Strategic Plan for Research into Benign Prostate Disease

For the first time, a strategic plan for research into benign prostate disease, based on the latest scientific knowledge, has been published by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK Prostate Research Strategic Plan is the culmination of discussions and meetings among experts over the past two years in an effort to outline a strategic vision for research into these elusive and multi-faceted diseases.

"The NIDDK Prostate Research Strategic Plan reflects NIH's commitment to advancing translational research by facilitating planning efforts among basic scientists, clinicians, advocacy groups, and patients," said NIDDK Director Griffin P. Rodgers, M.D. "The educational summaries in each section of the plan provide clear explanations of the scientific data and the reasoning behind each of the recommended research priorities."

The benign prostate diseases of focus in this effort include two of the most significant non-cancerous disorders affecting males - benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). BPH, an enlargement of the prostate gland, is often associated with lower urinary tract symptoms (LUTS). LUTS, which can include symptoms such as overactive bladder, restricted or excessive urination, and sensations of urgency, affects men of all races and ethnic groups and can become severe over time. CP/CPPS is generally described as inflammation of the prostate gland. There is no detectable bacterial basis, but CP/CPPS is sometimes associated with urinary symptoms, chronic pelvic pain, and sexual dysfunction. The source of the pain in this syndrome is unknown and there are no generally effective methods for preventing or treating the condition.

"The long-standing, unanswered questions about the causes of these disorders prompted the NIDDK to examine the state of the science and to develop a new vision for future research," explained Chris Mullins, Ph.D., NIDDK's Director of Basic Cell Biology Programs in Urologic and Kidney Disease, who along with Leroy M. Nyberg, M.D., Ph.D., lead this program for the NIH. "As part of this process we convened the Prostate Research Planning Committee, composed of clinical and basic scientists and epidemiologists from around the country, to review and evaluate past and current research and to make individual recommendations for new research priorities. The NIDDK Prostate Research Strategic Plan is the result of that collaborative effort."

The NIDDK Prostate Research Strategic Plan addresses the four major research areas judged critical for advancing the field. These include basic science, epidemiology and population-based studies, translational research, and clinical sciences. Selected major recommendations from the effort include:

• Promote interdisciplinary research that focuses on how benign prostate diseases are influenced by other organ-specific diseases and systemic conditions, such as obesity, high blood pressure, high cholesterol, cardiovascular disease, diabetes, and erectile dysfunction.
• Study the primary prevention of benign prostate diseases, including possible benefits of lifestyle changes such as avoidance of alcohol and caffeine, frequency of sexual practice, pelvic massage therapy, stress reduction, and diet modulation for relief of CP/CPPS.
• Develop data and human tissue resources from patients of various ages to derive information useful in investigating risk factors, underlying causes and natural history of disease progression, quality of life, quality of care, and decision making regarding treatment of benign prostate disease. Develop imaging approaches and other biomarker studies to assess severity and risk of progression based on physical and cellular findings.
• Develop targeted medical therapies based on new insights into disease-relevant cellular pathways and physiological events.
• Develop standardized, clinically significant benign prostate disease syndrome definitions and classifications based on measurable phenotypic features.
• Train and mentor epidemiologists, health services researchers, clinical investigators, and students interested in the study of benign prostate disease.

The plan is designed to be read by a broad audience of researchers, clinicians, advocacy groups, representatives of funding organizations, and patients. Each major section includes a mission statement, a lay summary, an overview of current knowledge, and high-priority recommendations for future research. The plan may be found at http://www2.niddk.nih.gov/NR/rdonlyres/318606D2-A9D1-4CAD-B9BF-8EB3009C83BE/0/NIDDKProstateStrategicPlan.pdf and may be purchased online in print or compact disc format at http://catalog.niddk.nih.gov/PubType.cfm?Type=182&CH=NKUDIC.