The prostate is the only organ in a man that continues to grow with age. John McNeal proposed, 40 years ago, that this BPH is characterized by an age-related reinitiation of benign neoplastic growth selectively in developmentally abortive distal ducts within the prostate transition-periurethral zone (TPZ), owing to a reawakening of inductive stroma selectively within these zones. An innovative variant of this hypothesis is that, owing to its location, the TPZ is continuously exposed to urinary components and/or autoantigens, which produces an inflammatory TPZ microenvironment that promotes recruitment of bone marrow-derived mesenchymal stem cells (MSCs) and generates a paracrine-inductive stroma that reinitiates benign neoplastic nodular growth. In support of this hypothesis, MSCs infiltrate human BPH tissue and have the ability to stimulate epithelial stem cell growth. These results provide a framework for defining both the aetiology of BPH in ageing men and insights into new therapeutic approaches.

中文翻译：

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间充质干细胞和BPH的胚胎苏醒理论。

前列腺是人中唯一随年龄增长而不断增长的器官。约翰·麦克尼尔（John McNeal）于40年前提出，该前列腺增生症的特征是与年龄相关的前列腺移行-尿道上带（TPZ）内发育中止的远端导管选择性地重新开始良性肿瘤生长，这是由于这些体内选择性地重新唤醒了诱导性基质区域。此假设的创新变体是，由于其位置，TPZ持续暴露于尿液成分和/或自身抗原，从而产生炎性TPZ微环境，从而促进骨髓来源的间充质干细胞（MSC）的募集并产生旁分泌诱导间质，可重新开始良性肿瘤性结节性生长。为了支持这一假设，MSC浸润人BPH组织并具有刺激上皮干细胞生长的能力。这些结果为定义老年男性BPH的病因和对新治疗方法的见解提供了框架。