5‐Alpha reductase inhibitors induce a prostate luminal to club cell transition in human benign prostatic hyperplasia. Joseph, D. B, Henry, G. H, Malewska, A., Reese, J. C, Mauck, R. J, Gahan, J. C, Hutchinson, R. C, Mohler, J. L, Roehrborn, C. G, & Strand, D. W The Journal of Pathology, 256(4):427–441, April, 2022.
5‐Alpha reductase inhibitors induce a prostate luminal to club cell transition in human benign prostatic hyperplasia [link]Paper  doi  abstract   bibtex   
Abstract Benign prostatic hyperplasia (BPH) is a progressive expansion of peri‐urethral prostate tissue common in aging men. Patients with enlarged prostates are treated with 5‐alpha reductase inhibitors (5ARIs) to shrink prostate volume by blocking the conversion of testosterone to dihydrotestosterone (DHT). A reduction in DHT levels can elicit atrophy and apoptosis of prostate secretory luminal cells, which results in a favorable clinical response characterized by improved lower urinary tract symptoms. However, the histologic response to 5ARI treatment is often heterogeneous across prostate acini and lower urinary tract symptoms can persist to require surgical intervention. We used two spatial profiling approaches to characterize gene expression changes across histologically normal and atrophied regions in prostates from 5ARI‐treated men. Objective transcriptomic profiling using the Visium spatial gene expression platform showed that 5ARI‐induced atrophy of prostate luminal cells correlated with reduced androgen receptor signaling and increased expression of urethral club cell genes including LTF , PIGR , OLFM4 , SCGB1A1 , and SCGB3A1 . Prostate luminal cells within atrophied acini adapted to decreased DHT conditions by increasing NF‐κB signaling and anti‐apoptotic BCL2 expression, which may explain their survival. Using GeoMx digital spatial profiling with a probe set to assess ~18 000 RNA targets, we confirmed that atrophied acini expressing SCGB3A1 displayed higher levels of club cell markers compared with histologically normal acini with NKX3‐1 expression. In addition, club‐like cells within regions of 5ARI‐induced atrophy closely resembled true club cells from the prostatic urethra. A comparison of histologically normal regions from 5ARI‐treated men and histologically normal regions from untreated men revealed few transcriptional differences. Taken together, our results describe a heterogeneous response to 5ARI treatment where cells in atrophied acini undergo an adaptation from a prostate secretory luminal to a club cell‐like state in response to 5ARI treatment. © 2021 The Pathological Society of Great Britain and Ireland.
@article{joseph_5alpha_2022,
	title = {5‐{Alpha} reductase inhibitors induce a prostate luminal to club cell transition in human benign prostatic hyperplasia},
	volume = {256},
	issn = {0022-3417, 1096-9896},
	url = {https://pathsocjournals.onlinelibrary.wiley.com/doi/10.1002/path.5857},
	doi = {10.1002/path.5857},
	abstract = {Abstract
            
              Benign prostatic hyperplasia (BPH) is a progressive expansion of peri‐urethral prostate tissue common in aging men. Patients with enlarged prostates are treated with 5‐alpha reductase inhibitors (5ARIs) to shrink prostate volume by blocking the conversion of testosterone to dihydrotestosterone (DHT). A reduction in DHT levels can elicit atrophy and apoptosis of prostate secretory luminal cells, which results in a favorable clinical response characterized by improved lower urinary tract symptoms. However, the histologic response to 5ARI treatment is often heterogeneous across prostate acini and lower urinary tract symptoms can persist to require surgical intervention. We used two spatial profiling approaches to characterize gene expression changes across histologically normal and atrophied regions in prostates from 5ARI‐treated men. Objective transcriptomic profiling using the Visium spatial gene expression platform showed that 5ARI‐induced atrophy of prostate luminal cells correlated with reduced androgen receptor signaling and increased expression of urethral club cell genes including
              LTF
              ,
              PIGR
              ,
              OLFM4
              ,
              SCGB1A1
              , and
              SCGB3A1
              . Prostate luminal cells within atrophied acini adapted to decreased DHT conditions by increasing NF‐κB signaling and anti‐apoptotic
              BCL2
              expression, which may explain their survival. Using GeoMx digital spatial profiling with a probe set to assess {\textasciitilde}18 000 RNA targets, we confirmed that atrophied acini expressing
              SCGB3A1
              displayed higher levels of club cell markers compared with histologically normal acini with
              NKX3‐1
              expression. In addition, club‐like cells within regions of 5ARI‐induced atrophy closely resembled true club cells from the prostatic urethra. A comparison of histologically normal regions from 5ARI‐treated men and histologically normal regions from untreated men revealed few transcriptional differences. Taken together, our results describe a heterogeneous response to 5ARI treatment where cells in atrophied acini undergo an adaptation from a prostate secretory luminal to a club cell‐like state in response to 5ARI treatment. © 2021 The Pathological Society of Great Britain and Ireland.},
	language = {en},
	number = {4},
	urldate = {2024-08-14},
	journal = {The Journal of Pathology},
	author = {Joseph, Diya B and Henry, Gervaise H and Malewska, Alicia and Reese, Jeffrey C and Mauck, Ryan J and Gahan, Jeffrey C and Hutchinson, Ryan C and Mohler, James L and Roehrborn, Claus G and Strand, Douglas W},
	month = apr,
	year = {2022},
	pages = {427--441},
}

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