Urologic Diseases Research Updates
Fall 2008

NIDDK Identifies Priorities for Prostate Research

For the first time, a strategic research plan for benign prostate diseases based on the latest scientific knowledge has been published by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK Prostate Research Strategic Plan is the culmination of discussions and meetings among experts over the past 2 years in an effort to outline a strategic vision for research into the causes, prevention, and treatment of these elusive and multifaceted diseases.

Research on benign prostate diseases includes two of the most significant noncancerous disorders affecting males—benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). These conditions are common, chronic, and costly.

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 feelings of urgency, affects men of all races and ethnic groups and can become severe over time. An estimated 50 percent of men in their 50s have BPH, and 26 to 40 percent of men between the ages of 40 and 79 have moderate to severe LUTS.

CP/CPPS is generally described as inflammation of the prostate gland. CP/CPPS is sometimes associated with urinary symptoms, pain, and sexual dysfunction. The source of pain in this syndrome is unknown and there generally are no effective methods for preventing or treating it.

The plan, developed by an expert group of basic scientists, epidemiologists, and clinical researchers, identifies research priorities in four key areas: basic science, epidemiology and population-based studies, translational opportunities, and clinical sciences. Selected recommendations from the plan include the following:

• 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. For example, the possible influence of high blood pressure on BPH/LUTS is a previously unexplored area of research.

• 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 benign prostate disease treatment.

• 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 longstanding, unanswered questions about the causes of these disorders prompted the NIDDK to examine the state of the science and develop a new vision for future research,” said Chris Mullins, Ph.D., the NIDDK’s director of basic cell biology programs in urologic and kidney disease. “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 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, lay summary, overview of current knowledge, and high-priority recommendations for future research.

For a complete copy of the NIDDK Prostate Research Strategic Plan, visit the NIDDK website at www.niddk.nih.gov. To buy a copy in print or compact disc format for $1, go to www.catalog.niddk.nih.gov/PubType.cfm?Type=182&CH=NKUDIC. The NIDDK has a fact sheet about BPH at www.kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement.

NIH Publication No. 09–5743
December 2008

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