Importance of Apelin in Prostate Hyperplasia and Effects of 5 Alpha Reductase on this Mechanism

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AIM: Apelin is a regulatory peptide that exerts its effects through the G protein-coupled APJ receptor (APJ-R), expressed across various organs. Studies on apelin in the male reproductive system remain limited. Adenomyomatous hyperplasia (AH) and related lower urinary tract symptoms become more prevalent with age. Similar to other sex organs, the prostate is highly responsive to hormones and growth factors. Dihydrotestosterone influences apoptosis and proliferation through intracellular androgen receptors, whereas 5α reductase inhibitors serve therapeutic and haemostatic purposes. This study aims to determine whether Apelin exerts differential effects on apoptosis and angiogenesis in the prostate tissues of AH and treated AH cases. MATERIAL AND METHODS: Cases diagnosed with adenomyomatous hyperplasia through prostatectomy and/or prostate transurethral resection (TUR) material between 2011 and 2013, either treated with (treatment-G) or without 5α-reduction inhibitor therapy (Adeno-G group), were included in the study. In addition, cases diagnosed in 2023 with benign prostate tissue via tru-cut biopsy (Benign-G) were incorporated. Paraffin-embedded tissue blocks from these cases were stained immunohistochemically using apelin antibody and evaluated under a light microscope. RESULTS: = 0.006). The Benign and Adeno groups exhibited similar positive/negative distributions (37.0% vs. 63.0% and 33.3% vs. 66.7%, respectively), whereas negative staining predominated in the treatment group (84.8%). CONCLUSIONS: The significant decrease in apelin levels in the treatment group, along with the apparent relationship between 5dihydrotestosterone (HT) levels and apelin, suggests a potential broader relevance beyond benign cases.