Millions of middle-aged and older men experience the symptoms of an enlarged prostate multiple times during the day and night. What they may not know is that the disease// known as BPH (benign prostatic hyperplasia), marked by urgency and frequent urination, is not one but at least a pair of disorders, and that one of the pair — tied to a newly identified gene — has far more serious implications.
In a study published in the February issue of the Journal of Urology, researchers at Johns Hopkins reported finding substantially higher levels of a protein made by a gene known as JM-27 in men whose BPH is more severe and more likely to lead to bladder-related complications if left untreated.
Although BPH affects the prostate, the resulting symptoms are often called “lower urinary tract symptoms,” or LUTS. These symptoms reflect not only the direct effects of the prostate on urinary flow and urgency, but functional changes in the bladder that result from the increased pressure.
The Hopkins team, lead by Robert Getzenberg, Ph.D., also developed a blood test that detects the JM-27 protein in men with severe symptoms. The JM-27 diagnostic test, if eventually approved by the FDA, could be used to identify men with this highly symptomatic form of the disease early, before there is any damage to the bladder or urinary tract.
“Our experiments show that the expression of this marker is related to the presence of the severe form of BPH and not to the size of the prostate or to the presence or risk of prostate cancer,” says Getzenberg. “What we’re looking at is two diseases: BPH that produces more mild symptoms and is less likely to lead to bladder and other urinary tract damage, and BPH that is highly symptomatic with increased potential to do damage to the bladder.”
In their latest study, Getzenberg and his team tested blood samples taken from 85 men. Twenty-nine had either no detectable BPH symptoms or mild ones, 39 exp
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