Efficacy of Prunus Domestica Extract in BPH
Condition: BPH
Study type: Interventional
Phase: Phase 4

Summary: 
      Benign prostatic hyperplasia (BPH) is a nonmalignant enlargement of the prostate Prunus
      domestica bark contains three groups of active constituents: phytosterols (including
      beta-sitosterol), pentacyclic triterpenoids (including ursolic and oleaic acids) and ferulic
      esters of long-chain fatty alcohols (including ferulic esters of docosanol and tetracosanol).

      The phytosterols, particularly beta-sitosterol, are found in numerous plants and are
      anti-inflammatory, inhibiting the synthesis of prostaglandins. Beta-sitosterol has been shown
      to be useful in cases of BPH by helping to reduce the normally elevated levels of
      prostaglandins in these patients.
    

Detailed description: 
      Benign prostatic hyperplasia (BPH) is a nonmalignant enlargement of the prostate. Symptoms
      related to BPH are one of the most common problems in older men. Histological evidence of BPH
      is found in more than is approximately 10% for men in their 30s, 20% for men in their 40s,
      reaches 50% to 60% for men in their 60s, and is 80% to 90% for men in their 70s and 80s. The
      majority of men over the age of 60 are considered to have urinary symptoms attributable to
      BPH.

      The proliferative disorder resulting in BPH affects both the stromal and the epithelial
      portions of the prostate. The enlarging prostate results in the progressive occlusion of the
      proximal urethra and can result in both obstructive and irritative urinary tract symptoms.

      The preferred medical treatment for many men with symptomatic benign prostatic hyperplasia is
      either an alpha-adrenergic-receptor antagonist (alpha-blocker), which reduces smooth-muscle
      tone in the prostate, and bladder neck, or a 5α-reductase inhibitor, which reduces prostate
      volume by inducing epithelial atrophy. These drugs have side effects including:-dizziness,
      fatigue, hypotension, headache, insomnia, gynecomastia, and retrograde ejaculation.

      The use of plants and herbs for medicinal purposes (phytotherapy) including treatment of BPH
      symptoms has been growing steadily in most countries. Usage of plant extracts is common in
      many countries of the world and is increasing in the United States. Phytotherapeutic agents
      represent nearly half of the medications dispensed for BPH in Italy, compared with 5% for
      alpha blockers and 5% for 5-alpha reductase inhibitors. In Germany and Austria, phytotherapy
      is the first-line treatment for mild to moderate urinary obstructive symptoms and represents
      > 90% of all drugs prescribed for the treatment of BPH. In the United States their use has
      also markedly increased, they are readily available as nonprescription dietary supplements
      and are often recommended in "natural health food stores or books" for self treatment of BPH
      symptoms.

      Prunus domestica, or European plum, is a small deciduous tree in the Rosaceae (rose) family
      that is an ancient domesticated species, known only in cultivation. It is now cultivated in
      temperate areas worldwide for its fruit.

      Mechanism of action The bark contains three groups of active constituents: phytosterols
      (including beta-sitosterol), pentacyclic triterpenoids (including ursolic and oleaic acids)
      and ferulic esters of long-chain fatty alcohols (including ferulic esters of docosanol and
      tetracosanol).

      The phytosterols, particularly beta-sitosterol, are found in numerous plants and are
      anti-inflammatory, inhibiting the synthesis of prostaglandins. Beta-sitosterol has been shown
      to be useful in cases of BPH by helping to reduce the normally elevated levels of
      prostaglandins in these patients. The elimination of the excess blood and vasal congestion
      helps reduce the size of prostate adenomas. The pentacyclic triterpenoids also help inhibit
      inflammation by blocking enzymatic activity. They are effective anti-edema agents and also
      help increase the integrity of small veins and capillaries. The third active group, the
      ferulic esters of long-chain fatty acids, act by inhibiting the absorption and metabolism of
      cholesterol. BPH and other cases of enlarged prostates are characterized by containing
      abnormally high levels of cholesterol. Plant efficacy was determined by measuring the effects
      of the herb on numerous parameters, including dysuria, nycturia, frequent urination,
      abdominal heaviness, residual urine, voiding volume, prostate volume, and peak flow.
      Consumption of P.Domestica resulted in significant amelioration of symptoms, reduction in
      prostate size, and clearance of bladder neck urethral obstruction.

      Different studies suggest that these phytochemicals appear to work synergistically to improve
      the symptoms of BPH. However, the most bioactive phytochemicals in pygeum are the
      phytosterols. Therefore, these components of pygeum extract are believed to exert the most
      important therapeutic effect in the treatment of BPH.
    

Intervention name(s): Prunus domestica extract
Intervention type(s): Dietary Supplement
Intervention description(s): Prosman 1 capsule twice a day
Other intervention name(s): Prosman
Intervention model: Single Group Assignment
Masking: None (Open Label)
Keywords: BPH; Prunus Domestica extract