The Innervation of the Human Prostate Gland—the Changes Associated with Benign Enlargement

Abstract

Different regions of the prostate gland, namely prostatic capsule, peripheral prostate and central prostate (subdivided into proximal (near the bladder neck), distal (near the verumontanum) and midway between these areas) were obtained from 32 obstructed (stable obstructed, n = 8; unstable obstructed, n = 13; acute retention, n = 11) and five control patients. The innervation of these tissues was studied both histochemically to localise acetylcholinesterase activity and immunohistochemically for dopamine-beta-hydroxylase, 5-hydroxytryptamine, vasoactive intestinal polypeptide, neuropeptide Y, leu- and met-enkephalin, calcitonin gene-related peptide, substance P and somatostatin. In control patients the greatest density of nerves was found in the proximal central prostate, followed by the anterior capsule and distal central prostate, with the least density in the peripheral prostate. The greatest density of nerves were acetylcholinesterase positive and immunoreactive to neuropeptide Y followed (in decreasing order) by nerves immunoreactive to: vasoactive intestinal polypeptide and dopamine beta-hydroxylase; leu-enkephalin and 5-hydroxytryptamine; calcitonin gene-related peptide; met-enkephalin; substance P; somatostatin. In addition a group of periacinar 5-hydroxytryptamine-immunoreactive cells and ganglia containing acetylcholinesterase, dopamine beta-hydroxylase and all of the peptides studied except somatostatin were identified. In the prostate gland from obstructed patients there was a significant reduction in the density of acetylcholinesterase-positive nerves (p less than 0.001) when compared with the controls. A similar trend was found for dopamine beta-hydroxylase, 5-hydroxytryptamine and all of the putative neuropeptides in most areas of the prostate, the most notable exceptions being in the peripheral prostate, with an increase in dopamine beta-hydroxylase- and leu-enkephalin-immunoreactive nerves in all three groups of obstructed patients an an increase in vasoactive intestinal polypeptide- and calcitonin gene-related peptide-immunoreactive nerves in those presenting in urinary retention. The functional significance of these findings is discussed.

Noradrenergic and cholinergic innervation of the accessory sexual glands in male sheep

“…The simultaneous presence of these two catecholamine-synthesising enzymes justifies naming these nerve fibres the noradrenergic ones. A more or less equal density of noradrenergic nerve fibres was found in the mucosa and muscular layer of the BU and SV, which is consistent with the results previously obtained in humans (Gu et al, 1983;Chapple et al, 1991;Hedlund et al, 1997) and pigs (Kaleczyc et al, 1999). It must be mentioned that in other studies of the SV of humans (Gosling and Dixon, 1994; as well as rats (Owman and Sjöstrand, 1965;Moss et al, 1987;Yuri, 1990) and guinea pigs (Owman and Sjöstrand, 1965;Wakade and Kirpekar, 1971;Al-Zuchair et al, 1975) noradrenergic nerve fibres were found only in the muscular layer.…”

“…The ovine prostate contained VIP-IR nerve fibres in a frequency comparable to the one found in the SV and BU but the abundance of NPY-IR nerve fibres was very low. Previously, numerous VIPand NPY-containing nerve fibres were found in the human ASG (Gu et al, 1983;Adrian et al, 1984;Higgins and Gosling, 1989;Lange and Unger, 1990;Chapple et al, 1991;Tainio, 1995;Hedlund et al, 1997;Dixon et al, 2000) and in the ASG of many other animal species (Alm et al, 1977(Alm et al, , 1980Stjernquist et al, 1983;Lamano-Carvalho et al, 1986;Moss et al, 1987;Yuri, 1990;Properzi et al, 1992;Iravani and Zar, 1994;Pinho et al, 1994;Ottesen et al, 1995;Domeneghini, 1997, 1998;Chow et al, 1997;Kaleczyc et al, 1999;Czaja et al, 2000;Majewski et al, 2001;Mirabella et al, 2003). The results of the previously mentioned studies can be summarised as follows: in all species the vast majority of VIP-IR nerve fibres were localised in the mucosal layer of the SV, BU and prostate, whereas only sparse VIP-IR nerve fibres were found within the smooth muscle layer.…”

“…The general opinion is that the development and function of the ASG are influenced both by the endocrine and the nervous system. The application of histochemical and immunohistochemical techniques has revealed autonomic nerve fibres (noradrenergic and cholinergic) Acta Veterinaria Hungarica 54, 2006 in all (or specific) ASG of man (Baumgarten et al, 1968;Dunzendorfer et al, 1976;Vaalasti and Hervonen, 1980;Gu et al, 1983;Higgins and Gosling, 1989;Chapple et al, 1991;Hedlund et al, 1997;Dixon et al, 2000), rat (Owman and Sjöstrand, 1965;Sjöstrand, 1965;Vaalasti and Hervonen, 1979;Moss et al, 1987;Yuri, 1990), hamster (Chow et al, 1997), guinea pig (Owman and Sjöstrand, 1965;Sjöstrand, 1965;Al-Zuchair et al, 1975;Lamano-Carvalho et al, 1986;Sjöstrand et al, 1998), rabbit, dog, cat (Owman and Sjöstrand, 1965;Sjöstrand, 1965), pig (Kaleczyc et al, 1999;Czaja et al, 2000;Majewski et al, 2001) and even in those of the water buffalo (Mirabella et al, 2003). It is known that nerve fibres may contain substances of peptide character, which act as neurotransmitters and/or neuromodulators.…”

Immunohistochemical characterisation of cholinergic nerve fibres supplying accessory genital glands in the pig

“…It is therefore possible, that VIP plays a role in the regulation of the secretory function of epithelial cells in this and other AGG. Immunoreactivity to SOM was found in a few nerve fibres supplying the human seminal vesicle and prostate (Gu et al, 1983;Chapple et al, 1991;Crowe et al, 1991;Tainio, 1995). Mirabella et al (2003) revealed SOM-IR nerve fibres innervating the prostate in the water buffalo.…”

The effects of SB 216469, an antagonist which discriminates between the α1A‐adrenoceptor and the human prostatic α1‐adrenoceptor

“…The human prostate receives a dense sympathetic innervation (Chapple et al, 1991) and stimulation of sympathetic nerves (Guh et al, 1995) or the exogenous administration of the sympathetic neurotransmitter noradrenaline causes contraction of human prostatic smooth muscle via al-adrenoceptors (Hieble et al, 1985). It is believed that this stimulation of prostatic al-adrenoceptors gives rise to the 'dynamic' component of bladder outlet obstruction observed in benign prostatic hyperplasia (BPH) and al-adrenoceptor antagonists have proven useful in the symptomatic relief of patients with benign prostatic hyperplasia.…”