and stromal cells by Sirab N¹, Robert G, Fasolo V, Descazeaud A, Vacherot F, Taille Ade L, Terry S.(PubMed)
(4) Serenoa repens for benign prostatic hyperplasia by Tacklind J¹, Macdonald R, Rutks I, Stanke JU, Wilt TJ.(*PubMed)
(5) Effect of D-004, a lipid extract from the Cuban royal palm fruit, on atypical prostate hyperplasia induced by phenylephrine in rats by Arruzazabala ML¹, Más R, Molina V, Noa M, Carbajal D, Mendoza N.(PubMed)
(6) Effect of D-004, a lipid extract from Cuban royal palm fruit, on histological changes of prostate hyperplasia induced with testosterone in rats by Noa M¹, Arruzazabala ML, Carbajal D, Más R, Molina V.(PubMed)
(7) Preventive effects of D-004, a lipid extract from Cuban royal palm (Roystonea regia) fruits, on testosterone-induced prostate hyperplasia in intact and castrated rodents by Arruzazabala ML¹, Carbajal D, Más R, Molina V, Rodríguez E, González V.(PubMed)
(8) Stewart KM."The African cherry (Prunus africana): can lessons be learned from an over-exploited medicinal tree?." [Review] Journal of Ethnopharmacology. 89(1):3-13, 2003 Nov.
(9)Efficacy and acceptability of tadenan (Pygeum africanum extract) in the treatment of benign prostatic hyperplasia (BPH): a multicentre trial in central Europe by Breza J¹, Dzurny O, Borowka A, Hanus T, Petrik R, Blane G, Chadha-Boreham H.(PubMed)
(10) Comparison of once and twice daily dosage forms of Pygeum africanum extract in patients with benign prostatic hyperplasia: a randomized, double-blind study, with long-term open label extension by Chatelain C¹, Autet W, Brackman F.(PubMed)
(11) Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis by Ishani A¹, MacDonald R, Nelson D, Rutks I, Wilt TJ.(PubMed)
(12) The medicinal action of androgens and green tea epigallocatechin gallate by Liao S.(PubMed)
(13) Structure-activity relationships for inhibition of human 5alpha-reductases by polyphenols by Hiipakka RA¹, Zhang HZ, Dai W, Dai Q, Liao S.(PubMed)
(14) Dietary soy and tea mitigate chronic inflammation and prostate cancer via NFκB pathway in the Noble rat model by Hsu A¹, Bruno RS, Löhr CV, Taylor AW, Dashwood RH, Bray TM, Ho E.(PubMed)
(15) The medicinal action of androgens and green tea epigallocatechin gallate by Liao S.(PubMed)
(16) Antiandrogenic activities of Glycyrrhiza glabra in male rats by Zamansoltani F¹, Nassiri-Asl M, Sarookhani MR, Jahani-Hashemi H, Zangivand AA.(PubMed)
(17) Onion and garlic intake and the odds of benign prostatic hyperplasia by Galeone C¹, Pelucchi C, Talamini R, Negri E, Dal Maso L, Montella M, Ramazzotti V, Franceschi S, La Vecchia C.(PubMed)
(18) Is garlic a promising food for benign prostatic hyperplasia and prostate cancer? by Devrim E¹, Durak I.(PubMed)
(19) [Epilobium parviflorum--in vitro study of biological action].[Article in Hungarian] by Hevesi Tóth B¹, Kéry A.(PubMed)
(20) Antioxidant and antiinflammatory effect of Epilobium parviflorum Schreb by Hevesi BT¹, Houghton PJ, Habtemariam S, Kéry A.(PubMed)
(21) Urtica dioica for treatment of benign prostatic hyperplasia: a prospective, randomized, double-blind, placebo-controlled, crossover study by Safarinejad MR.(PubMed)
(22) Long-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms--a placebo-controlled, double-blind, multicenter trial by Lopatkin N¹, Sivkov A, Walther C, Schläfke S, Medvedev A, Avdeichuk J, Golubev G, Melnik K, Elenberger N, Engelmann U.(PubMed)
(23) Efficacy and safety of a combination of Sabal and Urtica extract in lower urinary tract symptoms--long-term follow-up of a placebo-controlled, double-blind, multicenter trial by Lopatkin N¹, Sivkov A, Schläfke S, Funk P, Medvedev A, Engelmann U.(PubMed)
(24) [Stinging nettle root extract (Bazoton-uno) in long term treatment of benign prostatic syndrome (BPS). Results of a randomized, double-blind, placebo controlled multicenter study after 12 months].

[Article in German] by Schneider T¹, Rübben H.(PubMed)
(25) Red ginseng and 20(S)-Rg3 control testosterone-induced prostate hyperplasia by deregulating androgen receptor signaling by Bae JS¹, Park HS, Park JW, Li SH, Chun YS.(PubMed)
(26) Cernilton for benign prostatic hyperplasia by Wilt T¹, Mac Donald R, Ishani A, Rutks I, Stark G.(PubMed)
(27) systematic review of Cernilton for the treatment of benign prostatic hyperplasia by MacDonald R¹, Ishani A, Rutks I, Wilt TJ.(PubMed)