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• Phytohormone, particularly jasmonate (JA) and salicylate (SA) signaling, plays a central role in plant responses to herbivore and pathogen attack. Generally, SA mediates resistance responses against biotrophic pathogens and phloem-feeding insects, while JA mediates responses against necrotrophic pathogens and chewing insects. The phytohormonal responses mediating rice resistance to a piercing-sucking herbivore, the brown planthopper (BPH), remains unknown. • Here, we combined transcriptome analysis, hormone measurements, genetic analysis and a field study to address this issue. • Infestation by BPH adult females resulted in significant transcriptional reprograming. The upregulated genes were enriched in the JA signaling pathway. Consistently, the concentrations of JAs, but not SA, were dramatically increased in response to BPH attack. Two JA-deficient lines (AOC and MYC2 knockout) and two SA-deficient lines (nahG overexpression and NPR1 knockout) were constructed. BPH performed better on JA-deficient lines than on wild-type (WT) plants, but similarly on SA-deficient and WT plants. During BPH attack, the accumulation of defensive secondary metabolites was attenuated in JA-deficient lines compared with WT plants. Moreover, MYC2 mutants were more susceptible to planthoppers than WT plants in nature. • This study reveals that JA signaling functions in rice defense against BPH.

Objectives The objective of this study is to validate a hypothesis that a non‐invasive optical imaging assay targeting genomic VPAC receptors on malignant cells shed in voided urine will represent either benign prostatic hyperplasia (BPH) or prostatic cancer (PCa). Risk for BPH in men 50–70 years old is 50–70% and PCa is 17%. BPH and PCa can coexist in 20% of men with BPH. Most commonly practiced methods to diagnose BPH do not distinguish BPH from PCa. Patients (or Materials) and Methods Males with BPH (N = 97, 60.8 ± 6.3 years, prostate‐specific antigen 0.7 ± 0.4 ng/mL) and without oncologic disease (N = 35, 63.4 ± 5.8 years, prostate‐specific antigen < 1.5 ng/mL) signed informed consent form and provided voided urine. Urine was cytocentrifuged, cells collected on glass slide, fixed, treated with VPAC specific fluorophore TP4303 (Kd 3.1 × 10−8M), washed, incubated with DAPI and observed using a fluorescence microscope. Cells with no VPAC did not fluoresce (BPH) and those with VPAC had red‐orange fluorescence (PCa). Real‐time polymerase chain reaction analyses for VPAC and NKX3.1 assay for cell origin were performed. Results Eighty‐seven subjects were negative for VPAC expression. Positive VPAC expression was noted in 10 subjects. Patient chart review for clinical data on these 10 VPAC positive subjects showed five had nephrolithiasis, three had renal cysts, one had prostatitis and one was being treated with finasteride. Real‐time polymerase chain reaction analysis‐VPAC expressions for 7 normal and 12 BPH subjects were 1.31 ± 1.26 and 0.94 ± 0.89, respectively (P = 0.46). NKX3.1 showed cells of prostate origin for finasteride‐treated patient. Specificity for VPAC urine assay for excluding prostate cancer in this BPH cohort was 88.5%, positive predictive value 0.00% and negative predictive value 100%. Conclusion VPAC assay may contribute extensively for BPH diagnosis and warrant continued investigation.

IntroductionNumerous studies point to a role for the immune system in various animal models of hypertension. However, little is known about the immune system of Bph/2 mice, a spontaneously hypertensive strain.MethodTo address this, we conducted a comprehensive comparison of immune cell composition and response to polyclonal T cell activation in hypertensive Bph/2 mice and normotensive Bpn/3 control mice. We quantified immune cell populations by flow cytometry from spleen and inguinal, brachial and mesenteric lymph nodes.ResultsWhile composition of myeloid immune cell types was largely comparable between strains, we observed differences in B and T cell subpopulations. Specifically, we found an increased percentage of IgM+ IgDLo and IgM+ IgD- B cells in Bph/2 mice, suggesting greater baseline B cell activation or differences in B cell lineage. In addition, we observed a decreased percentage of CD4 effector memory T cells and CD8 central memory T cells. The diminished proportion of memory T cells in Bph/2 mice correlated with decreased proliferation and cytokine response of splenic T cells to polyclonal T cell activation. In splenic T cells from Bph/2 mice 24 h after activation, we observed a pronounced decrease in the majority of T cell cytokines. At 120 h after activation, the Th1 and Th17 cytokine responses of splenic T cells from Bph/2 mice were decreased, but other T cell cytokines were largely comparable between genotypes.Conclusion/DiscussionOverall, the data suggest a decreased percentage of memory T cells in Bph/2 mice that correlates with markedly diminished proliferation and cytokine response to polyclonal activation.

IntroductionIt has been shown that endoscopic enucleation of the prostate (EEP) allows for similar efficacy and safety, no matter what energy and type of instruments we use, but the length of learning may differ greatly. The aim of this systematic review is to verify if there is any significant difference between EEP methods in learning.Evidence acquisitionWe performed a systematic literature search in three databases and included only the articles containing their own data on the EEP learning curve assessment during the last 10 years. The primary endpoint was to determine the necessary experience needed to achieve a plateau. The secondary endpoints were to review methods used to evaluate a learning curve.Evidence synthesisThe final sample included 17 articles, containing a total of 4615 EEPs performed by 76 surgeons, the most common method was HoLEP (9/17). The majority of articles studying HoLEP report a learning curve of experience level achievement in roughly 30–40 (min 20; max 60) cases. The studies of GreenLight laser showed high heterogeneity in the results with minimum of 20 cases and maximum of 150–200 cases. TUEB required roughly 40–50 cases to reach the plateau.ConclusionAlthough EEP is considered challenging, it shows a steep learning curve with a plateau after 30–50 cases. Proper criteria are critical for accurate assessment of the learning curve. The Trifecta and Pentafecta criteria are currently the most appropriate method to evaluate EEP learning.

Isoflavone-rich legumes, including soy, are used for food production, as dietary supplements and in traditional medicine. Soy consumption correlates negatively with benign prostatic hyperplasia (BPH) and voiding symptoms. However, isoflavone effects on the prostate are hardly known. Here, we examined the effects on human prostate smooth muscle contractions and stromal cell growth, which are driving factors of voiding symptoms in BPH. Smooth muscle contractions were induced in prostate tissues from radical prostatectomy. Growth-related functions were studied in cultured stromal cells (WPMY-1). Neurogenic, α1-adrenergic and non-adrenergic contractions were strongly inhibited with 50 µM and by around 50% with 10 µM genistein. Daidzein inhibited neurogenic contractions using 10 and 100 µM. Agonist-induced contractions were inhibited by 100 µM but not 10 µM daidzein. A combination of 6 µM genistein with 5 µM daidzein still inhibited neurogenic and agonist-induced contractions. Proliferation of WPMY-1 cells was inhibited by genistein (>50%) and daidzein (<50%). Genistein induced apoptosis and cell death (by seven-fold relative to controls), while daidzein induced cell death (6.4-fold) without apoptosis. Viability was reduced by genistein (maximum: 87%) and daidzein (62%). In conclusion, soy isoflavones exert sustained effects on prostate smooth muscle contractions and stromal cell growth, which may explain the inverse relationships between soy-rich nutrition, BPH and voiding symptoms.

Uroflowmetry (UF) is a crucial guideline-recommended tool for men with benign prostatic obstruction (BPO). Moreover, UF is a helpful decision-making tool for the management of patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). In the last few years, telemedicine and telehealth have increased exponentially as cost-effective treatment options for both patients and physicians. Telemedicine and telehealth have been well positioned during the COVID-19 pandemic to prevent healthcare system overload and to ensure adequate management of patients through screening, diagnosis, and follow-up at home. In the present manuscript, the main characteristics and performance of a novel and low-cost device for home-based UF have been analyzed. The simple weight-transducer method has been applied to perform UF. An inexpensive load cell connected to a 24 bit analogic digital converter (ADC) sends data to a cloud server via SIM card or home Wi-Fi. Data are processed and shown in graphics with both volume and flow rate as a function of time, allowing for measurement of average flow rate, maximum flow rate, voided volume, and voiding time. A numerical algorithm allows for filtering of the dynamic effect due to the urine gravity acceleration and for removing the funnel to simplify the home measurement procedure. Through an online platform, the physician can see and compare each UF data. The device’s reliability has been validated in a first laboratory setting and showed excellent performance. This approach based on domiciliary tests and an online platform can revolutionize the urologic clinic landscape by offering a constant patient cost-effective follow-up, eliminating the time wasted waiting in the office setting.

ObjectiveTo evaluate predictive factors of urinary incontinence (UI) after holmium laser enucleation of the prostate (HoLEP).MethodsPatients (n = 2346) were included in a retrospective multicentric study from April 2012 to November 2017. Patients’ characteristics (age, BMI, percentage with diabetes), preoperative data (IPSS score, whole gland volume, urinary drainage), operative data (enucleation time, enucleation efficiency, tissue enucleated weight, total delivered energy) and postoperative data were recorded. Absence of UI was defined as no pads at 3 and 6 months. Surgeon experience was stratified in three categories: beginners (< 21 cases), intermediate (21–40 cases) and experienced (> 40 cases). Multivariate logistic regression analysis was performed.ResultsUI was observed in 14.5% of patients (340/2346) at 3 months (95%CI 13–16%) and in 4.2% (98/2346) at 6 months (95%CI 3–5%). On multivariate analysis at 3 months, increasing age (OR per SD = 1.3 [1.14–1.48]), elevated BMI (OR per SD = 1.23 [1.09–1.38]), preoperative urinary drainage (OR = 0.62 [0.45–0.85]), increasing enucleated tissue weight (OR per SD = 1.29 [1.16–1.45]) and experienced surgeon with at least 40 cases (OR = 0.56 [0.42–0.75]) were significantly associated with UI. At 6 months, increasing age (OR per SD = 1.25 [1.01–1.53]), elevated BMI (OR per SD = 1.25 [1.03–1.5]), increasing whole gland volume (OR per one SD log = 1.24 [1.01–1.53]) and diabetes disorder (OR = 1.7 [1.03–2.78]) were significantly associated with UI.ConclusionUI after HoLEP was observed in 14.5% of patients at 3 months and 4.2% at 6 months, with stress UI in half of the cases. Surgeon experience with at least 40 cases was the main predictive factor of 3 months UI after HoLEP and diabetes disorder of persistent UI at 6 months.

PurposeAssess long-term outcomes of prostatic artery embolization (PAE) for patients with benign prostatic hyperplasia (BPH).Materials and MethodsSingle centre retrospective study from 2009–2019 including 1072 patients who received PAE and had available follow-up. Patients were evaluated yearly at 1–10 years post PAE using the International Prostate Symptom Score (IPSS) and quality of life (QoL), prostate volume (PV), prostate-specific antigen (PSA), peak urinary flow rate (Qmax) and postvoid residual (PVR) volume. The need for prostatic medication, re-intervention rates, repeat PAE and prostatectomy rates were assessed with Kaplan–Meier survival analysis and compared between different embolic agents using Cox regression analysis.ResultsMean follow-up time was 4.39 ± 2.37 years. At last follow-up visit, mean IPSS and QoL improvements were − 10.14 ± 8.34 (p < .0001) and − 1.87 ± 1.48 (p < .0001) points, mean PV reduction was − 6.82 ± 41.11 cm3 (p = 0.7779), mean PSA reduction was − 1.12 ± 4.60 ng/mL (p = 0.9713), mean Qmax increase was 2.72 ± 6.38 mL/s (p = 0.0005), mean PVR reduction was − 8.35 ± 135.75 mL (p = 0.6786). There were 335 patients (31.3%) needing prostatic medication after PAE. Re-intervention rates were 3.4% at 1 year, 21.1% at 5 years and 58.1% at 10 years. Repeat-PAE rates were 2.3% at 1 year, 9.5% at 5 years and 23.1% at 10 years. Prostatectomy rates were 1.1% at 1 year, 11.6% at 5 years and 35.0% at 10 years. No significant differences were found between polyvinyl alcohol particles, Bead Block, Embospheres and Embozenes.ConclusionPAE induces durable long-term LUTS relief, with re-intervention rates of 20% in the first 5 years and 30%–60% > 5 years post-PAE.

Background: Benign prostatic hyperplasia (BPH) is a common condition affecting older men, primarily driven by hormonal imbalances and inflammation. This study aimed to investigate the effects of pomegranate peel extract, rich in anti-inflammatory and antioxidant polyphenolic compounds like anthocyanins and tannins, on BPH symptoms compared to a placebo. Methods: Forty patients aged 50-80 with BPH from Ghaem Hospital in Mashhad were randomly assigned to either the treatment or control group. The treatment group (20 patients) received 250 mg of pomegranate peel extract capsules three times daily alongside tamsulosin 0.4 mg nightly for four months. In the control group (20 patients) lactose capsules was prescribed as a placebo with the same dosing. The severity of lower urinary symptoms was assessed using the International Prostate Symptom Score (IPSS), along with prostate size via ultrasound at baseline and after 2 and 4 months and prostate-specific antigen (PSA) serum levels just at the beginning and end of study. Results: Baseline prostate sizes, PSA serum level and IPSS scores were comparable between two groups (P>0.05). At the 4-month follow-up, the pomegranate peel extract group demonstrated significantly lower symptom scores compared to the placebo group (P=0.004), although no meaningful difference was observed after 2 months (P=0.067). Moreover, the prostate size did not change meaningfully after 2 and 4 months in comparison with the placebo group (P=0.226 & 0.355) and also PSA serum level was not significantly lower in pomegranate group after 4 months of therapy (P=206). Conclusion: As indicated by the IPSS, a daily regimen of 250 mg of pomegranate peel extract for four months effectively alleviated BPH symptoms. This suggests its potential as a treatment option for BPH, warranting further human studies to explore its efficacy.

Background Obesity (waist circumference, body mass index (BMI)) and lifestyle factors (dietary habits, smoking, alcohol drinking, Sedentary behavior) have been associated with risk of benign prostatic hyperplasia (BPH) in observational studies, but whether these associations are causal is unclear. Methods We performed a univariable and multivariable Mendelian randomization study to evaluate these associations. Genetic instruments associated with exposures at the genome-wide significance level ( P  < 5 × 10 –8 ) were selected from corresponding genome-wide associations studies (n = 216,590 to 1,232,091 individuals). Summary-level data for BPH were obtained from the UK Biobank (14,126 cases and 169,762 non-cases) and FinnGen consortium (13,118 cases and 72,799 non-cases). Results from UK Biobank and FinnGen consortium were combined using fixed-effect meta-analysis. Results The combined odds ratios (ORs) of BPH were 1.24 (95% confidence interval (CI), 1.07–1.43, P  = 0.0045), 1.08 (95% CI 1.01–1.17, P  = 0.0175), 0.94 (95% CI 0.67–1.30, P  = 0.6891), 1.29 (95% CI 0.88–1.89, P  = 0.1922), 1.23 (95% CI 0.85–1.78, P  = 0.2623), and 1.04 (95% CI 0.76–1.42, P  = 0.8165) for one standard deviation (SD) increase in waist circumference, BMI, and relative carbohydrate, fat, protein and sugar intake, 1.05 (95% CI 0.92–1.20, P  = 0.4581) for one SD increase in prevalence of smoking initiation, 1.10 (95% CI 0.96–1.26, P  = 0.1725) and 0.84 (95% CI 0.69–1.02, P  = 0.0741) for one SD increase of log-transformed smoking per day and drinks per week, and 1.31 (95% CI 1.08–1.58, P  = 0.0051) for one SD increase in sedentary behavior. Genetically predicted waist circumference (OR = 1.26, 95% CI 1.11–1.43, P  = 0.0004) and sedentary behavior (OR = 1.14, 95% CI 1.05–1.23, P  = 0.0021) were associated with BPH after the adjustment of BMI. Conclusion This study supports independent causal roles of high waist circumference, BMI and sedentary behavior in BPH.