Clinical perspective on apoptosis in the management of the BPH patient

BACKGROUND. Traditionally, alpha (1)-adrenoceptor (AR) antagonists have bee n assumed to produce clinical benefit by an exclusive action an the tone of the periurethral stromal smooth muscle. However, recent evidence has emerg ed of additional intra- and extraprostatic actions. METHODS. This article attempts to put into clinical context the recently de scribed effects of certain alpha (1)-AR on prostate cell dynamics (i.e., pr oliferation and apoptosis). RESULTS AND CONCLUSIONS. There is good evidence that certain alpha (1)-AR a ntagonists, in addition to affecting stromal smooth muscle, have effects on prostatic apoptosis that contribute to the overall clinical profile. Furth ermore, this is not a class effect and may be restricted to balanced quinaz oline alpha blockers (BQABs), such as terazosin. Prostate Supplement 9:47-5 0, 2000. (C) 2000 Wiley-Liss, Inc.