Background: Several parameters including inflammatory mediators, hormones, dietary factors, inflammatory genes, and oxidative stress (OS) have been considered to play a role in the development of benign prostatic hyperplasia (BPH). Prostate tissue damage and OS may lead to compensatory cellular proliferation with resulting hyperplastic growth. Methods: We searched MEDLINE for articles in English published up to March 2014 using the key words ‘oxidative stress', ‘antioxidants' and ‘benign prostatic hyperplasia'. Results: Prostatic inflammation can cause the generation of free radicals. The extent of oxidative damage can be exacerbated by a decreased efficiency of antioxidant defense mechanisms. The balance between OS and the antioxidant component also has a role in developing prostate disease. Several works show the role of oxidant products and of depletion of antioxidant substances in BPH patients. It is accepted that free radicals play a role in carcinogenesis and that BPH should be considered a premalignant condition which may evolve into prostate cancer. High OS parameters and low antioxidant activity are more prominent in prostate cancer patients compared with BPH and controls. Conclusions: Further studies are needed to clarify the potential role of antioxidants in BPH also in view of preventing the progression to prostate cancer.

Keywords:
Antioxidants, Benign prostatic hyperplasia, Oxidative stress
1.
Djavan B, Margreiter M, Dianat SS: An algorithm for medical management in male lower urinary tract symptoms. Curr Opin Urol 2011;21:5-12.
2.
Ahmad M, Suhail N, Mansoor T, Banu N, Ahmad S: Evaluation of oxidative stress and DNA damage in benign prostatic hyperplasia patients and comparison with controls. Indian J Clin Biochem 2012;27:385-388.
3.
Bostanci Y, Kazzazi A, Momtahen S, Laze J, Djavan B: Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol 2013;23:5-10.
4.
Kullisaar T, Türk S, Punab M, Mändar R: Oxidative stress - cause or consequence of male genital tract disorders? Prostate 2012;72:977-983.
5.
Hamid AR, Umbas R, Mochtar CA: Recent role of inflammation in prostate diseases: chemoprevention development opportunity. Acta Med Indones 2011;43:59-65.
6.
Chughtai B, Lee R, Te A, Kaplan S: Role of inflammation in benign prostatic hyperplasia. Rev Urol 2011;13:147-150.
7.
Sciarra A, Mariotti G, Salciccia S, Gomez AA, Monti S, Toscano V, et al: Prostate growth and inflammation. J Steroid Biochem Mol Biol 2008;108:254-260.
8.
Wong CP, Bray TM, Ho E: Induction of proinflammatory response in prostate cancer epithelial cells by activated macrophages. Cancer Lett 2009;276:38-46.
9.
Yang B, Wagner J, Damaschke N, Yao T, Wuerzberger-Davis SM, Lee MH, et al: A novel pathway links oxidative stress to loss of insulin growth factor-2 (IGF2) imprinting through NF-κB activation. PLoS One 2014;9:e88052.
10.
Baltaci S, Orhan D, Cogus C, Turkolmez K, Tulunay O, Gogus O: Inducible nitric oxide synthase expression in BPH, low and high grade PIN and prostate carcinoma. BJU Int 2001;88:100-103.
11.
Gradini R, Realacci M, Ginepri A, Naso G, Santangelo C, Cela O, et al: Nitric oxide synthases in normal and benign hyperplastic human prostate: immunohistochemistry and molecular biology. J Pathol 1999;189:224-229.
12.
Wang W, Bergh A, Damber JE: Chronic inflammation in benign prostate hyperplasia is associated with focal upregulation of cyclooxygenase-2, Bcl-2, and cell proliferation in the glandular epithelium. Prostate 2004;61:60-72.
13.
Palapattu GS, Sutcliffe S, Bastain PJ, Platz EA: Prostate carcinogenesis and inflammation: emerging insights. Carcinogenesis 2004;26:1170-1181.
14.
Sugar LM: Inflammation and prostate cancer. Can J Urol 2006;13(suppl 1):46-47.
15.
Tsujii M, DuBois RN: Alterations in cellular adhesion and apoptosis in epithelial cells overexpressing prostaglandin endoperoxide synthase 2. Cell 1995;83:493-501.
16.
Di Silverio F, Bosman C, Salvatori M, Albanesi L, Proietti, Pannunzi L, et al: Combination therapy with rofecoxib and finasteride in the treatment of men with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Eur Urol 2005;47:72-78.
17.
Arsova-Sarafinovska Z, Eken A, Matevska N, Erdem O, Sayal A, Savaser A, et al: Increased oxidative/nitrosative stress and decreased antioxidant enzyme activities in prostate cancer. Clin Biochem 2009;42:1228-1235.
18.
Dotan Y, Lichtenberg D, Pinchuk I: Lipid peroxidation cannot be used as a universal criterion of oxidative stress. Prog Lipid Res 2004;43:200-207.
19.
Meagher EA, FitzGerald GA: Indices of lipid peroxidation in vivo: strengths and limitations. Free Radic Biol Med 2000;28:1745-1750.
20.
Pace G, Di Massimo C, De Amicis D, Corbacelli C, Di Renzo L, Vicentini C, et al: Oxidative stress in benign prostatic hyperplasia and prostate cancer. Urol Int 2010;85:328-333.
21.
Aydin A, Arsova-Sarafinovska Z, Sayal A, Eken A, Erdem O, Erten K, et al: Oxidative stress and antioxidant status in non-metastatic prostate cancer and benign prostatic hyperplasia. Clin Biochem 2006;39:176-179.
22.
Goswami K, Nandeesha H, Koner BC, Nandakumar DN: A comparative study of serum protein-bound sialic acid in benign and malignant prostatic growth: possible role of oxidative stress in sialic acid homeostasis. Prostate Cancer Prostatic Dis 2007;10:356-359.
23.
Merendino RA, Salvo F, Saija A, Di Pasquale G, Tomaino A, Minciullo PL, et al: Malondialdehyde in benign prostate hypertrophy: a useful marker? Mediators Inflamm 2003; 12:127-128.
24.
Srivastava DS, Mittal RD: Free radical injury and antioxidant status in patients with benign prostate hyperplasia and prostate cancer. Indian J Clin Biochem 2005;20:162-165.
25.
Aryal M, Pandeya A, Das BK, Lamsal M, Majhi S, Pandit R, et al: Oxidative stress in patients with benign prostate hyperplasia. J Nepal Med Assoc 2007;46:103-106.
26.
Almushatat AS, Talwar D, McArdle PA, Williamson C, Sattar N, O'Reilly DS, et al: Vitamin antioxidants, lipid peroxidation and the systemic inflammatory response in patients with prostate cancer. Int J Cancer 2006;118:1051-1053.
27.
Montuschi P, Barnes P, Roberts LJ II: Insights into oxidative stress: the isoprostanes. Curr Med Chem 2007;14:703-717.
28.
Savas M, Verit A, Ciftci H, Yeni E, Aktan E, Topal U, et al: Oxidative stress in BPH. J Nepal Med Assoc 2009;48:41-45.
29.
Jones KJ, Chetram MA, Bethea DA, Bryant LK, Odero-Marah V, Hinton CV: Cysteine (C)-X-C receptor 4 regulates NADPH oxidase-2 during oxidative stress in prostate cancer cells. Cancer Microenviron 2013, Epub ahead of print.
30.
Doğru-Abbasoğlu S, Aykaç-Toker G, Koçak T, Unlüer E, Uysal M: Antioxidant enzyme activities and lipid peroxides in the plasma of patients with benign prostatic hyperplasia or prostate cancer are not predictive. J Cancer Res Clin Oncol 1999;125:402-404.
31.
Khandrika L, Kumar B, Koul S, Marone P, Koul HK: Oxidative stress in prostate cancer. Cancer Lett 2009;282:125-136.
32.
Olinski R, Zastawny TH, Foksinski M, Barecki A, Dizdaroglu M: DNA base modifications and antioxidant enzyme activities in human benign prostatic hyperplasia. Free Radic Biol Med 1995;18:807-813.
33.
Ntais C, Polycarpou A, Ioannidis JP: Association of GSTM1, GSTT1, and GSTP1 gene polymorphisms with the risk of prostate cancer: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2005;14:176-181.
34.
Rebbeck TR: Molecular epidemiology of the human glutathione S-transferase genotypes GSTM1 and GSTT1 in cancer susceptibility. Cancer Epidemiol Biomarkers Prev 1997;6:733-743.
35.
Mittal RD, Kesarwani P, Singh R, Ahirwar D, Mandhani A: GSTM1, GSTM3 and GSTT1 gene variants and risk of benign prostate hyperplasia in North India. Dis Markers 2009;26:85-91.
36.
Kumar V, Yadav CS, Datta SK, Singh S, Ahmed RS, Goel S, et al: Association of GSTM1 and GSTT1 polymorphism with lipid peroxidation in benign prostate hyperplasia and prostate cancer: a pilot study. Dis Markers 2011;30:163-169.
37.
Eichholzer M, Steinbrecher A, Kaaks R, Teucher B, Linseisen J, Rohrmann S: Effects of selenium status, dietary glucosinolate intake and serum glutathione S-transferase α activity on the risk of benign prostatic hyperplasia. BJU Int 2012;110:E879-E885.
38.
Zachara BA, Szewczyk-Golec K, Tyloch J, Wolski Z, Szylberg T, Stepien S, et al: Blood and tissue selenium concentrations and glutathione peroxidase activities in patients with prostate cancer and benign prostate hyperplasia. Neoplasma 2005;52:248-254.
39.
Winkler BS, Orselli SM, Rex TS: The redox couple between glutathione and ascorbic acid: a chemical and physiological perspective. Free Radic Biol Med 1994;17:333-349.
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2014
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