Article
Highly Concentrated β-Sitosterol Inhibits Human Prostate Smooth Muscle Contraction: The Rise of Phytotherapy in LUTS/BPH
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Published: | November 20, 2024 |
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Introduction: Recently, DGU and EAU recommended phytotherapeutics in their guidelines on management of non-neurogenic male LUTS [1]. While production techniques and plant extracts differ between manufacturers and their countries of origin, phytosterols seem to be the smallest common denominator of phytotherapeutics available for LUTS/BPH [1], [2]. We therefore investigated the effects of highly-concentrated phytosterol (β-Sitosterol) on human prostate smooth muscle contraction.
Methods: Apoprostat® forte capsules (>80% β-Sitosterol) were dissolved in ethanol (10ml ethanol/capsule). Prostate tissues were obtained from patients undergoing radical prostatectomy for prostate cancer (n=100 patients). Contractility of tissue strips was assessed in an organ bath and normalized to KCl [1], [2], [3]. Percentages of inhibition reflect area under the curve (AUC) for treatment vs. solvent.
Results: Apoprostat® forte (30, 10, and 3µg/ml) concentration-dependently inhibited α1-adrenergic contractions up to 57%, 71%, and 69% for noradrenaline (A-C), phenylephrine (D-F), and methoxamine (G-I), and non-adrenergic contractions up to 69% and 46% for thromboxane A2-analogue U46619 (J-L) and endothelin-1 (M-O) vs. control (ethanol), respectively. Electric field stimulation-induced neurogenic contractions were inhibited up to 63% (P-R).
Figure 1 [Fig. 1]
Conclusion: Phytoestrogen β-Sitosterol inhibits prostatic contraction, which may contribute to low prevalence of LUTS/BPH in Asia [2]. Using the highest concentrate of β-Sitosterol available on the German market, our results provide a powerful basis explaining the in-vivo-efficacy of phytotherapeutics for LUTS/BPH [1].
Conflict of interest: As part of study participation, paid lectures and advisory board activities, the authors have contacts with the following companies:
- Merck
- Trovagene
- MSD
- Pfizer
- Apogepha
- Cardiff Oncology
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