Figure 1 The central role of chronic prostate

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Figure 1 The central role of chronic prostate inflammation in the development and progression of BPH–LUTS Figure 1 | The central role of chronic prostate inflammation in the development and progression of BPH–LUTS. The prostate is considered an immune-competent organ, characterized by the presence of a complex intraglandular immune system that ensures the sterility of the genitourinary tract and the prevention of autoimmune reactions towards self-antigens. Several stimuli, such as infections, metabolic syndrome, urine reflux and the ageing process, that activate different, mostly unknown, molecular pathways are considered to be triggers for the dysregulation of the prostatic immune system and the development chronic prostatic inflammation. The continuous activation of immune cells, changes in the complex network of cytokines and growth factors, and associated hormonal changes are implicated in sustaining the prostatic inflammatory process. The consequent tissue damage and chronic process of wound healing and tissue remodelling could lead to a persistent stimulation of stromal and epithelial prostatic cells, potentially resulting in BPH development and progression. AR, androgen receptor; BPH, benign prostatic hyperplasia; CCL3, C-C motif chemokine ligand 3; EMT, epithelial–mesenchymal transition; FGF, fibroblast growth factor; HIF1α, hypoxia-inducible factor 1α;m IFN, interferon; IL, interleukin; MCP-1, monocyte chemotactic protein-1; TGF, transforming growth factor; VEGF, vascular endothelial growth factor. De Nunzio, C. et al. (2016) Inflammatory mediators in the development and progression of benign prostatic hyperplasia Nat. Rev. Urol. doi:10.1038/nrurol.2016.168