Departments of Urology Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands.
What's known on the subject? and What does the study add? The male steroid hormone metabolism is an important target in the treatment of prostatic diseases. However, present literature is inconsistent about intraprostatic concentrations of steroid hormones and the role of intraprostatic steroid hormones in the arise and the course of prostatic disease is yet to be determined. Part I of this two-piece reviews the different methods of steroid hormone measurement and gives an overview of steroid hormone concentrations in normal and diseased prostatic tissue. More accurate methods of measurement and increased knowledge of androgenic steroid hormonal pathways of the prostate could lead to better treatment of prostatic diseases. Owing to inconsistencies and methodological differences, the present peer-reviewed literature lacks conclusive data on the intraprostatic levels of androgens, in particular dihydrotestosterone (DHT), in untreated benign prostatic hyperplasia (BPH) and prostate cancer. To date, no difference has been shown between DHT concentrations in normal prostatic tissue and BPH, and nor has a difference been shown in DHT concentrations between the histologically distinct regions of the prostate. Recent literature has also failed to show a consistent difference in androgen level between BPH and prostate cancer. The role of intraprostatic DHT in the pathogenesis of BPH and in the initiation and progression of prostate cancer thus remains to be established. Increased knowledge of the mechanisms of the androgenic steroid pathways in prostatic diseases, with a special focus on intraprostatic androgen levels may lead to more optimized and more personalized forms of treatment, and probably new therapeutic targets as well.
van der Sluis TM, Vis AN, van Moorselaar RJ, Bui HN, Blankenstein MA, Meuleman EJ, Heijboer AC. Are you the author?
Reference: BJU Int. 2011 Oct 12. Epub ahead of print.