IL-6, IL-8, and IL-17 may perpetuate chronic immune response in BPH and induce fibromuscular growth by an autocrine or paracrine loop[45, 46] or via induction of COX-2 expression.[47] Immune reaction may be activated via Toll-like receptor signaling and mediated by macrophages and T cells.[46] Conversely, anti-inflammatory factors such as macrophage inhibitory cytokine-1[48] may be decreased in symptomatic BPH tissues. This evidence concerns the gene IL17A and benign prostatic hyperplasia.