Role of metabolic ghrelin hormones for smooth muscle contraction and growth in benign prostatic hyperplasia

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In benign prostatic hyperplasia (BPH), increased prostate smooth muscle tone and prostate enlargement may promote bladder outlet obstruction and lower urinary tract symptoms (LUTS). The prevalence of such voiding symptoms is strikingly high. Smooth muscle tone and hyperplastic growth in the prostate are important targets for medical therapy of LUTS suggestive of BPH. However, the efficacy of available medications is insufficient, so that new options may be appreciated. The metabolic syndrome represents an important risk factor for LUTS in patients with BPH. Although this link has now been established based on epidemiological studies, underlying molecular mechanisms connecting LUTS/BPH with metabolic syndrome are still poorly understood. Previous studies dedicated to such mechanisms were rare, and focussed on inflammatory mediators or lipoproteins. However, metabolism and obesity may be driven by metabolic hormones, including ghrelin and its receptor (ghrelin/growth hormone secretagogue receptor, GHSR). Here, we propose investigations addressing the possible role of ghrelin and GHSR for regulation of prostate smooth muscle tone and prostate growth, including in vivo investigations in a rodent model of BPH.