Maurice E. Fabiani

Evidence for activation of the renin–angiotensin system in the human prostate: increased angiotensin II and reduced AT1 receptor expression in benign prostatic hyperplasia

The expression and cellular localization of angiotensin II (Ang II) and AT1 receptor proteins were examined in the normal human prostate and benign prostatic hyperplasia (BPH) by immunohistochemistry. In the normal prostate, Ang II immunoreactivity was localized to the basal layer of the epithelium and AT1 receptor immunostaining was found predominantly on stromal smooth muscle and also on vascular smooth muscle of prostatic blood vessels. Ang II immunoreactivity was markedly increased in hyperplastic acini in BPH compared with acini in the normal prostate (normal: 7.4±0.2%, n=5 vs. BPH: 22.7±1.9%, n=5, p<0.001). However, AT1 receptor immunoreactivity was significantly decreased in BPH compared with the normal prostate [normal: 16.4±2.2%, n=4 vs. BPH: 9.4±1.3%, n=5, p<0.05 (p=0.025)]. The present study demonstrates the presence of Ang II peptide in the basal layer of the epithelium and AT1 receptors on stromal smooth muscle, suggesting that Ang II may mediate paracrine functions on cellular growth and smooth muscle tone in the human prostate. Furthermore, AT1 receptor down‐regulation in BPH may be due to receptor hyperstimulation by increased local levels of Ang II in BPH. These data extend previous findings in support of the novel concept that overactivity of the renin–angiotensin system (RAS) may be involved in the pathophysiology of BPH. Copyright

Localization of angiotensin-converting enzyme in the human prostate: pathological expression in benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) is the most common hyperplastic disease in man and it is characterized by increased cellular growth (stromal and epithelial hyperplasia) and enhanced local sympathetic tone, both of which are known to be augmented by activation of the renin–angiotensin system (RAS) in other tissues. Angiotensin‐converting enzyme (ACE) is an integral component of the RAS that is responsible for the production of the active peptide angiotensin II from the inactive precursor angiotensin I. The present study was undertaken to map the anatomical localization of ACE protein and messenger ribonucleic acid (mRNA) in the normal human prostate and to establish whether their expression is pathologically altered in BPH. Human prostate samples were obtained at post‐mortem and histologically defined as normal or hyperplastic. ACE protein binding/expression was determined by in vitro autoradiography and immunohistochemistry using the ACE‐specific radioligand [125I]‐MK351A and a mouse anti‐ACE polyclonal antibody, respectively, whereas the spatiotemporal distribution of ACE mRNA was determined by in situ hybridization using 35S‐labelled oligonucleotide probes. ACE protein was localized to the glandular epithelium in the human prostate. ACE binding and immunostaining were increased in BPH compared with normal (non‐hyperplastic) prostate specimens [X‐ray film autoradiography: normal 873±48 dpm/mm2 (n=8) vs. BPH 1631±274 dpm/mm2 (n=6), p<0.05; emulsion autoradiography: normal 3.1±0.5 grains/mm2 (n=6) vs. BPH 32.8±8.6 grains/mm2 (n=5), p<0.01]. ACE mRNA was also localized to glandular epithelial cells in the human prostate with a significant increase in ACE mRNA expression in BPH compared with the normal prostate [normal 11.04±2.03 grains/cell (n=220 cells total) vs. BPH 22.29±1.34 grains/cell (n=198 cells total), p<0.05]. The findings of the present study suggest that ACE is localized to the glandular epithelium of the human prostate and that its expression, at both protein and mRNA level, is aberrantly increased in BPH. These data support the concept that hyperactivity of the local RAS in the prostate may be involved in the pathogenesis of BPH. Copyright

In vivo inhibition of angiotensin receptors in the rat kidney by candesartan cilexetil: a comparison with losartan.

The present study examined the in vivo effects of candesartan cilexetil compared with losartan on angiotensin II (Ang II) receptor binding in the rat kidney after oral administration. Male Sprague-Dawley rats (250 to 300 g) were gavaged with candesartan cilexetil or losartan in doses of 0.1, 0.3, 1, 3, 10, or 30 mg/kg, or corresponding vehicle. Rats were killed at 0, 1, 2, 8, or 24 h after drug administration, trunk blood collected, and kidneys removed. The effects of candesartan cilexetil and losartan on Ang II receptor binding were determined by quantitative in vitro autoradiography using the radioligand [125I]-[Sar1,Ile8] Ang II. Ang II receptor binding in the kidney was mainly due to AT1 receptors with high levels of binding localized to the inner stripe of the outer medulla and glomeruli in cortical regions. Candesartan cilexetil (0.1 to 30 mg/kg) inhibited Ang II receptor binding to all anatomical sites of the kidney, in a dose-dependent manner. Losartan (0.1 to 30 mg/kg) also produced dose-dependent inhibition of Ang II receptor binding but was approximately 10- to 30-fold less potent than candesartan cilexetil. Inhibition of Ang II receptor binding was near maximal about 1 h after administration of candesartan cilexetil (10 mg/kg) or losartan (10 mg/kg), with both drugs producing persistent blockade at 24 h despite plasma renin activity and plasma drug concentrations returning to near normal levels. In vitro, candesartan, losartan, and EXP3174 (1 x 10(-10) to 1 x 10(-5) mol/L) displaced [125I]-[Sar1,Ile8] Ang II binding from AT1 receptors in the kidney in a concentration-dependent manner with a rank order of potency of candesartan > EXP3174 > losartan. The concentration required to displace 50% of radioligand binding (IC50) by candesartan, EXP3174, and losartan was 0.9+/-0.1 nmol/L, 3.4+/-0.4 nmol/L, and 8.9+/-1.1 nmol/L, respectively. In conclusion, the findings of the present study suggest that candesartan cilexetil is more potent than losartan in antagonizing AT1 receptors in the kidney in vivo. Nonetheless, both candesartan cilexetil and losartan produce rapid, complete, and sustained blockade of AT1 receptors in the rat kidney. Tissue blockade of Ang II receptors in target organs, such as the kidney, may contribute to the beneficial effects of Ang II receptor antagonists as antihypertensive agents.

Regulation of angiotensin II receptors in the prostate of the transgenic (mRen-2)27 rat: effect of angiotensin-converting enzyme inhibition.

We examined the regulation/expression of angiotensin II (Ang II) receptors in the transgenic (TG) (mRen-2)27 rat compared to the normal Sprague-Dawley (SD) rat. Ang II receptor binding and mRNA expression were determined by quantitative autoradiography and real-time PCR, respectively. Ang II receptors in the rat prostate rat were of the AT(1) receptor subtype and were significantly reduced in the prostate of the TG rat compared to the normal SD rat. However, AT(1) receptor binding was significantly higher in the prostate of the TG rat treated with the ACE inhibitor lisinopril compared to the untreated TG rat and comparable to the control SD rat. In contrast to the protein, AT(1) receptor mRNA expression was not reduced in the prostate of the TG rat compared to the SD rat. However, AT(1) receptor mRNA was markedly reduced in the prostate of the lisinopril-treated TG rat compared to the untreated TG rat or control SD rat. In conclusion, the findings suggest that AT(1) receptors are present in the rat prostate at a protein level and are subject to down-regulation in the TG rat which may be due to receptor internalisation as a consequence of receptor hyper-stimulation by increased local tissue levels of Ang II. Moreover, AT(1) receptor protein and mRNA expression in the prostate may be inversely modulated.

Angiotensin AT4 receptors in the normal human prostate and benign prostatic hyperplasia

Abstract The cellular localisation and expression of angiotensin AT4 receptors was examined in the normal human prostate and benign prostatic hyperplasia (BPH) by quantitative in vitro autoradiography using [125I]-Ang IV. In the normal human prostate, AT4 receptors were localised to the glandular epithelium. Interestingly, specific AT4 receptor binding was significantly reduced in BPH compared to the normal prostate, as quantitated macroscopically (normal: 5038±476 dpm/mm2, n=6 vs BPH: 2701±176 dpm/mm2, n=6, P