Benign prostatic hyperplasia(BPH) in Vitamin A Points of View

Benign prostatic hyperplasia(BPH) is defined as a condition of increased in the number of cells of prostate gland, causing partial, or sometimes virtually complete obstruction of the urinary tract. According to statistic, BPH commonly starts at age of 30 and symptoms usually can not be realized until age of 50. More than half of men between age of 60-70 are experience symptoms of BPH and only 10% are required treatment. Epidemiological studies, linking herbal medicine in reduced risk of benign prostate hyperplasia have produced a certain positive result, but multi centers and large sample size to identify the principle ingredient and to validate these result are necessary.

Vitamin A is a general term of Vitamin A Retinol, retinal, beta-carotene, alpha-carotene, gamma-carotene, and beta-cryptoxanthin best known for its functions for vision health and antioxidant scavenger and essential for growth and differentiation of a number of cells and tissues.
Recommended intakes of vitamin A, according to  the Institute of Medicine of the National Academies (formerly National Academy of Sciences) is 600 µg daily as extremely high doses (>9000 mg) can be toxicity as causes of dry, scaly skin, fatigue, nausea, loss of appetite, bone and joint pains, headaches, etc.

1. Retinols
Vitamin A (retinol) and its derivatives, the retinoids concentration was 2-fold elevated in BPH compared with the tissues of normal prostate, and prostate carcinoma tissues of that may be an indication of role of retinoids in the physiology of the prostate and possibly also in the pathophysiology of prostate cancer(1). In human INSL3 in patients with benign prostate hyperplasia (BPH), all-trans-retinoic acid showed to up-regulate LGR8 gene activity in a dose- and time-dependent manner while having no effect on INSL3 gene activity(2). the study of the effects of 9-cis retinoic acid (9cRA) in suppressing prostate cell proliferation (PECP) and carcinogenesis in p27(Kip1) deficient mice, showed that 9cRA suppress prostate intraepithelial neoplasia (PIN) in all three p27(a cell cycle suppressor gene) genotypes through decreased suppress prostate cell proliferation (PECP) and increased cellular senescence(3).

2. Carotenoids(beta-carotene, alpha-carotene, gamma-carotene and beta-cryptoxanthin) Carotenoids, plant pigments, converted to vitamin A after intake, play an important role in prevention and treatment of some diseases through its antioxidant effects. Dietary carotenoids risk of BPH and prostate cancer is associated to age and fat intake. The study of 100 patients with prostate cancer and two different control series [100 benign prostatic hyperplasia (BPH) patients and 100 general hospital patients] showed a risk differentiation of  reduction by dietary beta-carotene and vitamin A was significant in the older men (70-79 years), but not in the younger men (50-69 years) with protective effect against prostate cancer related to the low overall fat intake in Japan(4). According to Johns Hopkins Bloomberg School of Public Health, consumption of fruit and vegetables rich in beta-carotene was inversely related to BPH(5)(6).
The Kyoto University study, in a case-control study of prostatic cancer and BPH, consisted of 100 patients with prostatic cancer, matched for hospital, age (+/- 3 yr) and hospital admission date (+/- 3 months) to patients with benign prostatic hyperplasia (BPH) and hospital controls indicated a correlation of daily intake of beta-carotene (RR = 2.13: 1.20-3.77), as compared with hospital controls, were significantly correlated with prostatic cancer development(7). Lower concentration of of carotenoids, may be an indication of disease progression rather than the systemic inflammatory response in patients with prostate cancer reported by the ¹University Department of Surgery, Royal Infirmary(8). Unfortunately, according to Kyoto Prefectural University of Medicine, serum beta-carotene and smoking are associated to increased risk with the development of BPH(9).

Taking altogether, although controversial, vitamin A may be associated to reduced risk of BPH but further large sample size studies are necessary to clarify it effectiveness. Overdoses can lead to toxic symptoms. Please make sure you follow the guideline of the Institute of Medicine of the National Academies. As always, all articles written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying.

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References
(1) Abnormal level of retinoic acid in prostate cancer tissues by Pasquali D¹, Thaller C, Eichele G.(PubMed)
(2) INSL3 in the benign hyperplastic and neoplastic human prostate gland by Klonisch T¹, Müller-Huesmann H, Riedel M, Kehlen A, Bialek J, Radestock Y, Holzhausen HJ, Steger K, Ludwig M, Weidner W, Hoang-Vu C, Hombach-Klonisch S.(PubMed)
(3) p27(Kip1) deficiency promotes prostate carcinogenesis but does not affect the efficacy of retinoids in suppressing the neoplastic process by Taylor W¹, Mathias A, Ali A, Ke H, Stoynev N, Shilkaitis A, Green A, Kiyokawa H, Christov K.(PubMed)
(4) Dietary beta-carotene and cancer of the prostate: a case-control study in Kyoto, Japan by Ohno Y¹, Yoshida O, Oishi K, Okada K, Yamabe H, Schroeder FH.(PubMed)
(5) Fruit and vegetable consumption, intake of micronutrients, and benign prostatic hyperplasia in US men. by Rohrmann S¹, Giovannucci E, Willett WC, Platz EA.(PubMed)
(6) Intake of selected micronutrients and the risk of surgically treated benign prostatic hyperplasia: a case-control study from Italy by Tavani A¹, Longoni E, Bosetti C, Maso LD, Polesel J, Montella M, Ramazzotti V, Negri E, Franceschi S, La Vecchia C.(PubMed)
(7) A case-control study of prostatic cancer with reference to dietary habits by Oishi K¹, Okada K, Yoshida O, Yamabe H, Ohno Y, Hayes RB, Schroeder FH.(PubMed)
(8) Vitamin antioxidants, lipid peroxidation and the systemic inflammatory response in patients with prostate cancer by Almushatat AS¹, Talwar D, McArdle PA, Williamson C, Sattar N, O'Reilly DS, Underwood MA, McMillan DC.(PubMed)
(9) [Epidemiological study on diet, smoking and alcohol drinking in the relationship to prostatic weight].[Article in Japanese] by Nukui M.(PubMed)