The effect of hexanic extract of Serenoa repens on prostatic inflammation: results from a randomized biopsy study

World J Urol. 2019 Mar;37(3):539-544. doi: 10.1007/s00345-018-2409-1. Epub 2018 Jul 19.


Purpose: To evaluate the effect of hexanic extract of Serenoa repens (HESr) on prostatic inflammation in patients with diagnosed prostatic inflammation.

Methods: Patients with prostatic inflammation histologically confirmed by TRUS prostatic biopsy were randomized either to receive HESr (320 mg/day) or no treatment. A second biopsy was performed 6 months later according to standard clinical practice. Inflammation was assessed by the Irani's score and immunohistochemical staining using the CD3, CD4 and CD8 (for T-leucocytes), CD20 (for B-leucocytes) and CD163 (for macrophages) antibodies.

Results: Overall 97 patients were eligible for analysis. In the HESr group the mean inflammation grading and aggressiveness grading score significantly decreased from 1.55 and 1.55 at baseline to 0.79 (p = 0.001) and 0.87 (p = 0.001) at the second biopsy, respectively. In the control group the mean inflammation grading score was 1.44 at first biopsy and 1.23 at the second biopsy. The mean aggressiveness gradings core was 1.09 and 0.89, respectively. No statistical significance was found (p = 0.09 and p = 0.74).The mean decrease in all inflammation scores was statistically higher in the HESr patients compared to controls. The immunohistochemical staining showed a significant change in the expression of the analyzed antibodies for the HESr patients compared to the first biopsy. In the nontreatment group, no significant difference was found at the second biopsy. The change in expression of each antibody in the HESr group was statistical significant compared to control.

Conclusions: HESr seems to reduce prostatic inflammation in terms of histological and immunohistochemical parameters in this specific patients population.

Keywords: Benign prostatic hyperplasia; Immunohistochemistry; Inflammation; Serenoa repens.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Antigens, CD / metabolism
  • Antigens, CD20 / metabolism
  • Antigens, Differentiation, Myelomonocytic / metabolism
  • B-Lymphocytes / immunology
  • B-Lymphocytes / metabolism
  • B-Lymphocytes / pathology*
  • Biopsy
  • CD3 Complex / metabolism
  • CD4 Antigens / metabolism
  • CD4-Positive T-Lymphocytes / immunology
  • CD4-Positive T-Lymphocytes / metabolism
  • CD4-Positive T-Lymphocytes / pathology*
  • CD8 Antigens / metabolism
  • CD8-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / metabolism
  • CD8-Positive T-Lymphocytes / pathology*
  • Hexanes
  • Humans
  • Inflammation
  • Macrophages / immunology
  • Macrophages / metabolism
  • Macrophages / pathology*
  • Male
  • Middle Aged
  • Phytotherapy*
  • Plant Extracts / therapeutic use*
  • Prostate / immunology
  • Prostate / metabolism
  • Prostate / pathology*
  • Prostatitis / drug therapy*
  • Prostatitis / immunology
  • Prostatitis / metabolism
  • Prostatitis / pathology
  • Receptors, Cell Surface / metabolism
  • Serenoa*


  • Antigens, CD
  • Antigens, CD20
  • Antigens, Differentiation, Myelomonocytic
  • CD163 antigen
  • CD3 Complex
  • CD4 Antigens
  • CD8 Antigens
  • Hexanes
  • Plant Extracts
  • Receptors, Cell Surface