5α-Reductase Activity in the Prostate

    December 2001 in “ Urology
    William D. Steers
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    TLDR Blocking the enzyme 5α-reductase can shrink the prostate and help treat enlarged prostate issues.
    The document from December 2001 discusses the role of 5α-reductase in the prostate gland, highlighting that dihydrotestosterone (DHT), produced from testosterone by this enzyme, is the primary androgen responsible for prostate development and the pathogenesis of benign prostatic hyperplasia (BPH). Inhibitors of 5α-reductase can reduce prostate size by 20% to 30% through apoptosis and reduced vascularization. The prostate predominantly expresses the type-2 isozyme of 5α-reductase, while the liver and skin express the type-1 isozyme. Deficiencies in type-2 5α-reductase have been identified in patients, and knockout mice lacking this isozyme exhibit a similar phenotype to men with the deficiency. The document also notes the presence of 5α-reductase in other genitourinary tissues and its influence on neuronal nitric-oxide synthase in the corpus cavernosum. Clinical trials are underway for drugs that inhibit both type-1 and type-2 5α-reductase to improve the treatment of BPH.
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