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Chronic inflammation is another factor shown to play an important role in the initiation of BPH and many other diseases.(6) Is inflammation a cause or a consequence of BPH? One analysis showed that bacterial and noninfectious chronic prostatitis could represent “inciting” factors leading to tissue hyperproliferation, possibly via the recently demonstrated antigen-presenting capacity of prostatic stromal cells, which enables them to induce and sustain intraglandular immune responses.(7)
According to a major meta-analysis, chronic inflammation appears to be one of these predictive factors. The clinical studies showed a relationship between chronic prostatic inflammation and prostate volume or urinary symptoms. In microscopic studies, numerous inflammatory cells were found to be infiltrating BPH tissues.
Immune cells release cytokines and growth factors that modulate the immune response, but evidence also shows that they promote prostatic cell growth. In addition, prostatic cells themselves are able to secrete inflammatory mediators and stimulate their own growth. Once this vicious circle gets under way, it appears that feedback controls can be overwhelmed, leading to progressive increases in prostate volume.(8)
In another study connecting inflammation with BPH, inflammatory cells were noted in 282 patients treated by surgery for a complicated and/or symptomatic BPH. Inflammatory cells were found to have infiltrated prostate tissues in a majority of the patients, indicating a role for inflammation in the development of BPH based on the incidence of inflammation, prostate volume, and other measures. These findings suggest that progressive prostate enlargement may be strongly influenced by chronic inflammatory processes.(9)
Overall, recent evidence indicates that BPH is a complex disease, but one of the mechanisms leading to prostatic enlargement and urinary symptoms is chronic prostatic inflammation, thus suggesting that inflammation may be a therapeutic target for BPH.