Inhibitory Effect of Silodosin, Tamsulosinand Terazosin in Phenylephrine Induced-Prostate Smooth Muscle Contraction (a Comparative in vitro Study)
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 6, Issue 4
Abstract
Objective: This in vitro study aims to compare the inhibitory effect of those α-blocker to the phenylephrine inducedprostate smooth muscle contraction. Research Method: Twenty eight eligible BPH patients were randomly allocated to 4 groups which are one control group (without α-blocker therapy) and 3 intervention groups treated with silodosin, tamsulosinand terazosine for 7 days prior to TURP surgery. The prostate tissue samples were taken during TURP surgery. This sample prepared on organ bath containing thyrod liquid and further induced with phenilephrin at dose 10-4μg/ml to measure its contraction. A oneway anova analysis was performed to investigate the significant difference among groups. Result: The mean contraction result in control, silodosin, tamsulosinand terazosin groups were 7,798mV, 1,718mV, 3,416mV, and 5,956 mV respectively (Table 1). There was a significant difference contraction value among 4 groups(p=0,000). The silodosin treatment group had the lowest mean contraction value against the controls compared with the tamsulosin and terazosin groups. Conclusion: Silodosin has the strongest inhibitory effect in phenylephrineinduced prostate smooth muscle contraction in the invitro study. BPH is a chronic progressive disease associated with lower urinary tract symptoms (LUTS) which its prevalence increases with ageand reduces the quality of life in elderly male [1,2]. Treatment for BPH aims to relieve two types of urinary tract obstruction: mechanical urinary tract obstruction caused by tissue compression due to an enlarged prostateand functional urinary tract obstruction caused by constriction of the urinary tract and prostatic smooth muscle via sympathetic α1 adrenoceptors (α1-AR). As a result, α1-AR antagonists are widely recognized as the firstline pharmacotherapy for BPH treatment [3]. Several α1-AR antagonists with its difference of selectivity are available for treatment of this disease, including silodosin, tamsulosin and terazosin. Many studies showed that those α-blocker seem to have similar efficacy in improving symptoms and urinary flow rates [4]. The high selectivity of the α1-adrenergic receptor antagonist has great efficacy and is associated with minimal side effect on cardiovascular system. Based on study that was conducted on hamsters, silodosin has a very high selectivity upto 38 times compared with tamsulosin. Another study on invivo animal test subject that compared silodosin, tamsulosin, and prazosin concluded that silodosin showed the highest selectivity compared with tamsulosin and prasozin [5]. Previous invitro study has shown that long term treatment of α- adrenergic receptor antagonists (tamsulosin 0,4mg once daily) in BPH patient can increase phenylephrineinduced prostate smooth muscle contraction [6]. This is probably due to a supersensitization mechanism in long term treatment. It is not yet clear, however, whether the use of adrenergic receptor antagonists in BPH in a short period of time can affect the contraction of smooth prostate smooth muscle.On short term crossover study comparing several types of alpha blockers, showed that 7 days treatment of alpha blocker was sufficient to determine its effectiveness and efficacy. Clinical research also suggests that different types of alpha blockers having different selectivity and affinityhave similar effectiveness on improving symptoms of IPSS and urinary outflow on BPH patient [4]. The differences in selectivity and affinity from each alpha blocker allegedly to have different effects on the prostate smooth muscle contractility. Therefore, research that compare the inhibitory effect of several alpha blocker against prostate smooth muscle contraction is needed.
Authors and Affiliations
Basuki B Purnomo, Ryan Akhmad AS, Besut Daryanto, Setyawati Soeharto
Keywords
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- EP ID EP592379
- DOI 10.26717/BJSTR.2018.06.001401
- Views 163
- Downloads 0
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