In vitro neuroendocrine differentiation of BPH-1 cells under beta2 adrenergic receptor stimulation

Epidemiologic and experimental animal studies have shown that stress can alter tumor growth and that adrenergic fibers from the sympathetic nervous system, acting through stromal {beta}2 adrenergic receptors, promote tumor cell survival during the initial phases of cancer development. Recent epidemiological data suggest that beta blocker intake improves survival of prostate cancer patients. Hypertension and high blood pressure have been suggested to increase likelihood of prostate cancer development, suggesting that the use of beta blockers in these patients could reduce prostate cancer risk. Signaling mediated by {beta} adrenergic receptors promotes neuroendocrine differentiation in the LNCaP prostate cancer cell line. Although neuroendocrine cells are a minor population in the epithelial compartment of normal prostate glands, the population of neuroendocrine-like cells that express markers such as SYN, Bcl-2, Dll-3, and AMACR correlates with cancer progression, androgen-independent state, and poor prognosis in prostate cancer patients. As recent studies show that an increase in neuroendocrine cell density occurs before development of benign prostatic hyperplasia, a non-lethal disease affecting the transition zone, in hypertensive rats, we investigated whether neuroendocrine differentiation is associated with benign prostatic hyperplasia. Our results showed that isobutyl-methyl-xanthine, which blocks cAMP degradation, and forskolin, an adenylate cyclase activator, triggered sustained activation of the cAMP/PKA pathway and led to an increase in neuroendocrine differentiation markers in BPH-1 cells, which are a benign prostatic hyperplasia cell line. Similar results were observed by combining the {beta} adrenergic receptors agonist isoproterenol with forskolin. The same treatments reduced BPH-1 cell proliferation rates by 40% and 60%, respectively. Effects on AMACR and SYN expression and cell proliferation were fully reversed by the {beta}2 blocker carvedilol. These data suggest that {beta} adrenergic receptors are linked to the development of neuroendocrine-like cells and benign prostatic hyperplasia. As 20% of the prostate cancer tumors occur in this zone, this observation warrants further investigation.