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Prostatic artery occlusion: initial findings on pathophysiological response in a canine prostate model
BACKGROUND: Prostatic artery embolization (PAE) is an alternative treatment for symptomatic benign prostatic hyperplasia (BPH) in men. A technical modification of conventional PAE has been developed in a canine prostate model consisting of prostatic artery occlusion (PAO) using Onyx(®) whose therape...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9827397/ https://www.ncbi.nlm.nih.gov/pubmed/36632152 http://dx.doi.org/10.21037/tau-22-423 |
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author | Lucas-Cava, Vanesa Sánchez-Margallo, Francisco Miguel Moreno-Lobato, Beatriz Dávila-Gómez, Luis Lima-Rodríguez, Juan Rafael García-Martínez, Virginio López-Sánchez, Carmen Sun, Fei |
author_facet | Lucas-Cava, Vanesa Sánchez-Margallo, Francisco Miguel Moreno-Lobato, Beatriz Dávila-Gómez, Luis Lima-Rodríguez, Juan Rafael García-Martínez, Virginio López-Sánchez, Carmen Sun, Fei |
author_sort | Lucas-Cava, Vanesa |
collection | PubMed |
description | BACKGROUND: Prostatic artery embolization (PAE) is an alternative treatment for symptomatic benign prostatic hyperplasia (BPH) in men. A technical modification of conventional PAE has been developed in a canine prostate model consisting of prostatic artery occlusion (PAO) using Onyx(®) whose therapeutic effect is prostate shrinkage. However, the underlying mechanisms are not well clarified. The purpose was to evaluate the biological mechanisms responsible for therapeutic effects of PAO in the canine prostate. METHODS: Ten adult male beagles (5.0±0.82 years) underwent PAO with Onyx-18 (n=7) and prostatic artery angiography as control (n=3). Blood samples were taken at different time points of follow-up (baseline, 1 week, 2 weeks, 1 month, 3 months and 6 months) to measure the serum canine prostate specific esterase (CPSE). MRI examinations were also performed to document the prostate volume (PV) before and after interventions at different time points of follow-up. Prostates were harvested at 2 weeks (n=2) in the PAO-group, and the remaining ones (n=8) at 6 months for the determinations of intraprostatic testosterone and dihydrotestosterone (DHT) by ELISA, apoptosis by TUNEL assay and histopathological study. RESULTS: The mean serum CPSE concentration started to decrease significantly from 2 weeks to 6 months after PAO along with PV compared with baseline data. In addition, a moderate but significant correlation was observed between CPSE and PV (r=0.655, P=0.000). Regarding intraprostatic androgens, testosterone was significantly higher after PAO than control (19.70 vs. 4.87 ng/mL, P=0.002), whereas DHT was lower but no significant (112.52 vs. 138.35 pg/mL, P=0.144). In histological study, PAO induced a severe hemorrhagic necrosis in the whole prostates along with inflammatory cell infiltration at early 2 weeks, and then diffuse interstitial fibrosis with atrophy of the glandular epithelium and intraprostatic cavity formation at 6 months. Apoptosis was detected in all specimens with higher apoptotic index after PAO at 2 weeks (7.35%) and at 6 months (4.38%) compared with control (2.64%), without statistically significant difference between groups. CONCLUSIONS: PAO induces hemorrhagic ischemia predominantly resulting in necrosis rather than apoptosis with prostate shrinkage. CPSE is a potential biomarker to assess the response to PAO in the canine prostate. |
format | Online Article Text |
id | pubmed-9827397 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-98273972023-01-10 Prostatic artery occlusion: initial findings on pathophysiological response in a canine prostate model Lucas-Cava, Vanesa Sánchez-Margallo, Francisco Miguel Moreno-Lobato, Beatriz Dávila-Gómez, Luis Lima-Rodríguez, Juan Rafael García-Martínez, Virginio López-Sánchez, Carmen Sun, Fei Transl Androl Urol Original Article BACKGROUND: Prostatic artery embolization (PAE) is an alternative treatment for symptomatic benign prostatic hyperplasia (BPH) in men. A technical modification of conventional PAE has been developed in a canine prostate model consisting of prostatic artery occlusion (PAO) using Onyx(®) whose therapeutic effect is prostate shrinkage. However, the underlying mechanisms are not well clarified. The purpose was to evaluate the biological mechanisms responsible for therapeutic effects of PAO in the canine prostate. METHODS: Ten adult male beagles (5.0±0.82 years) underwent PAO with Onyx-18 (n=7) and prostatic artery angiography as control (n=3). Blood samples were taken at different time points of follow-up (baseline, 1 week, 2 weeks, 1 month, 3 months and 6 months) to measure the serum canine prostate specific esterase (CPSE). MRI examinations were also performed to document the prostate volume (PV) before and after interventions at different time points of follow-up. Prostates were harvested at 2 weeks (n=2) in the PAO-group, and the remaining ones (n=8) at 6 months for the determinations of intraprostatic testosterone and dihydrotestosterone (DHT) by ELISA, apoptosis by TUNEL assay and histopathological study. RESULTS: The mean serum CPSE concentration started to decrease significantly from 2 weeks to 6 months after PAO along with PV compared with baseline data. In addition, a moderate but significant correlation was observed between CPSE and PV (r=0.655, P=0.000). Regarding intraprostatic androgens, testosterone was significantly higher after PAO than control (19.70 vs. 4.87 ng/mL, P=0.002), whereas DHT was lower but no significant (112.52 vs. 138.35 pg/mL, P=0.144). In histological study, PAO induced a severe hemorrhagic necrosis in the whole prostates along with inflammatory cell infiltration at early 2 weeks, and then diffuse interstitial fibrosis with atrophy of the glandular epithelium and intraprostatic cavity formation at 6 months. Apoptosis was detected in all specimens with higher apoptotic index after PAO at 2 weeks (7.35%) and at 6 months (4.38%) compared with control (2.64%), without statistically significant difference between groups. CONCLUSIONS: PAO induces hemorrhagic ischemia predominantly resulting in necrosis rather than apoptosis with prostate shrinkage. CPSE is a potential biomarker to assess the response to PAO in the canine prostate. AME Publishing Company 2022-12 /pmc/articles/PMC9827397/ /pubmed/36632152 http://dx.doi.org/10.21037/tau-22-423 Text en 2022 Translational Andrology and Urology. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Lucas-Cava, Vanesa Sánchez-Margallo, Francisco Miguel Moreno-Lobato, Beatriz Dávila-Gómez, Luis Lima-Rodríguez, Juan Rafael García-Martínez, Virginio López-Sánchez, Carmen Sun, Fei Prostatic artery occlusion: initial findings on pathophysiological response in a canine prostate model |
title | Prostatic artery occlusion: initial findings on pathophysiological response in a canine prostate model |
title_full | Prostatic artery occlusion: initial findings on pathophysiological response in a canine prostate model |
title_fullStr | Prostatic artery occlusion: initial findings on pathophysiological response in a canine prostate model |
title_full_unstemmed | Prostatic artery occlusion: initial findings on pathophysiological response in a canine prostate model |
title_short | Prostatic artery occlusion: initial findings on pathophysiological response in a canine prostate model |
title_sort | prostatic artery occlusion: initial findings on pathophysiological response in a canine prostate model |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9827397/ https://www.ncbi.nlm.nih.gov/pubmed/36632152 http://dx.doi.org/10.21037/tau-22-423 |
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