Serenoa repens for benign prostatic hyperplasia

Center for Chronic Disease Outcomes Research (111-0), Minneapolis Veterans Affairs Medical Center, One Veterans Drive, Minneapolis, MN 55417, USA.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 04/2009; 2(2):CD001423. DOI: 10.1002/14651858.CD001423.pub2
Source: PubMed


Benign prostatic hyperplasia (BPH) is the nonmalignant enlargement of the prostate gland that is caused by an increase in volume of epithelial (top layer of tissue that line cavities and surfaces of the body) and stromal (connective tissue) cells. This increase in cells can, over time, create fairly large, discrete nodules in the periurethral region of the prostate, and in turn can restrict the urethral canal causing partial or complete blockage. The use of plants and herbs (phytotherapy) for the treatment of lower urinary tract symptoms associated with BPH is common and has been growing steadily in most Western countries. The extract of the berry of the American saw palmetto, or dwarf palm plant, Serenoa repens (SR), which is also known by its botanical name of Sabal serrulatum, is one of several phytotherapeutic agents available for the treatment of BPH. The update of this review included 32 randomized controlled trials involving 5666 men. Compared with placebo, Serenoa repens, at double and triple the usual dose, provides no improvement for nocturia, peak urine flow, and symptom scores for men with benign prostatic hyperplasia.

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Available from: James Tacklind,
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    • "reported positive effects on urinary tract symptoms and flow measurements. On the contrary, a review carried out by Tacklind et al. (2009) concluded that saw palmetto did not improve urinary flow or prostate size. The difference may be the consequence of two high-quality, large-scale, long-term follow-up clinical trials that Tacklind and coworkers discussed in their review. "
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    ABSTRACT: Benign prostate hyperplasia (BPH) is a common condition affecting older men, with an incidence that is age-dependent. Histological BPH, which typically develops after the age of 40 years, ranges in prevalence from >50% at 60 years to as high as 90% by 85 years of age. Typical symptoms include increased frequency of urination, nocturia, urgency, hesitancy, and weak urine stream. Conventional medicines used for the treatment of BPH include alpha blockers and 5-alpha reductase inhibitors. This articles review the mode of action, the efficacy, and the safety, including herb-drug interactions of the most common botanicals (Serenoa repens, Pygeum africanum, Urtica dioica, and Cucurbita pepo) and nutraceuticals (isoflavones, lycopene, selenium, and β-Sitosterol) in controlling the lower urinary tract symptoms associated to BPH. Copyright © 2013 John Wiley & Sons, Ltd.
    Phytotherapy Research 07/2014; 28(7). DOI:10.1002/ptr.5084 · 2.66 Impact Factor
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    • "Phytotherapeutic supplements, mainly based on Saw Palmetto-derived Serenoa Repens (SeR), are numerous and used frequently; however, data supporting efficacy are limited, making treatment recommendations difficult [12]. SeR is often associated with other natural compounds such as Lycopene (Ly), a carotenoid, and Selenium (Se), an essential trace element, to maximize its therapeutic activity in BPH [13]. "
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    ABSTRACT: The apoptosis machinery is a promising target against benign prostatic hyperplasia (BPH). Inhibitors of apoptosis proteins (IAPs) modulate apoptosis by direct inhibition of caspases. Serenoa Repens (SeR) may be combined with other natural compounds such as Lycopene (Ly) and Selenium (Se) to maximize its therapeutic activity in BPH. We investigated the effects of SeR, Se and Ly, alone or in association, on the expression of four IAPs, cIAP-1, cIAP-2, NAIP and survivin in rats with experimental testosterone-dependent BPH. Moreover, caspase-3, interleukin-6 (IL-6) and prostate specific membrane antigen (PSMA) have been evaluated.Rats were administered, daily, with testosterone propionate (3 mg/kg/sc) or its vehicle for 14 days. Testosterone injected animals (BPH) were randomized to receive vehicle, SeR (25 mg/kg/sc), Se (3 mg/kg/sc), Ly (1 mg/kg/sc) or the SeR-Se-Ly association for 14 days. Animals were sacrificed and prostate removed for analysis. BPH animals treated with vehicle showed unchanged expression of cIAP-1 and cIAP-2 and increased expression of NAIP, survivin, caspase-3, IL-6 and PSMA levels when compared with sham animals. Immunofluorescence studies confirmed the enhanced expression of NAIP and survivin with a characteristic pattern of cellular localization. SeR-Se-Ly association showed the highest efficacy in reawakening apoptosis; additionally, this therapeutic cocktail significantly reduced IL-6 and PSMA levels. The administration of SeR, Se and Ly significantly blunted prostate overweight and growth; moreover, the SeR-Se-Ly association was most effective in reducing prostate enlargement and growth by 43.3% in treated animals. The results indicate that IAPs may represent interesting targets for drug therapy of BPH.
    Journal of Biomedical Science 03/2014; 21(1):19. DOI:10.1186/1423-0127-21-19 · 2.76 Impact Factor
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    • "Serenoa repens or saw palmetto is a fan palm, extracts of which are used in alternative medicine for the treatment of benign prostatic hyperplasia [41]. An in vitro study has demonstrated that Serenoa repens is a potent inhibitor of CYP enzymes 3A4, 2D6, and 2C9 [32]; however, a small study conducted in 12 healthy volunteers failed to demonstrate changes in CYP enzyme activity after multiple doses of Serenoa repens [42]. "
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    ABSTRACT: Cyclosporine (CyA) is a well-known immunosuppressant with a narrow therapeutic window. Its bioavailability is affected by many other traditional drugs and herbal extracts. Cytochrome P-450 isoenzymes CYP3A4 and CYP3A5 and protein P-glycoprotein (P-gp) are involved in CyA bioavailability. Interactions of CyA with herbal extracts are not well known, but, given their increased concomitant use, it is important to know which extracts, many of which are commonly self-prescribed, can affect CyA blood concentrations. Decreased CyA blood concentration has been shown with St John’s wort in case reports and, in vivo animal studies, with ginger, liquorice, scutellariae radix, and quercetin. Increased CyA concentration has been reported in patients with grapefruit juice, chamomile, or berberine, and with cannabidiol or resveratrol in animal studies. Effects of Echinacea and Serenoa repens on CyA levels have not been shown consistently, but concomitant use should be avoided. Although findings from animal studies cannot be directly translated into humans, avoiding concomitant use of herbal extracts is prudent until human clinical studies have ruled out any possible interaction. Clinicians should interview their patients carefully about their use of herbal supplements before CyA administration, and those receiving CyA should be warned about possible interactions between herbal preparations and CyA.
    Journal of Toxicology 01/2014; 2014(4):145325. DOI:10.1155/2014/145325
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