非那雄胺对增生前列腺组织细胞外基质的影响

Influence of Finasteride on Extracellular Matrix in Benign Prostate Hyperplasia Patients and Its Mechanism

目的评价非那雄胺对良性前列腺增生(benign prostate hyperplasia,BPH)细胞外基质(extracellularmatrixc,ECM)的影响,并探讨其作用机制。方法 2008年6月2009年3月选择具备手术指征的BPH患者20例,按入院顺序随机分为非那雄胺组和安慰剂组。服药4周后,行经尿道前列腺切除术(transurethral resection prostate,TURP),留取组织标本。另取正常前列腺标本6例,用免疫组织化学法结合图像分析系统研究正常组、安慰剂组和非那雄胺组前列腺组织纤维连接蛋白(FN)、胶原(CL)、基质金属蛋白酶2(MMP-2)、金属蛋白酶组织抑制因子2(TIMP-2)的阳性表达。结果安慰剂组前列腺组织的FN、CL的阳性表达较正常组增强(P<0.01),MMP-2/TIMP-2差异无统计学意义(P>0.05);非那雄胺组与安慰剂组相比,FN、CL的阳性表达减弱(P<0.01),而MMP-2/TIMP-2增高(P<0.01)。结论非那雄胺能降低BPH组织ECM成分,避免其沉积,其作用机制可能与其促进ECM降解有关。

Objective To evaluate influence of finasteride on extracellular matrix（ECM） in benign prostate hyperplasia（BPH） patients and study the mechanism.Methods Twenty BPH patients needing surgery were randomly divided into 2 groups according to the sequence of hospitalization from June 2008 to March 2009.The finasteride group and the placebo group had 10 patients each.Transurethral resection prostate（TURP） were performed and the specimens were collected after 4 weeks of drug administration.Moreover,6 normal prostatic tissues were selected.Expressions of fibronectin（FN）,collagen（CL）,matrix metalloproteinase-2（MMP-2） and tissue inhibitor of metalloproteinase-2（TIMP-2） were studied in prostatic tissues in all groups（including the normal group） by immunohistochemistry and image analysis system.Results Expressions of FN and CL were significantly higher than those in the normal group（P0.01）,while expressions of MMP-2 and TIMP-2 were not significantly different between them（P0.05）.Compared with the placebo group,expressions of FN and CL in the finateride group were significantly lower than the placebo group（P0.01）,while expressions of MMP-2 and TIMP-2 were significantly higher（P0.01）.Conclusions BPH is related to ECM depositing.Finasteride can decrease ECM of BPH and refrain it from depositing.Possibly,the principle is that finasteride can promote the degradation of ECM.