EXTRACT OF BRYOPHYLLUM PINNATUM IN THE THERAPY OF EXPERIMENTAL CHRONIC PELVIC PAIN SYNDROME

Prostatitis is the most common disease of the prostate, surpassing benign prostatic hypertrophy (BPH) and prostate cancer in morbidity.

Chronic abacterial prostatitis (CAP) or chronic pelvic pain syndrome (CPPS) accounts for more than 90% of patients with prostatitis.

Objective is to evaluate the effect of Bryophyllum pinnatum extract on morphological changes in the prostate and bladder in an experimental model of CAP/CPPS.

Material and methods. The experiment was performed on 75 male rats weighing 255±38 g in compliance with the rules for handling experimental animals. The CPPS model was implemented in 60 animals (certificate No. 651 on registration as know-how «Method for modeling chronic abacterial prostatitis»). The animals were randomly divided into the main group (MG, n=40, received Bryophyllum pinnatum enterally 100 mg/kg/day), the positive control group (PC, n=20, CPPS model without treatment) and the negative control group (NC, n=15, anesthesia was performed without CPPS modelling). On the 2^nd and 4^th weeks, ½ of each group was withdrawn from the experiment, the bladder and prostate were taken for morphological examination, the absolute and relative dynamics of their weight at the control points were recorded. The obtained data were processed statistically; the differences were considered reliable when the probability of occurrence of an event was more than 95% (р<0,05).

Results and discussion. In animals of the experimental observation groups, a statistically significant delay in weight gain was recorded at both control points compared to the NC group (p<0.01). Bryophyllum pinnatum extract did not statistically affect the body weight deficit, but significantly reduced both the absolute and relative weight of the bladder and prostate gland (p<0.05). We recorded both a decrease in inflammatory agranulocytic infiltration of the interacinar spaces of the prostate and the submucosal layer of the bladder wall in the MG compared to the PC group (p<0.01). In addition, the use of Bryophyllum pinnatum extract is associated with its antiproliferative effect on the urothelium of the bladder and the acinar epithelium of the prostate glands.

Conclusion: Thus, Bryophyllum pinnate extract exhibits antiproliferative and anti-inflammatory effects, which should be associated with the pathogenetic effect on CAP/CPPS in the experimental model.

1. Labetov I.A., Kovalev G.V., Volkova O.V., SHul'gin A.S., SHkarupa D.D. Effektivnost' sfokusirovannoi udarno-volnovoi terapii v lechenii khronicheskogo prostatita, sindroma khronicheskoi tazovoi boli u muzhchin (Efficiency of focused shock wave therapy in the treatment of chronic prostatitis, chronic pelvic pain syndrome in men) Vestnik urologii. 2022;10(3):28-35. (In Russ), https://doi.org/10.21886/2308-6424-2022-10-3-28-35

2. Pontari M., Giusto L. New developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome. Curr. Opin. Urol. 2013;23(6):565-569. (In Engl), doi: 10.1097/MOU.0b013e3283656a55

3. Khan FU, Ihsan AU, Khan HU, Jana R, Wazir J, Khongorzul P, Waqar M, Zhou X. Comprehensive overview of prostatitis. Biomed Pharmacother. 2017;94:1064-1076. (In Engl), doi: 10.1016/j.biopha.2017.08.016.

4. Weihua Fu, Shijian Li, Qianwei Li, Jiwei Yao, Weibing Li, Junan Yan. The effect of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) on semen parameters in human males: a systematic review and meta-analysis. PLoS One. 2014;9(4). – P. 1-10 (In Engl), doi: 10.1371/journal.pone.0094991

5. Hu Y, Niu X, Wang G, Huang J, Liu M, Peng B. Chronic prostatitis/chronic pelvic pain syndrome impairs erectile function through increased endothelial dysfunction, oxidative stress, apoptosis, and corporal fibrosis in a rat model. Andrology. 2016;4(6):1209-1216. (In Engl), doi: 10.1111/andr.12273

6. Liu Y, Mikrani R, Xie D, Wazir J, Shrestha S, Ullah R, Baig MMFA, Ahmed A, Srivastava PK, Thapa KB, Zhou X. Chronic prostatitis/chronic pelvic pain syndrome and prostate cancer: study of immune cells and cytokines. Fundam Clin Pharmacol. 2020;34(2):160-172. (In Engl), doi: 10.1111/fcp.12517.

7. Ma X, Lao Y, Bai Y, Guan X, Jiang J, Cui M, Dong Z. J Study progress of etiologic mechanisms of chronic prostatitis/chronic pelvic pain syndrome. Int Immunopharmacol. 2025;148:114-128. (In Engl), doi: 10.1016/j.intimp.2025.114128.

8. Belousov I.I., CHernogubova E.A., Kogan M.I. Rol' endotelial'noi disfunktsii v patogeneze nevospalitel'noi formy khronicheskogo abakterial'nogo prostatita (The role of endothelial dysfunction in the pathogenesis of non-inflammatory form of chronic abacterial prostatitis). Urologiya. 2013;(3):39-42. (In Russ), doi: https://dx.doi.org/10.18565/urology.2018.3.12-18

9. Pontari MA, Ruggieri MR. Mechanisms in prostatitis/chronic pelvic pain syndrome. J Urol. 2004;172(3):839-45. (In Engl), doi: 10.1097/01.ju.0000136002.76898.04.

10. Tyuzikov I.A., Grekov E.A. Khronicheskii prostatit, sindrom khronicheskoi tazovoi boli: sovremennye trendy i perspektivy lecheniya s pozitsii dokazatel'noi meditsiny (Chronic prostatitis, chronic pelvic pain syndrome: modern trends and treatment prospects from the standpoint of evidence-based medicine). Eksperimental'naya i klinicheskaya urologiya. 2022;15(1):90-101. (In Russ), doi: https://doi.org/10.29188/2222-8543-2022-15-1-90-100

11. Sivkov A.V., Romih V.V., Zaharchenko A.V. Khronicheskii prostatit kategorii IIIV, sindrom khronicheskoi tazovoi boli i seksual'nye disfunktsii (Chronic prostatitis category IIIB, chronic pelvic pain syndrome and sexual dysfunction). Andrologiya i genital'naya hirurgiya. 2015;16(4):18-26. (In Russ), doi: 10.17650/2070-9781-2015-16-4-18-26

12. Zeng F, Chen H, Yang J, Wang L, Cui Y, Guan X, Wang Z, Niu J, Zu X, Qi L, Zhang X, Tang Z, Liu L. Development and validation of an animal model of prostate inflammation-induced chronic pelvic pain: evaluating from inflammation of the prostate to pain behavioral modifications. PLoS One. 2014;9(5). – P. 1-6. (In Engl)

13. Ittmann M. Anatomy and Histology of the Human and Murine Prostate. Cold Spring Harb Perspect Med. 2018;8(5). – P. 1-7. (In Engl), doi: 10.1101/cshperspect.a030346.

14. Wang W, Naveed M, Baig M, Abbas M, Xiaohui Z. Experimental rodent models of chronic prostatitis and evaluation criteria. Biomed Pharmacother. 2018;108:1894-1901. (In Engl), doi: 10.1016/j.biopha.2018.10.010.

15. Raskosha O.V., Kichigin A.I. Osnovnye printsipy nadlezhashchei laboratornoi praktiki (NLP, GLP) pri obustroistve vivariya i organizatsii nauchnykh issledovanii (Basic principles of good laboratory practice (NLP, GLP) in the arrangement of a vivarium and the organization of scientific research). Vestnik instituta biologii Komi nauchnogo centra Ural'skogo otdeleniya RAN. 2016;3(197):19-25. (In Russ), doi: https://doi.org/10.31140/j.vestnikib.2016.3(197).3

16. Prikaz Minzdrava Rossii ot 01.04.2016 N 199n «Ob utverzhdenii Pravil nadlezhashchei laboratornoi praktiki» (Zaregistrirovano v Minyuste Rossii 15.08.2016 N 43232) (Order of the Ministry of Health of Russia dated 01.04.2016 N 199n «On approval of the Rules of Good Laboratory Practice» (Registered in the Ministry of Justice of Russia on 15.08.2016 N 43232) URL: https://www.consultant.ru/document/cons_doc_LAW_203348/ (Accessed: 17.05.2025) (In Russ).

17. «GOST R 52379-2005. Natsional'nyi standart Rossiiskoi Federatsii. Nadlezhashchaya klinicheskaya praktika» (utv. Prikazom Rostekhregulirovaniya ot 27.09.2005 N 232-st) («GOST R 52379-2005. National standard of the Russian Federation. Good clinical practice» (approved by Order of Rostekhregulirovanie dated 27.09.2005 N 232-st) URL: https://www.consultant.ru/law/podborki/nacionalnyj_standart_nadlezhaschaya_klinicheskaya_praktika/ (Accessed: 17.05.2025) (In Russ).

18. Fürer K [et al.] Inhibition of porcine detrusor contractility by the flavonoid fraction of Bryophyllum pinnatum--a potential phytotherapeutic drug for the treatment of the overactive bladder syndrome. Phytomedicine. 2015;22(1):158-164. (In Engl)

19. Chibli LA, Rodrigues KC, Gasparetto CM, Pinto NC, Fabri RL, Scio E, Alves MS, Del-Vechio-Vieira G, Sousa OV. Anti-inflammatory effects of Bryophyllum pinnatum (Lam.) Oken ethanol extract in acute and chronic cutaneous inflammation. J Ethnopharmacol. 2014;154(2):330-338. (In Engl), doi: 10.1016/j.jep.2014.03.035.