Korean J Androl.  2012 Apr;30(1):1-12. 10.5534/kja.2012.30.1.1.

5alpha-Reductase

Affiliations
  • 1Park's Urologic Clinic, Changwon, Korea.
  • 2Department of Urology, Dongguk University College of Medicine, Seoul, Korea.
  • 3Department of Urology, Seoul National University College of Medicine, Seoul, Korea. jspaick@snu.ac.kr

Abstract

Androgen acts via the androgen receptor and can play a critical role in the development and growth of the prostate and the pathophysiology of prostatic diseases. Testosterone is the most abundant circulating androgen and is converted to dihydrotestosterone (DHT), a more potent androgen, by steroid 5alpha-reductase. There are two 5alpha-reductase isoenzymes, type 1 and type 2, in humans and animals. Type 2 5alpha-reductase predominates in the prostate. While deficiency of type 2 5alpha-reductase causes male pseudohermaphroditism, increased DHT has been implicated in benign prostatic hyperplasia and prostate cancer. The aim of this article is to highlight the significance of 5alpha-reductase in the development and growth of the prostate and pathogenesis of prostatic diseases.

Keyword

5alpha-reductase; Sexual development; Prostate; Prostatic hyperplasia; Prostate neoplasms

MeSH Terms

46, XY Disorders of Sex Development
Animals
Dihydrotestosterone
Growth and Development
Humans
Isoenzymes
Prostate
Prostatic Diseases
Prostatic Hyperplasia
Prostatic Neoplasms
Receptors, Androgen
Sexual Development
Testosterone
Dihydrotestosterone
Isoenzymes
Receptors, Androgen
Testosterone

Reference

1). Zhu YS, Katz MD, Imperato-McGinley J. Natural potent androgens: lessons from human genetic models. Baillieres Clin Endocrinol Metab. 1998; 12:83–113.
Article
2). Veltri R, Rodriguez R. Molecular biology, endocrinology, and physiology of the prostate and seminal vesicles. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. editors.Campbell Walsh urology. 9th ed.Philadelphia: Saunders;2006. p. 2677–726.
3). Roehrborn CG, McConnell JD. Benign prostatic hyperplasia: etiology, pathophysiology, epidemiology, and natural history. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. editors.Campbell Walsh urology. 9th ed.Philadelphia: Saunders;2006. p. 2727–65.
4). Imperato-McGinley J, Gautier T, Zirinsky K, Hom T, Palomo O, Stein E, et al. Prostate visualization studies in males homozygous and heterozygous for 5 alpha-reductase deficiency. J Clin Endocrinol Metab. 1992; 75:1022–6.
Article
5). Bartsch G, Rittmaster RS, Klocker H. Dihydrotestosterone and the concept of 5alpha-reductase inhibition in human benign prostatic hyperplasia. Eur Urol. 2000; 37:367–80.
6). Russell DW, Wilson JD. Steroid 5 alpha-reductase: two genes/two enzymes. Annu Rev Biochem. 1994; 63:25–61.
7). Zhu YS, Sun GH. 5α-reductase isozymes in the prostate. J Med Sci. 2005; 25:1–12.
8). Mahendroo MS, Cala KM, Russell DW. 5 alpha-reduced androgens play a key role in murine parturition. Mol Endocrinol. 1996; 10:380–92.
Article
9). Wilson JD. The role of 5alpha-reduction in steroid hormone physiology. Reprod Fertil Dev. 2001; 13:673–8.
10). Iehlé C, Radvanyi F, Gil Diez de Medina S, Ouafik LH, Gérard H, Chopin D, et al. Differences in steroid 5alpha-reductase iso-enzymes expression between normal and pathological human prostate tissue. J Steroid Biochem Mol Biol. 1999; 68:189–95.
11). Thomas LN, Douglas RC, Vessey JP, Gupta R, Fontaine D, Norman RW, et al. 5alpha-reductase type 1 immunostaining is enhanced in some prostate cancers compared with benign prostatic hyperplasia epithelium. J Urol. 2003; 170:2019–25.
12). Habib FK, Ross M, Bayne CW, Bollina P, Grigor K, Chapman K. The loss of 5alpha-reductase type I and type II mRNA expression in metastatic prostate cancer to bone and lymph node metastasis. Clin Cancer Res. 2003; 9:1815–9.
13). Spencer JR, Torrado T, Sanchez RS, Vaughan ED Jr, Imperato-McGinley J. Effects of flutamide and finasteride on rat testicular descent. Endocrinology. 1991; 129:741–8.
Article
14). Prahalada S, Tarantal AF, Harris GS, Ellsworth KP, Clarke AP, Skiles GL, et al. Effects of finasteride, a type 2 5-alpha reductase inhibitor, on fetal development in the rhesus monkey (Macaca mulatta). Teratology. 1997; 55:119–31.
Article
15). Andriole G, Bruchovsky N, Chung LW, Matsumoto AM, Rittmaster R, Roehrborn C, et al. Dihydrotestosterone and the prostate: the scientific rationale for 5alpha-reductase inhibitors in the treatment of benign prostatic hyperplasia. J Urol. 2004; 172:1399–403.
16). Wright AS, Douglas RC, Thomas LN, Lazier CB, Rittmaster RS. Androgen-induced regrowth in the castrated rat ventral prostate: role of 5alpha-reductase. Endocrinology. 1999; 140:4509–15.
17). Park JS, Paick JS. Prostate disease and erectile dysfunction. Park JS, editor. Male sexual dysfunction. 2nd ed.Seoul: Koonja;2008. p. 581–670.
18). Levine AC, Liu XH, Greenberg PD, Eliashvili M, Schiff JD, Aaronson SA, et al. Androgens induce the expression of vascular endothelial growth factor in human fetal prostatic fibroblasts. Endocrinology. 1998; 139:4672–8.
19). Hayek OR, Shabsigh A, Kaplan SA, Kiss AJ, Chen MW, Burchardt T, et al. Castration induces acute vasoconstriction of blood vessels in the rat prostate concomitant with a reduction of prostatic nitric oxide synthase activity. J Urol. 1999; 162:1527–31.
Article
20). McConnell JD, Bruskewitz R, Walsh P, Andriole G, Lieber M, Holtgrewe HL, et al. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group. N Engl J Med. 1998; 338:557–63.
21). McConnell JD, Roehrborn CG, Bautista OM, Andriole GL Jr, Dixon CM, Kusek JW, et al. Medical Therapy of Prostatic Symptoms (MTOPS) Research Group. The longterm effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003; 349:2387–98.
Article
22). Roehrborn CG, Boyle P, Nickel JC, Hoefner K, Andriole G. ARIA3001 ARIA3002 and ARIA3003 Study Investigators. Efficacy and safety of a dual inhibitor of 5-alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology. 2002; 60:434–41.
Article
23). Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Nandy I, et al. CombAT study group. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol. 2010; 57:123–31.
Article
24). Nickel JC, Gilling P, Tammela TL, Morrill B, Wilson TH, Rittmaster RS. Comparison of dutasteride and finasteride for treating benign prostatic hyperplasia: the Enlarged Prostate International Comparator Study (EPICS). BJU Int. 2011; 108:388–94.
Article
25). Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010; 60:277–300.
Article
26). National Cancer Center. Cancer registry system in Korea [Internet]. Goyang: National Cancer Center [cited 2012 January]. Arailable from:. http://www.ncc.re.kr.
27). Makridakis NM, Ross RK, Pike MC, Crocitto LE, Kolonel LN, Pearce CL, et al. Association of mis-sense substitution in SRD5A2 gene with prostate cancer in African-American and Hispanic men in Los Angeles, USA. Lancet. 1999; 354:975–8.
Article
28). Jaffe JM, Malkowicz SB, Walker AH, MacBride S, Peschel R, Tomaszewski J, et al. Association of SRD5A2 genotype and pathological characteristics of prostate tumors. Cancer Res. 2000; 60:1626–30.
29). Homma Y, Kaneko M, Kondo Y, Kawabe K, Kakizoe T. Inhibition of rat prostate carcinogenesis by a 5alpha-reductase inhibitor, FK143. J Natl Cancer Inst. 1997; 89:803–7.
30). Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med. 2003; 349:215–24.
Article
31). Thompson IM, Klein EA, Lippman SM, Coltman CA, Djavan B. Prevention of prostate cancer with finasteride: US/European perspective. Eur Urol. 2003; 44:650–5.
Article
32). Thompson IM, Chi C, Ankerst DP, Goodman PJ, Tangen CM, Lippman SM, et al. Effect of finasteride on the sensitivity of PSA for detecting prostate cancer. J Natl Cancer Inst. 2006; 98:1128–33.
Article
33). Redman MW, Tangen CM, Goodman PJ, Lucia MS, Coltman CA Jr, Thompson IM. Finasteride does not increase the risk of high-grade prostate cancer: a bias-adjusted modeling approach. Cancer Prev Res (Phila). 2008; 1:174–81.
Article
34). Walsh PC. Urological oncology: prostate cancer. J Urol. 2004; 171:506–17.
Article
35). Zaccheo T, Giudici D, Panzeri A, di Salle E. Effect of the 5 alpha-reductase inhibitor PNU 156765, alone or in combination with flutamide, in the Dunning R3327 prostatic carcinoma model in rats. Chemotherapy. 1998; 44:284–92.
36). Lazier CB, Thomas LN, Douglas RC, Vessey JP, Rittmaster RS. Dutasteride, the dual 5alpha-reductase inhibitor, inhibits androgen action and promotes cell death in the LNCaP prostate cancer cell line. Prostate. 2004; 58:130–44.
37). Andriole GL, Bostwick DG, Brawley OW, Gomella LG, Marberger M, Montorsi F, et al. REDUCE study group. Effect of dutasteride on the risk of prostate cancer. N. Engl J Med. 2002; 362:1192–202.
Article
38). Hamilton RJ, Freedland SJ. 5-α reductase inhibitors and prostate cancer prevention: where do we turn now? BMC Med. 2011; 9:105.
Article
39). Theoret MR, Ning YM, Zhang JJ, Justice R, Keegan P, Pazdur R. The risks and benefits of 5α-reductase inhibitors for prostate-cancer prevention. N Engl J Med. 2011; 365:97–9.
Article
40). US Food and Drug Administration: December 1, 2010 Meeting of the Oncologic Drugs Advisory Committee. FDA core presentation: NDA020180/s034: Proscar (finasteride 5mg tablet) [cited 2012 March 27]. Arailable from:. http://www.fda.gov/downloads/Advisory-Committees/CommitteesMeetingMaterials/Drugs/OncologicDrugsAdvisoryCommittee/UCM236786.pdf.
41). Cai LQ, Imperato-McGinley J, Zhu YS. Regulation of prostate 5alpha-reductase-2 gene expression and prostate weight by dietary fat and caloric intake in the rat. Prostate. 2006; 66:738–48.
42). Cai LQ, Cai J, Wu W, Zhu YS. 17α-Estradiol and genistein inhibit high fat diet induced prostate gene expression and prostate growth in the rat. J Urol. 2011; 186:1489–96.
Article
43). Uemura M, Tamura K, Chung S, Honma S, Okuyama A, Nakamura Y, et al. Novel 5 alpha-steroid reductase (SRD5A3, type-3) is overexpressed in hormone-refractory prostate cancer. Cancer Sci. 2008; 99:81–6.
Full Text Links
  • KJA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr