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Wang M, Dai B, Liu Q, Wang X, Xiao Y, Zhang G, Jiang H, Zhang X, Zhang L. Polystyrene nanoplastics exposure causes erectile dysfunction in rats. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 280:116551. [PMID: 38875818 DOI: 10.1016/j.ecoenv.2024.116551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/11/2024] [Accepted: 06/03/2024] [Indexed: 06/16/2024]
Abstract
Polystyrene nanoplastics (PS-NPs), emerging and increasingly pervasive environmental contaminants, have the potential to cause persistent harm to organisms. Although previous reports have documented local accumulation and adverse effects in a variety of major organs after PS-NPs exposure, the impact of PS-NPs exposure on erectile function remains unexplored. Herein, we established a rat model of oral exposure to 100 nm PS-NPs for 28 days. To determine the best dose range of PS-NPs, we designed both low-dose and high-dose PS-NPs groups, which correspond to the minimum and maximum human intake doses, respectively. The findings indicated that PS-NPs could accumulate within the corpus cavernosum and high dose but not low dose of PS-NPs triggered erectile dysfunction. Moreover, the toxicological effects of PS-NPs on erectile function include fibrosis in the corpus cavernous, endothelial dysfunction, reduction in testosterone levels, elevated oxidative stress and apoptosis. Overall, this study revealed that PS-NPs exposure can cause erectile dysfunction via multiple ways, which provided new insights into the toxicity of PS-NPs.
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Affiliation(s)
- Ming Wang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Institute of Urology, Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei 230022, China
| | - Bangshun Dai
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Institute of Urology, Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei 230022, China
| | - Qiushi Liu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Institute of Urology, Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei 230022, China
| | - Xiaobin Wang
- Department of Urology, Southern University of Science and Technology Hospital, Shenzhen 518052, China
| | - Yunzheng Xiao
- Department of Urology, Southern University of Science and Technology Hospital, Shenzhen 518052, China
| | - Guilong Zhang
- School of Pharmacy, Shandong Technology Innovation Center of Molecular Targeting and Intelligent Diagnosis and Treatment, Binzhou Medical University, Yantai 264003, China.
| | - Hui Jiang
- Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center, Beijing 100034, China.
| | - Xiansheng Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Institute of Urology, Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei 230022, China.
| | - Li Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Institute of Urology, Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei 230022, China; Center for Scientific Research of the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
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2
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Wang S, Zhang A, Liu K, Pan Y, Kang J, Niu S, Song Y, Zhang Z, Li Y, Liu L, Liu X. A study of diabetes-induced erectile dysfunction treated with human umbilical cord mesenchymal stem cells. Andrologia 2022; 54:e14440. [PMID: 35415927 DOI: 10.1111/and.14440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/22/2022] [Accepted: 04/03/2022] [Indexed: 12/12/2022] Open
Abstract
The present study aimed to assess the value of human umbilical cord mesenchymal stem cells (hUC-MSCs) for the treatment of diabetes-induced erectile dysfunction (DMED). We established a type 1 diabetes model through intra-abdominal streptozotocin injection. After 10 weeks, an apomorphine test was performed to screen the rats for erectile dysfunction (ED). The rats were divided into three groups: normal control group (n = 10), DMED group (n = 9) and DMED+hUC-MSC group (n = 9). After 4 weeks of hUC-MSC therapy, erectile function was evaluated by intracavernous pressure measurements, and penile tissue collagen and smooth muscle were examined by haematoxylin-eosin and Masson's trichrome staining. In addition, western blotting, immunohistochemistry and RT-PCR analysis of TLR4, VEGF and eNOS were performed. The results showed that hUC-MSC treatment restored erectile function (p < .05) and reversed the smooth muscle/collagen ratio changes of DMED rats (p < .05). Furthermore, hUC-MSC treatment inhibited the expression of TLR4 (p < .05) and enhanced VEGF and eNOS expression (p < .05). In conclusion, hUC-MSC treatment restored the erectile function of diabetic rats by inhibiting TLR4, improving corpora cavernosa fibrosis, and increasing VEGF and eNOS expression.
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Affiliation(s)
- Shangren Wang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Aiqiao Zhang
- Department of Neonatology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Department of Neonatology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Kang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yang Pan
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiaqi Kang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shuai Niu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuxuan Song
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhexin Zhang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuezheng Li
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
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Zhou J, Yin Y, Yang Y, Peng D, Wei J, Yin G, Tang Y. Knockdown of miR-423-5p simultaneously upgrades the eNOS and VEGFa pathways in ADSCs and improves erectile function in diabetic rats. J Cell Mol Med 2021; 25:9796-9804. [PMID: 34545676 PMCID: PMC8505849 DOI: 10.1111/jcmm.16927] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 12/11/2022] Open
Abstract
This study aimed to explore the possibility of miR‐423‐5p modified adipose‐derived stem cell (ADSCs) therapy on streptozotocin (STZ)‐induced diabetes mellitus erectile dysfunction (DMED) rats. MiR‐423‐5p was knocked down in ADSCs. ADSCs, NC‐miR‐ADSCs and miR‐ADSCs were co‐cultured with human umbilical vein endothelial cells (HUVECs). Normal and high glucose media were supplemented. The supernatant and HUVECs were collected for assessment of eNOS and VEGFa expression, cell proliferation, and apoptosis. HUVECs co‐cultured with ADSCs or miR‐ADSCs exhibited higher eNOS and VEGFa protein expression levels compared to DM groups. MiR‐ADSCs enhanced HUVEC proliferation compared to the ADSCs and NC‐miR‐ADSCs. Lower apoptotic rates were observed when HUVECs were co‐cultured with miR‐ADSCs, compared to ADSCs and NC‐miR‐ADSCs. Fifteen male Sprague‐Dawley (SD) rats aged 12 weeks were induced to develop diabetes mellitus by intraperitoneal injection with STZ, and five healthy SD rats were used as normal controls. Eight weeks after developing diabetes, the rats received ADSCs and miR‐ADSCs via injection into the corpora cavernosa, whereas normal controls and DM controls were injected with saline. Erectile function and histological assessment of penile tissues were performed 8 weeks after injection. The ICP/MAP indicated that erectile function was impaired in the DM rats compared with the normal group. Injection of ADSCs and miR‐ADSCs improved erectile function significantly and was associated with the overexpression of eNOS and VEGFa. MiR‐423‐5p knockdown in ADSCs ameliorated high glucose‐mediated damage to HUVECs and improved erectile function in DM rats by inducing eNOS and VEGFa overexpression, indicating that miR‐423‐5p may be a potential target in the treatment of DMED.
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Affiliation(s)
- Jun Zhou
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yinghao Yin
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yuan Yang
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Dongyi Peng
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jingchao Wei
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Guangming Yin
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yuxin Tang
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China.,Department of Urology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.,Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province, China
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Fan J, Peng T, Hui J, Ding W, He B, Zhang H, Wei A. Erectile Dysfunction in Type-2 Diabetes Mellitus Patients: Predictors of Early Detection and Treatment. Urol Int 2021; 105:986-992. [PMID: 33951654 DOI: 10.1159/000514700] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/24/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE To identify risk factors and potential predictors of erectile dysfunction (ED) in type-2 diabetes mellitus (T2DM) patients for early detection and treatment. METHODS A retrospective cohort was used to assess the clinical data of 105 diabetic patients with ED from May 2019 to April 2020 age-matched to 105 diabetic patients without ED. Potential risk factors that could contribute to ED were compared between the groups. Erectile function was evaluated using the International Index of Erectile Function-5 questionnaire. RESULTS There were higher rates of diabetic peripheral neuropathy (p = 0.036) and retinopathy (p < 0.001), longer duration of diabetes (p < 0.001), lower estimated glomerular filtration rate (p = 0.010) values, and higher uric acid (p < 0.001) and C-reactive protein (p = 0.001) levels in the ED group compared to the non-ED group. Multivariate logistic analysis identified uric acid, diabetic retinopathy, and T2DM course as independent predictors of diabetic ED. Diabetics with retinopathy and T2DM for ≥49 months were 3.028 and 3.860 times more likely to have ED, respectively. Uric acid values ≥392.5 μmol/L were associated with 18.638 times greater risk of having ED, though the values were within normal range. CONCLUSION In T2DM patients, higher uric acid (≥392.5 μmol/L), longer diabetes duration (≥49 months), and the presence of diabetic retinopathy were important and reliable predictors for diabetic ED. For patients who have high risk factors for developing ED, diligent screening and early treatment are necessary.
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Affiliation(s)
- Junhong Fan
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Tianwen Peng
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jialiang Hui
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wei Ding
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Urology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Binglin He
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Haibo Zhang
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Anyang Wei
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Cong R, Wang Y, Wang Y, Zhang Q, Zhou X, Ji C, Yao L, Song N, Meng X. Comprehensive Analysis of lncRNA Expression Pattern and lncRNA-miRNA-mRNA Network in a Rat Model With Cavernous Nerve Injury Erectile Dysfunction. J Sex Med 2020; 17:1603-1617. [PMID: 32675050 DOI: 10.1016/j.jsxm.2020.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/03/2020] [Accepted: 05/10/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Long noncoding RNAs (lncRNAs) are differentially expressed in erectile dysfunction (ED) associated with aging and diabetes mellitus; however, the lncRNA expression profile in cavernous nerve (CN) injury-related ED (CNI-ED) is unknown. AIM To investigate the dysregulated lncRNAs, microRNAs (miRNAs), and mRNA expression in CNI-ED and construct a potential lncRNA-miRNA-mRNA network. METHODS 22 male Sprague-Dawley (SD) rats were divided into bilateral CN crush (BCNC) and Sham groups. Using second-generation high-throughput sequencing technology, we analyzed the expression profiles of lncRNA, miRNA, and mRNA of the 2 groups. 17 differentially expressed lncRNAs were selected and further validated by quantitative real-time polymerase chain reaction (RT-qPCR). The lncRNA-miRNA-mRNA network, Gene Ontology (GO) term enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed using Cytoscape. OUTCOMES Intra-cavernosal pressure, mean arterial pressure, smooth muscle content, and the expression of miRNA, mRNA, and lncRNA were measured. RESULTS The BCNC group showed decreased intra-cavernosal/mean arterial pressure as well as decreased smooth muscle/collagen ratios compared with the Sham group. The RNA sequencing results revealed dysregulated expressions of 65 lncRNA, 14 miRNA, and 750 mRNA in the BCNC group based on the following criteria: fold change >2 and P < .05. Among the 17 lncRNAs further selected based on mean count number >4 in both groups, 3 lncRNAs (TCONS_00028173, TCONS_00049985, and TCONS_00058429) were further validated for differential expression by RT-qPCR. GO analysis suggests that these 3 lncRNAs could regulate various processes such as myotube differentiation and muscle cell differentiation. Furthermore, the KEGG pathway analysis showed that the mRNAs in the competing endogenous RNA (ceRNA) network are involved in pathways, including axon guidance and vascular endothelial growth factor signaling pathway. CLINICAL TRANSLATION Our findings may provide new information on molecular pathophysiology of CNI-ED and suggest further research to find a more effective therapy for CNI-ED. STRENGTHS & LIMITATIONS This study is the first to identify the lncRNA expression pattern and propose a ceRNA network in a rat model with cavernous nerve injury-related erectile dysfunction. However, analogous studies are needed to confirm these findings in humans. In addition, we constructed the network by only confirming the lncRNA. CONCLUSION Our study reveals differential expression profiles of lncRNAs, miRNAs, and mRNAs between the BCNC and Sham groups and suggests that these differentially expressed lncRNAs may play critical roles in CNI-ED by regulating apoptosis and fibrosis in the corpus cavernosum via targeting mRNAs or miRNAs. Cong R, Wang Y, Wang Y. Comprehensive Analysis of lncRNA Expression Pattern and lncRNA-miRNA-mRNA Network in a Rat Model With Cavernous Nerve Injury Erectile Dysfunction. J Sex Med 2020;17:1603-1617.
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Affiliation(s)
- Rong Cong
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yi Wang
- Department of Urology, Affiliated Hospital of Nantong University, Nantong, China
| | - Yamin Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qijie Zhang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiang Zhou
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chengjian Ji
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Liangyu Yao
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ninghong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Department of Urology, The Affiliated Kizilsu Kirghiz Autonomous Prefecture People's Hospital of Nanjing Medical University, Artux, China.
| | - Xianghu Meng
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Yang J, Yu Z, Zhang Y, Zang G, Zhuan L, Tang Z, Liu Y, Wang T, Wang S, Liu J. Preconditioning of adipose‐derived stem cells by phosphodiesterase‐5 inhibition enhances therapeutic efficacy against diabetes‐induced erectile dysfunction. Andrology 2019; 8:231-240. [DOI: 10.1111/andr.12661] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 04/08/2019] [Accepted: 05/06/2019] [Indexed: 12/17/2022]
Affiliation(s)
- J. Yang
- Department of Urology, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
- Institute of Urology of Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
| | - Z. Yu
- Department of Urology, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
- Institute of Urology of Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
| | - Y. Zhang
- Department of Urology, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
- Institute of Urology of Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
| | - G.‐H. Zang
- Department of Urology, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
- Institute of Urology of Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
| | - L. Zhuan
- Department of Urology, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
- Institute of Urology of Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
| | - Z. Tang
- Department of Urology, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
- Institute of Urology of Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
| | - Y. Liu
- Department of Neurology, Tongji Medical College Huazhong University of Science and Technology Hubei China
| | - T. Wang
- Department of Urology, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
- Institute of Urology of Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
| | - S.‐G. Wang
- Department of Urology, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
- Institute of Urology of Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
| | - J.‐H. Liu
- Department of Urology, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
- Institute of Urology of Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and Technology HubeiChina
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7
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Lee YC, Huang SP, Tsai CC, Cheng KH, Juan YS, Wu WJ, Bao BY, Huang CN, Wang CJ, Liu CC. Associations of VEGF Gene Polymorphisms With Erectile Dysfunction and Related Risk Factors. J Sex Med 2017; 14:510-517. [DOI: 10.1016/j.jsxm.2017.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/27/2017] [Accepted: 02/08/2017] [Indexed: 01/08/2023]
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Abstract
Erectile dysfunction (ED) is a common complication of diabetes, affecting up to 75% of all diabetic men. Although the aetiology of diabetic ED is multifactorial, endothelial dysfunction is recognized as a mainstay in the pathophysiology of the disease. Endothelial dysfunction is induced by the detrimental actions of high glucose levels and increased oxidative stress on endothelial cells that make up the vascular lining. Besides directly injuring the endothelium, diabetes might also hamper vascular repair mechanisms of angiogenesis and vasculogenesis. These states exacerbate and maintain endothelial dysfunction, impairing vasorelaxation events and cavernosal blood perfusion, which are crucial for normal erectile function.
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Li L, Zhang D, Li P, Damaser M, Zhang Y. Virus integration and genome influence in approaches to stem cell based therapy for andro-urology. Adv Drug Deliv Rev 2015; 82-83:12-21. [PMID: 25453258 DOI: 10.1016/j.addr.2014.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 09/22/2014] [Accepted: 10/07/2014] [Indexed: 12/21/2022]
Abstract
Despite the potential of stem cells in cell-based therapy, major limitations such as cell retention, ingrowth, and trans-differentiation after implantation remain. One technique for genetic modification of cells for tissue repair is the introduction of specific genes using molecular biology techniques, such as virus integration, to provide a gene that adds new functions to enhance cellular function, and to secrete trophic factors for recruiting resident cells to participate in tissue repair. Stem cells can be labeled to track cell survival, migration, and lineage. Increasing evidence demonstrates that cell therapy and gene therapy in combination remarkably improve differentiation of implanted mesenchymal stromal cells (MSCs), revascularization, and innervation in genitourinary tissues, especially to treat urinary incontinence, erectile dysfunction, lower urinary tract reconstruction, and renal failure. This review discusses the benefits, safety, side effects, and alternatives for using genetically modified MSCs in tissue regeneration in andro-urology.
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10
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Toque HA, Caldwell RW. New approaches to the design and discovery of therapies to prevent erectile dysfunction. Expert Opin Drug Discov 2014; 9:1447-69. [DOI: 10.1517/17460441.2014.949234] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Ichim TE, Warbington T, Cristea O, Chin JL, Patel AN. Intracavernous administration of bone marrow mononuclear cells: a new method of treating erectile dysfunction? J Transl Med 2013; 11:139. [PMID: 23758954 PMCID: PMC3718667 DOI: 10.1186/1479-5876-11-139] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 04/23/2013] [Indexed: 02/06/2023] Open
Abstract
While PDE5 inhibitors have revolutionized treatment of ED, approximately 30% of patients are non-responsive. A significant cause of this is vascular and smooth muscle dysfunction, as well as nerve atrophy. Autologous administration of bone marrow mononuclear cells (BMMC) has been performed in over 2000 cardiac patients without adverse effects, for stimulation of angiogenesis/regeneration. Despite its ease of access, and dependence on effective vasculature for function, comparatively little has been perform in terms of BMMC therapy for ED. Here we outline the rationale for use of autologous BMMC in patients with ED, as well as provide early safety data on the first use of this procedure clinically.
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Affiliation(s)
- Thomas E Ichim
- Institute for Molecular Medicine, Huntington Beach, CA, USA.
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12
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Kim SO, Lee HS, Ahn K, Park K. COMP-angiopoietin-1 promotes cavernous angiogenesis in a type 2 diabetic rat model. J Korean Med Sci 2013; 28:725-30. [PMID: 23678264 PMCID: PMC3653085 DOI: 10.3346/jkms.2013.28.5.725] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 02/25/2013] [Indexed: 11/20/2022] Open
Abstract
Cartilage oligomeric matrix protein-angiopoietin-1 (COMP-Ang1) is an angiogenic factor for vascular angiogenesis. The aim was to investigate the effect of an intracavernosal injection of COMP-Ang1 on cavernosal angiogenesis in a diabetic rat model. Male Otsuka Long-Evans Tokushima Fatty (OLETF) rats made up the experimental group (1 yr old) and Long-Evans Tokushima Otsuka (LETO) rats made up the control group. The experimental group was divided into vehicle only, 10 µg COMP-Ang1, and 20 µg COMP-Ang1. COMP-Ang1 was injected into the corpus cavernosum of the penis. After 4 weeks, the penile tissues of the rats were obtained for immunohistochemistry and Western blot analysis. The immunoreactivity of PECAM-1 and VEGF was increased in the COMP-Ang1 group compared with the vehicle only group. Moreover, the expression of PECAM-1 and VEGF was notably augmented in the 20 µg Comp Ang-1 group. In the immunoblotting study, the expression of PECAM-1 and VEGF protein was significantly less in the OLEFT rats than in the control LETO rats. However, this expression was restored to control level after intracavernosal injection of COMP-Ang1. These results show that an intracavernosal injection of COMP-Ang1 enhances cavernous angiogenesis by structurally reinforcing the cavernosal endothelium.
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Affiliation(s)
- Sun-Ouck Kim
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
- Sexual Medicine Research Center, Chonnam National University Medical School, Gwangju, Korea
| | - Hyun-Suk Lee
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
- Sexual Medicine Research Center, Chonnam National University Medical School, Gwangju, Korea
| | - Kyuyoun Ahn
- Department of Anatomy, Chonnam National University Medical School, Gwangju, Korea
- Sexual Medicine Research Center, Chonnam National University Medical School, Gwangju, Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
- Sexual Medicine Research Center, Chonnam National University Medical School, Gwangju, Korea
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Lin F, Gou X. Panax notoginseng saponins improve the erectile dysfunction in diabetic rats by protecting the endothelial function of the penile corpus cavernosum. Int J Impot Res 2013; 25:206-11. [PMID: 23595104 DOI: 10.1038/ijir.2013.19] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 02/07/2013] [Accepted: 03/13/2013] [Indexed: 02/01/2023]
Abstract
Diabetes mellitus (DM)-associated ED is predominantly due to neurovascular dysfunction mediated by nitric oxide (NO) suppression. Panax notoginseng saponins (PNS) are widely used for treating cardiovascular disease in China. The aim of this study was to evaluate the effects of PNS on penile erection and corpus cavernosum tissues in rats with diabetes-associated ED. Four weeks after PNS treatment, erectile function was assessed by intracavernous pressure (ICP) and mean arterial pressure (MAP) measurements. The level of NO, cyclic guanosine monophosphate (cGMP) and advanced glycation end products (AGEs) in cavernous tissue were assessed. Immunohistochemical staining and TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) were performed for detecting endothelial NO synthase (eNOS) and apoptosis, respectively. The results show that ICP/MAP ratio was significantly increased in high-dose (150 mg kg(-1) per day) PNS-treated group compared with the diabetic ED untreated group (DM group). Compared with the untreated group, the expression of eNOS and the levels of NO and cGMP were increased in the PNS-treated groups. Moreover, apoptosis was markedly decreased in the group that received 150 mg kg(-1) per day of PNS. These results suggest that PNS may be used for improving the ED in diabetic rats via the NO/cGMP pathway and restores the function of endothelium in corpus cavernosum.
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Affiliation(s)
- F Lin
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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14
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Kwon MH, Tuvshintur B, Kim WJ, Jin HR, Yin GN, Song KM, Choi MJ, Kwon KD, Batbold D, Ryu JK, Suh JK. Expression of the apelin-APJ pathway and effects on erectile function in a mouse model of vasculogenic erectile dysfunction. J Sex Med 2013; 10:2928-41. [PMID: 23578329 DOI: 10.1111/jsm.12158] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Much attention has recently been focused on therapeutic angiogenesis as a treatment for erectile dysfunction (ED). The apelin and apelin receptor (APJ) system is known to cause endothelium-dependent vasodilatation and to be involved in angiogenesis. AIM To examine the differential expression of apelin and APJ in animal models of vasculogenic ED and to determine whether and how enhancement of apelin-APJ signaling restores erectile function in hypercholesterolemic mice. METHODS Acute cavernous ischemia was induced in C57BL/6J mice by bilateral occlusion of internal iliac arteries, and chronic vasculogenic ED was induced by feeding a high-cholesterol diet or by intraperitoneal injection of streptozotocin. MAIN OUTCOME MEASURES Messenger RNA (mRNA) levels of apelin and APJ were determined in cavernous tissue of each vasculogenic ED model by semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR). We evaluated erectile function by electrical stimulation of the cavernous nerve in hypercholesterolemic mice 1, 3, 7, and 14 days after a single intracavernous injection of apelin protein (5 μg/20 μL). The penis was harvested for histologic examinations and Western blot analysis. RESULTS The cavernous mRNA expression of apelin and APJ was up-regulated in acute ischemia model and down-regulated in chronic vasculogenic ED models. A significant restoration of erectile function was noted 1 day after injection of apelin protein into the penis of hypercholesterolemic mice; however, erectile function returned to baseline values thereafter. The beneficial effects of apelin on erectile function resulted mainly from an activation of endothelial nitric oxide synthase and increase in nitric oxide bioavailability through reduction in reactive oxygen species-mediated endothelial apoptosis rather than through direct endothelial cell proliferation. CONCLUSION These findings suggest that apelin-APJ signaling is a potential therapeutic target in the treatment of vasculogenic ED. Further studies are needed to develop a potent agonist for APJ and to determine the role of repeated dosing of apelin on long-term recovery of erectile function.
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Affiliation(s)
- Mi-Hye Kwon
- National Research Center for Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
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Fan M, Xu X, He X, Chen L, Qian L, Liu J, Qing J, Chao Z, Sun X. Protective effects of hydrogen-rich saline against erectile dysfunction in a streptozotocin induced diabetic rat model. J Urol 2012; 190:350-6. [PMID: 23220246 DOI: 10.1016/j.juro.2012.12.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2012] [Indexed: 02/03/2023]
Abstract
PURPOSE Hydrogen has antioxidative stress and anti-inflammatory effects. We investigated the effect of hydrogen on erectile dysfunction in streptozotocin induced diabetic rats. MATERIALS AND METHODS Diabetes was induced in Sprague-Dawley® rats by a single intravenous injection of streptozotocin. Diabetic rats were then randomized to a diabetes mellitus group and to a diabetic group that received hydrogen saline. The latter 8 rats were fed saturated hydrogen saline (5 ml/kg per day) by intragastric administration for 8 weeks. At the end of week 8 erectile function was assessed by measuring the increase in intracavernous pressure after cavernous nerve electrostimulation. We measured nitric oxide synthase activity, and malondialdehyde, 8-hydroxydeoxyguanosine, and nitrite and nitrate in the corpus cavernosum. eNOS protein immunolocalization in cavernous tissues was detected by immunohistochemistry. eNOS, Bcl-2 and Bax protein expression was determined by Western blot. We determined eNOS, Bcl-2 and Bax mRNA using real-time reverse transcriptase-polymerase chain reaction. RESULTS Oxidative stress is involved in the pathophysiological mechanism of erectile dysfunction. Maximum intracavernous pressure in diabetic rats decreased significantly compared to controls and increased significantly compared to untreated diabetic rats after hydrogen-rich saline treatment. Decreased nitric oxide synthase activity, nitrite and nitrate, and eNOS expression as well as increased 8-hydroxydeoxyguanosine and malondialdehyde were found in the diabetic group compared to controls. Hydrogen-rich saline improved nitric oxide synthase activity, and malondialdehyde, nitrite and nitrate, and 8-hydroxydeoxyguanosine levels in the diabetic rat corpus cavernosum. Decreased eNOS in diabetic rats was ameliorated by hydrogen-rich saline. Also, apoptosis in the diabetic rat corpus cavernosum was significantly enhanced compared with controls. Hydrogen-rich saline therapy may decrease apoptosis in cavernous tissues and it ameliorated erectile dysfunction in diabetic rats by inhibiting oxidative stress and apoptosis. CONCLUSIONS Hydrogen-rich saline effectively improved erectile function in a streptozotocin induced diabetic rat model of erectile dysfunction.
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Affiliation(s)
- Min Fan
- Department of Urology, Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China
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Ying C, Yang M, Zheng X, Hu W, Wang X. Effects of Intracavernous Injection of Adipose-Derived Stem Cells on Cavernous Nerve Regeneration in a Rat Model. Cell Mol Neurobiol 2012; 33:233-40. [DOI: 10.1007/s10571-012-9890-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 11/03/2012] [Indexed: 12/19/2022]
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Ryu JK, Tumurbaatar M, Jin HR, Kim WJ, Kwon MH, Piao S, Choi MJ, Yin GN, Song KM, Kang YJ, Koh YJ, Koh GY, Suh JK. Intracavernous delivery of freshly isolated stromal vascular fraction rescues erectile function by enhancing endothelial regeneration in the streptozotocin-induced diabetic mouse. J Sex Med 2012; 9:3051-65. [PMID: 23088258 DOI: 10.1111/j.1743-6109.2012.02962.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Men with diabetic erectile dysfunction (ED) often have severe endothelial dysfunction and respond poorly to oral phosphodiesterase-5 inhibitors. AIM To examine whether and how freshly isolated stromal vascular fraction (SVF) promotes cavernous endothelial regeneration and restores erectile function in diabetic animals. METHODS Eight-week-old C57BL/6J mice were used. Diabetes was induced by intraperitoneal injection of streptozotocin. SVF was isolated from epididymal adipose tissues of green fluorescence protein transgenic mice. At 8 weeks after the induction of diabetes, the animals were divided into six groups: controls, diabetic mice, and diabetic mice treated with a single intracavernous injection of phosphate-buffered saline (PBS) or SVF (1 × 10(4) cells, 1 × 10(5) cells, or 2 × 10(5) cells/20 µL, respectively). MAIN OUTCOME MEASURES Two weeks later, erectile function was measured by cavernous nerve stimulation. The penis was stained with antibodies to CD31, CD34, phosphohistone H3, phospho-endothelial nitric oxide synthase (eNOS), and vascular endothelial growth factor-A (VEGF-A). We also performed Western blot for phospho-eNOS and eNOS, and determined cyclic guanosine monophosphate (cGMP) concentration in the corpus cavernosum tissue. RESULTS Significant improvement in erectile function was noted in diabetic mice treated with SVF at concentrations of 1 × 10(5) and 2 × 10(5) cells, which reached up to 82% of the control values. Local delivery of SVF significantly increased cavernous endothelial cell proliferation, eNOS phosphorylation, and cGMP expression compared with that in the untreated group and the PBS-treated diabetic group. Intracavernous injection of SVF increased cavernous VEGF-A expression and induced recruitment of CD34(+)CD31(-) progenitor cells. Some SVF underwent differentiation into cavernous endothelial cells. SVF-induced promotion of cavernous angiogenesis and erectile function was abolished in the presence of VEGF-Trap, a soluble VEGF-A neutralizing antibody. CONCLUSION The results support the concept of cavernous endothelial regeneration by use of SVF as a curative therapy for diabetic ED.
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Affiliation(s)
- Ji-Kan Ryu
- National Research Center for Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
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Hakim L, Van der Aa F, Bivalacqua TJ, Hedlund P, Albersen M. Emerging tools for erectile dysfunction: a role for regenerative medicine. Nat Rev Urol 2012; 9:520-36. [PMID: 22824778 DOI: 10.1038/nrurol.2012.143] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Erectile dysfunction (ED) is the most common sexual disorder reported by men to their health-care providers and the most investigated male sexual dysfunction. Currently, the treatment of ED focuses on 'symptomatic relief' of ED and, therefore, tends to provide temporary relief rather than providing a cure or reversing the cause. The identification of a large population of "difficult-to-treat" patients has triggered researchers to identify novel treatment approaches, which focus on cure and restoration of the underlying cause of ED. Regenerative medicine has developed extensively in the past few decades and preclinical trials have emphasized the benefit of growth factor therapy, gene transfer, stem cells and tissue engineering for the restoration of erectile function. Development of clinical trials involving immunomodulation in postprostatectomy ED patients and the use of maxi-K channels for gene therapy are illustrative of the advances in the field. However, the search for novel treatment targets and a wealth of preclinical studies represent a dynamic and continuing field of enquiry.
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Affiliation(s)
- Lukman Hakim
- Laboratory of Experimental Urology, Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
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Chung E, Brock GB. Emerging and Novel Therapeutic Approaches in the Treatment of Male Erectile Dysfunction. Curr Urol Rep 2011; 12:432-43. [DOI: 10.1007/s11934-011-0216-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Jin HR, Kim WJ, Song JS, Piao S, Choi MJ, Tumurbaatar M, Shin SH, Yin GN, Koh GY, Ryu JK, Suh JK. Intracavernous delivery of a designed angiopoietin-1 variant rescues erectile function by enhancing endothelial regeneration in the streptozotocin-induced diabetic mouse. Diabetes 2011; 60:969-80. [PMID: 21270241 PMCID: PMC3046858 DOI: 10.2337/db10-0354] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Patients with diabetic erectile dysfunction often have severe endothelial dysfunction and respond poorly to oral phosphodiesterase-5 inhibitors. We examined the effectiveness of the potent angiopoietin-1 (Ang1) variant, cartilage oligomeric matrix protein (COMP)-Ang1, in promoting cavernous endothelial regeneration and restoring erectile function in diabetic animals. RESEARCH DESIGN AND METHODS Four groups of mice were used: controls; streptozotocin (STZ)-induced diabetic mice; STZ-induced diabetic mice treated with repeated intracavernous injections of PBS; and STZ-induced diabetic mice treated with COMP-Ang1 protein (days -3 and 0). Two and 4 weeks after treatment, we measured erectile function by electrical stimulation of the cavernous nerve. The penis was harvested for histologic examinations, Western blot analysis, and cGMP quantification. We also performed a vascular permeability test. RESULTS Local delivery of the COMP-Ang1 protein significantly increased cavernous endothelial proliferation, endothelial nitric oxide (NO) synthase (NOS) phosphorylation, and cGMP expression compared with that in the untreated or PBS-treated STZ-induced diabetic group. The changes in the group that received COMP-Ang1 restored erectile function up to 4 weeks after treatment. Endothelial protective effects, such as marked decreases in the expression of p47(phox) and inducible NOS, in the generation of superoxide anion and nitrotyrosine, and in the number of apoptotic cells in the corpus cavernosum tissue, were noted in COMP-Ang1-treated STZ-induced diabetic mice. An intracavernous injection of COMP-Ang1 completely restored endothelial cell-cell junction proteins and decreased cavernous endothelial permeability. COMP-Ang1-induced promotion of cavernous angiogenesis and erectile function was abolished by the NOS inhibitor, N-nitro-L-arginine methyl ester, but not by the NADPH oxidase inhibitor, apocynin. CONCLUSIONS These findings support the concept of cavernous endothelial regeneration by use of the recombinant Ang1 protein as a curative therapy for diabetic erectile dysfunction.
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Affiliation(s)
- Hai-Rong Jin
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - Woo Jean Kim
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - Jae Sook Song
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - Shuguang Piao
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - Min Ji Choi
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - Munkhbayar Tumurbaatar
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - Sun Hwa Shin
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - Guo Nan Yin
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - Gou Young Koh
- Department of Biological Sciences and National Research Laboratory for Vascular Biology, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - Ji-Kan Ryu
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
- Corresponding author: Jun-Kyu Suh, , and Ji-Kan Ryu,
| | - Jun-Kyu Suh
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
- Corresponding author: Jun-Kyu Suh, , and Ji-Kan Ryu,
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Jin HR, Kim WJ, Song JS, Piao S, Tumurbaatar M, Shin SH, Choi MJ, Tuvshintur B, Song KM, Kwon MH, Yin GN, Koh GY, Ryu JK, Suh JK. Intracavernous delivery of synthetic angiopoietin-1 protein as a novel therapeutic strategy for erectile dysfunction in the type II diabetic db/db mouse. J Sex Med 2011; 7:3635-46. [PMID: 20584113 DOI: 10.1111/j.1743-6109.2010.01925.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Patients with erectile dysfunction (ED) associated with type II diabetes often have impaired endothelial function and tend to respond poorly to oral phosphodiesterase type 5 inhibitors. Therefore, neovascularization is a promising strategy for curing diabetic ED. AIM To determine the effectiveness of a soluble, stable, and potent angiopoietin-1 (Ang1) variant, cartilage oligomeric matrix protein (COMP)-Ang1, in promoting cavernous angiogenesis and erectile function in a mouse model of type II diabetic ED. Methods. Sixteen-week-old male db/db mice (in which obesity and type II diabetes are caused by a mutation in the leptin receptor) and control C57BL/6J mice were used and divided into four groups (N=14 per group): age-matched controls; db/db mice receiving two successive intracavernous injections of phosphate-buffered saline (PBS) (days -3 and 0; 20 µL); db/db mice receiving a single intracavernous injection of COMP-Ang1 protein (day 0; 5.8 µg/20 µL); and db/db mice receiving two successive intracavernous injections of COMP-Ang1 protein (days -3 and 0; 5.8 µg/20 µL). MAIN OUTCOME MEASURES Two weeks later, erectile function was measured by electrical stimulation of the cavernous nerve. The penis was then harvested and stained with antibodies to platelet/endothelial cell adhesion molecule-1 (PECAM-1) (endothelial cell marker), phosphohistone H3 (PH3, a nuclear protein indicative of cell proliferation), phospho-endothelial nitric oxide synthase (eNOS), and eNOS. Penis specimens from a separate group of animals were used for cyclic guanosine monophosphate (cGMP) and cyclic adenosine monophosphate (cAMP) quantification. RESULTS Local delivery of COMP-Ang1 protein significantly increased eNOS phosphorylation and cGMP and cAMP expression compared with that in the group treated with PBS. Repeated intracavernous injections of COMP-Ang1 protein completely restored erectile function and cavernous endothelial content through enhanced cavernous neoangiogenesis as evaluated by PECAM-1 and PH3 immunohistochemistry and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling assay, whereas a single injection of COMP-Ang1 protein elicited partial improvement. CONCLUSION Cavernous neovascularization using recombinant Ang1 protein is a novel therapeutic strategy for the treatment of ED resulting from type II diabetes.
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Affiliation(s)
- Hai-Rong Jin
- National Research Laboratory of Regenerative Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
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Yoshimura N, Kato R, Chancellor MB, Nelson JB, Glorioso JC. Gene therapy as future treatment of erectile dysfunction. Expert Opin Biol Ther 2010; 10:1305-14. [PMID: 20662742 DOI: 10.1517/14712598.2010.510510] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD Erectile dysfunction (ED) is a major men's health problem. Although the high success rate of treating ED by phosphodiesterase 5 (PDE5) inhibitors has been reported, there are a significant number of ED patients who do not respond to currently available treatment modalities. AREAS COVERED IN THIS REVIEW To elucidate the current status of gene therapy applications for ED, gene therapy approaches for ED treatment are reviewed. WHAT THE READER WILL GAIN Gene therapy strategies that can enhance nitric oxide (NO) production or NO-mediated signaling pathways, growth factor-mediated nerve regeneration or K(+) channel activity in the smooth muscle could be promising approaches for the treatment of ED. Although the majority of gene therapy studies are still in the preclinical phase, the first clinical trial using non-viral gene transfer of Ca(2+)-activated, large-conductance K(+) channels into the corpus cavernosum of ED patients showed positive results. TAKE HOME MESSAGE Gene therapy represents an exciting future treatment option for ED, especially for people with severe ED unresponsive to current first-line therapies such as PDE5 inhibitors although the long-term safety of both viral and non-viral gene therapies should be established.
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Affiliation(s)
- Naoki Yoshimura
- University of Pittsburgh School of Medicine, Department of Urology, Suite 700 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
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Lysiak JJ, Kavoussi PK, Ellati RT, Steers WD, Annex BH. Angiogenesis Therapy for the Treatment of Erectile Dysfunction. J Sex Med 2010; 7:2554-63. [DOI: 10.1111/j.1743-6109.2010.01830.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Galiano M, Pignot G, Costa C, Vallancien G, Virag R. Dysfonction érectile et cellules endothéliales caverneuses. Prog Urol 2010; 20:188-93. [DOI: 10.1016/j.purol.2009.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Revised: 07/07/2009] [Accepted: 07/27/2009] [Indexed: 10/20/2022]
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Hirata H, Kawamoto K, Kikuno N, Kawakami T, Kawakami K, Saini S, Yamamura S, Dahiya R. Restoring Erectile Function by Antioxidant Therapy in Diabetic Rats. J Urol 2009; 182:2518-25. [DOI: 10.1016/j.juro.2009.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Indexed: 02/07/2023]
Affiliation(s)
- Hiroshi Hirata
- Department of Urology, San Francisco Veterans Affairs Medical Center and University of California-San Francisco, San Francisco, California
| | - Ken Kawamoto
- Department of Urology, San Francisco Veterans Affairs Medical Center and University of California-San Francisco, San Francisco, California
| | - Nobuyuki Kikuno
- Department of Urology, San Francisco Veterans Affairs Medical Center and University of California-San Francisco, San Francisco, California
| | - Toshifumi Kawakami
- Department of Urology, San Francisco Veterans Affairs Medical Center and University of California-San Francisco, San Francisco, California
| | - Kazumori Kawakami
- Department of Urology, San Francisco Veterans Affairs Medical Center and University of California-San Francisco, San Francisco, California
| | - Sharanjot Saini
- Department of Urology, San Francisco Veterans Affairs Medical Center and University of California-San Francisco, San Francisco, California
| | - Soichiro Yamamura
- Department of Urology, San Francisco Veterans Affairs Medical Center and University of California-San Francisco, San Francisco, California
| | - Rajvir Dahiya
- Department of Urology, San Francisco Veterans Affairs Medical Center and University of California-San Francisco, San Francisco, California
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Abstract
INTRODUCTION The endothelial monolayer plays a crucial role in the vasodilation and hemodynamic events involved in erection physiology. Due to its relevant functions, a close link has been established between endothelial integrity and erectile dysfunction (ED). Endothelial dysfunction is induced by the detrimental actions of vascular risk factors (VRFs), identified as common correlates for the development of cardiovascular disease and ED. It is currently recognized that ED is the early harbinger of a more generalized vascular systemic disorder, and, therefore, an evaluation of endothelial health in ED patients should be of prime relevance. Several noninvasive methods for endothelial function assessment have been proposed, including the Penile Nitric Oxide Release Test (PNORT). AIM To highlight the most recent gathered knowledge on basic and clinical mechanisms underlying loss of cavernosal endothelial function promoted by VRFs and to discuss local and systemic methods for endothelial function assessment in ED individuals, focusing on the PNORT. MAIN OUTCOME MEASURES A complete revision on the novel basic and clinical links between endothelial and ED. METHODS A systematic review of the literature regarding the aforementioned issues. RESULTS Risk factor-associated cavernosal endothelial dysfunction is mostly induced by unifying mechanisms, including oxidative stress and impaired endothelial nitric oxide functional activities, which present clinically as ED. Several techniques to evaluate endothelial dysfunction were revised, with advantages and limitations debated, focusing on our detailed expertise using the PNORT method. CONCLUSIONS The established endothelial-erectile dysfunction connection was thoroughly revised, from basic mechanisms to the clinical importance of endothelial dysfunction assessment as diagnosis for generalized vascular disease. Further studies are required to disclose efficient approaches to repair disabled endothelium and both restore and prevent endothelial dysfunction.
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Affiliation(s)
- Carla Costa
- Faculty of Medicine of the University of Porto, Department of Biochemistry (U38-FCT), Porto, Portugal.
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Chen Y, Dai Y, Wang R. Treatment strategies for diabetic patients suffering from erectile dysfunction. Expert Opin Pharmacother 2008; 9:257-66. [PMID: 18201148 DOI: 10.1517/14656566.9.2.257] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Erectile dysfunction is a common complication of diabetes. Clinical practice has no treatment modality specifically designed for the difficult to treat diabetic erectile dysfunction due to the multifactorial and complex pathophysiology of development. PDE type 5 inhibitors are the first-line treatment option. Non-responders should have total and free testosterone checked and testosterone replacement is recommended for hypogonadal patients. For patients who cannot take PDE type 5 inhibitors, or are proven non-responders, the vacuum constriction device continues to serve as a major treatment option. Intracavernosal injection is the most effective medical therapy for diabetic erectile dysfunction despite its high dropout rate. Use of the Medicated Urethral System for Erection to overcome the disadvantages of needle injection is disappointing due to lack of effectiveness. Penile prosthesis will continue to play an important role in diabetic patients with severe erectile dysfunction in coming years.
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Affiliation(s)
- Yun Chen
- Department of Urology, Affiliated Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210008, China
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Pu XY, Wang XH, Gao WC, Yang ZH, Li SL, Wang HP, Wu YL. Insulin-like growth factor-1 restores erectile function in aged rats: modulation the integrity of smooth muscle and nitric oxide-cyclic guanosine monophosphate signaling activity. J Sex Med 2008; 5:1345-54. [PMID: 18355170 DOI: 10.1111/j.1743-6109.2008.00817.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Insulin-like growth factor-1 (IGF-1) is one of the growth factors that have a wide range of biologic effects. We have confirmed that gene transfer of IGF-1 to the penis could improve erectile capacity. However, there are some limitations in gene therapies, such as toxicity or a risk of insertional mutagenesis. Protein treatment may be another choice for decreasing these risks. AIM To investigate whether intracavernosal injection of IGF-1 protein can restore erectile function in the aging rat. MAIN OUTCOME MEASURES Erectile responses, morphological changes, and nitric oxide-cyclic guanosine monophosphate (NO-cGMP) signaling pathways-related marker were determined. METHODS Ten young (4 months) and 30 old (24 months) Sprague-Dawley male rats were enrolled in this study. The old rats were divided into three groups: vehicle-only (N = 10), IGF-1 1 microg/kg (N = 10) and IGF-1 10 microg/kg treatment group (N = 10). After 4 and 8 weeks of single IGF-1 injection treatment, intracavernous pressure (ICP) responses with electrical stimulation to the cavernous nerve were evaluated. The percent of smooth muscle in corpus cavernosum tissue, the expression of mRNA and protein of endothelial nitric oxide synthase (eNOS) were also evaluated. The activity of nitric oxide synthase (NOS) and concentration of guanosine 3',5'-cyclic-monophosphate (cGMP) that act upon the major NO-cGMP signaling pathways in penile tissue were also analyzed. RESULTS After IGF-1 treatment, the ICP responses was significantly increased as the young control group in both the IGF-1 1 microg/kg and the IGF-1 10 microg/kg group compared with the vehicle-only group at 4 and 8 weeks (P < 0.05). Masson's trichrom staining showed the percentage of cavernosal smooth muscle was increased in IGF-1 treatment group. IGF-1 increased e-NOS expression. NOS activities and cGMP concentrations were also significantly increased in IGF-1 treatment rats. CONCLUSIONS IGF-1 improved erectile function in aged rats via restoration the integrity of smooth muscle of corpus cavernosum and modulation of NO-cGMP pathways.
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Affiliation(s)
- Xiao-Yong Pu
- Guangdong Provincial People's Hospital-Department of Urology, Cancer Center and The Medical Research Center, Guangdong, Guangzhou, China
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Vascular endothelial growth factor (VEGF) gene therapy using a nonviral gene delivery system improves erectile function in a diabetic rat model. Int J Impot Res 2008; 20:307-14. [DOI: 10.1038/ijir.2008.1] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Strong TD, Gebska MA, Burnett AL, Champion HC, Bivalacqua TJ. Endothelium-specific gene and stem cell-based therapy for erectile dysfunction. Asian J Androl 2008; 10:14-22. [DOI: 10.1111/j.1745-7262.2008.00362.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
Erectile dysfunction (ED) is highly prevalent in diabetes mellitus. Pathophysiological mechanisms underlying diabetes-associated ED are in large part due to endothelial dysfunction, which functionally refers to the inability of the endothelium to produce vasorelaxing messengers and to maintain vasodilation and vascular homeostasis. The precise mechanisms leading to endothelial dysfunction in the diabetic vasculature, including the penis, are not yet fully understood. Hyperglycemia affects endothelial nitric oxide synthase activity and nitric oxide production/bioavailability, nitric oxide-independent relaxing factors, oxidative stress, production and/or action of hormones, growth factors and/or cytokines, and generation and activity of opposing vasoconstrictors. Considering recent advances in the field of vascular biology and diabetes, the emphasis in this review is placed on the mechanisms of hyperglycemia-induced endothelial dysfunction in the pathophysiology of diabetes-associated ED.
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Affiliation(s)
- B Musicki
- Department of Urology, Johns Hopkins University, SOM, Baltimore, MD 21287, USA.
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