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Momentary increase in plasma calcitonin gene-related peptide is involved in hot flashes in men treated with castration for carcinoma of the prostate
Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Biomedicine and Surgery, Urology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Biomedicine and Surgery, Urology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
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2001 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 166, no 5, 1720-1723 p.Article in journal (Refereed) Published
Abstract [en]

Purpose

In women the vasodilatory neuropeptides calcitonin gene-related peptide and neuropeptide Y seem to be involved in menopausal hot flashes. We assessed whether plasma calcitonin gene-related peptide and neuropeptide Y change during hot flashes in men after castration.

Materials and Methods

We evaluated 10 men 61 to 81 years old who underwent castration due to cancer of the prostate and had frequent hot flashes for changes in plasma calcitonin gene-related peptide and neuropeptide Y during 1 day at the outpatient clinic. At least 5 blood samples were obtained between flashes and 4 were obtained during each flash. The samples were analyzed for calcitonin gene-related peptide and neuropeptide Y using radioimmunoassay technique. Hot flashes were objectively recorded by measuring peripheral skin temperature and skin conductance.

Results

Plasma calcitonin gene-related peptide increased 46% (95% confidence interval 21 to 71) during flashes in the 6 men in whom it was measurable. This change was statistically significant (p = 0.028). The concentration of neuropeptide Y was below the detection limit. Skin conductance and temperature increased significantly during flashes.

Conclusions

Calcitonin gene-related peptide is involved in the mechanisms of hot flashes in men who underwent castration due to prostate carcinoma. Thus, there may be a similar mechanism of hot flashes in women and in men deprived of sex steroids.

Place, publisher, year, edition, pages
2001. Vol. 166, no 5, 1720-1723 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-25313DOI: 10.1016/S0022-5347(05)65660-1Local ID: 9754OAI: oai:DiVA.org:liu-25313DiVA: diva2:245641
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Vasomotor symptoms in men and the role of Calcitonin Gene-Related Peptide
Open this publication in new window or tab >>Vasomotor symptoms in men and the role of Calcitonin Gene-Related Peptide
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Hot flushes is a cotmnon phenomenon in women during the menopausal transition. In men treated with castration because of prostate cancer, hot flushes are probably the most cotmnon and distressing side-effect and are as common in these men as in menopausal women but the course of the flushes is unknown. Flushes also occur in healthy aging men, but the prevalence is unknown. The mechanisms behind hot flushes are not fully understood. They are probably caused by instability in the thermoregulatory centre due to a decrease in sex hotmone concentrations. Calcitonin Gene-Related Peptide (CGRP) and perhaps also Neuropeptide Y (NPY) are probably involved in menopausal hot flushes in women and could also be involved in men following therapeutic castration.

The aims of this thesis were to compare different methods of castration as regards the occunence and course of hot flushes, and to investigate the prevalence of hot flushes in an unselected population of elderly men. A further aim was to see if CGRP and NPY are involved in hot flushes in men, in the same way as has previously been suggested in women.

In this thesis two different modalities of castration therapy were compared: 1. castration by means of estrogens (Polyestradiol phosphate) and 2. total androgen blockade (a. bilateral orchiectomy or b. GnRH-analogue combined with oral anti-androgen). A much lower incidence of hot flushes were seen in the first group (1). Flushes induced by castration with estrogen were also milder and tended to disappear with time.

The prevalence of hot flushes in a male population 55 years of age and above was investigated by means of a questionnaire. Thirty per cent of the men repotted flushes and half of these found the flushes distressing, i.e. every sixth man in the study. There was an association between flushes and a number of symptoms that are often related to low testosterone concentrations in the blood.

The 24-hour urinaty excretion of CGRP was investigated in 17 men with prostate cancer before and after castration. Thirteen of the 17 men developed hot flushes after castration, but the urinary excretion of CGRP was not significantly altered.

Blood-samples were taken during hot flushes in 10 men for analysis of CGRP- and NPY-plasma concentrations. CGRP increased in 6 men (we failed to obtain CGRP measurements in the other men due to technical problems). NPY concentrations were below the detection limit for the analysis in all samples.

In conclusion vasomotor symptoms are common in men subjected to castration therapy. Different castration modalities result in different prevalence of hot flushes, something that should be considered when choosing the method of castration for men with prostate cancer. Hot flushes also occur in normal, aging men. The mechanisms behind hot flushes in men and women may be similar. CGRP may be involved in hot flushes in castrated men.

In order to be able to develop new treatment regimens for these vasomotor symptoms fmther studies on the mechanisms behind hot flushes should be undertaken, in both castrated and in otherwise healthy elderly men.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2002. 78 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 758
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25712 (URN)10089 (Local ID)91-7373-202-8 (ISBN)10089 (Archive number)10089 (OAI)
Public defence
2002-12-06, Berzeliussalen, Hälsouniversitetet, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-19Bibliographically approved

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Spetz, Anna-ClaraPettersson, BillVarenhorst, EberhardTheodorsson, ElvarThorell, Lars-HåkanHammar, Mats

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