ObjectiveClinical treatment of erectile dysfunction (ED) caused by cavernous nerve (CN) injury during pelvic surgery is difficult. Low‐intensity pulsed ultrasound (LIPUS) can be a potential strategy for neurogenic ED (NED). However, whether Schwann cells (SCs) can respond to LIPUS stimulation signals is unclear. This study aims to elucidate the signal transmission between SCs paracrine exosome (Exo) and neurons stimulated by LIPUS, as well as to analyze the role and potential mechanisms of exosomes in CN repair after injury.MethodsThe major pelvic ganglion (MPG) neurons and MPG/CN explants were stimulated with LIPUS of different energy intensities to explore the appropriate LIPUS energy intensity. The exosomes were isolated and purified from LIPUS‐stimulated SCs (LIPUS‐SCs‐Exo) and non‐stimulated SCs (SCs‐Exo). The effects of LIPUS‐SCs‐Exo on neurite outgrowth, erectile function, and cavernous penis histology were identified in bilateral cavernous nerve crush injury (BCNI)‐induced ED rats.ResultsLIPUS‐SCs‐Exo group can enhance the axon elongation of MPG/CN and MPG neurons compared to SCs‐Exo group in vitro. Then, the LIPUS‐SCs‐Exo group showed a stronger ability to promote the injured CN regeneration and SCs proliferation compared to the SCs‐Exo group in vivo. Furthermore, the LIPUS‐SCs‐Exo group increased the Max intracavernous pressure (ICP)/mean arterial pressure (MAP), lumen to parenchyma and smooth muscle to collagen ratios compared to the SCs‐Exo group in vivo. Additionally, high‐throughput sequencing combined with bioinformatics analysis revealed the differential expression of 1689 miRNAs between the SCs‐Exo group and the LIPUS‐SCs‐Exo group. After LIPUS‐SCs‐Exo treatment, the phosphorylated levels of Phosphatidylinositol 3‐kinase (PI3K), protein kinase B (Akt) and forkhead box O (FoxO) in MPG neurons increased significantly compared to negative control (NC) and SCs‐Exo groups.ConclusionOur study revealed that LIPUS stimulation could regulate the gene of MPG neurons by changing miRNAs derived from SCs‐Exo, then activating the PI3K‐Akt‐FoxO signal pathway to enhance nerve regeneration and restore erectile function. This study had important theoretical and practical significance for improving the NED treatment.

Background Cavernous nerve injury‐induced erectile dysfunction caused by pelvic surgery or trauma is refractory to conventional medications and required an alternative treatment. Low‐intensity pulsed ultrasound is a noninvasive mechanical therapy that promotes nerve regeneration. Objectives To investigate the therapeutic effect and potential mechanism of low‐intensity pulsed ultrasound in the treatment of neurogenic erectile dysfunction. Materials and methods Thirty rats were randomly divided into the sham‐operated group, bilateral cavernous nerve injury group, and bilateral cavernous nerve injury + low‐intensity pulsed ultrasound group. The erectile function was assessed 3 weeks after daily low‐intensity pulsed ultrasound treatment. The penile tissues and cavernous nerve tissues were harvested and subjected to histologic analysis. Primary Schwann cells and explants were extracted from adult rats. The effects of low‐intensity pulsed ultrasound on proliferation, migration, and nerve growth factor expression of Schwann cells and axonal elongation were examined in vitro. RNA sequencing and western blot assay were applied to predict and verify the molecular mechanism of low‐intensity pulsed ultrasound‐induced Schwann cell activation. Results Our study showed that low‐intensity pulsed ultrasound promoted Schwann cells proliferation, migration, and neurotrophic factor nerve growth factor expression. Meanwhile, low‐intensity pulsed ultrasound exhibits a stronger ability to enhance Schwann cells‐mediated neurite outgrowth of major pelvic ganglion neurons and major pelvic ganglion/cavernous nerve explants in vitro. In vivo experiments demonstrated that the erectile function of the rats in the bilateral cavernous nerve injury + low‐intensity pulsed ultrasound group was significantly higher than those in the bilateral cavernous nerve injury groups. Moreover, the expression levels of smooth muscle and cavernous endothelium also increased significantly in the bilateral cavernous nerve injury + low‐intensity pulsed ultrasound group. In addition, we observed the higher density and number of cavernous nerve regenerating axons in the bilateral cavernous nerve injury + low‐intensity pulsed ultrasound group, indicating that low‐intensity pulsed ultrasound promotes axonal regeneration following cavernous nerve injury in vivo. RNA sequencing analysis and bioinformatic analysis suggested that low‐intensity pulsed ultrasound might trigger the activation of the PI3K/Akt pathway. Western blot assay confirmed that low‐intensity pulsed ultrasound activated Schwann cells through TrkB/Akt/CREB signaling. Conclusions Low‐intensity pulsed ultrasound promoted nerve regeneration and ameliorated erectile function by enhancing Schwann cells proliferation, migration, and neurotrophic factor nerve growth factor expression. The TrkB/Akt/CREB axis is the possible mechanism of low‐intensity pulsed ultrasound‐mediated Schwann cell activation. Low‐intensity pulsed ultrasound‐based therapy could be a novel potential treatment strategy for caverno...

Cisplatin is an efficient chemotherapeutic agent for various solid tumors, but its usage is restricted by nephrotoxicity. A single dose of cisplatin can cause acute kidney injury (AKI), which is characterized by rapid reduction in kidney function. However, the efficacy of current therapies, such as hydration, is limited. It is vital to develop novel therapeutic reagents that have anticancer and renoprotective properties. The objective of this study was to determine whether ammonium tetrathiomolybdate (TM), a copper ion chelator used to treat cancer and disorders of copper metabolism, may offer protection against cisplatin-induced AKI. In this study, we demonstrated that TM treatment had antioxidative effects and mitigated cisplatin-induced AKI both in vivo and in vitro. Mechanically, TM inhibited NRF2 ubiquitination, which activated the NRF2 pathway in HK-2 cells and promoted the expression of target genes. It should be noted that the protective effect conferred by TM against cisplatin was compromised by the knockdown of the NRF2 gene. Furthermore, TM selectively activated the NRF2 pathways in the liver and kidney. The current study provided evidence for additional clinical applications of TM by showing that it activates NRF2 and has a favorable therapeutic impact on cisplatin-induced AKI.

Cisplatin is an efficient chemotherapeutic agent for various solid tumors, but its usage is restricted by nephrotoxicity. A single dose of cisplatin can cause acute kidney injury (AKI), which is characterized by rapid reduction in kidney function. However, the current therapies, such as hydration, are limited. It is vital to develop novel therapeutic reagents that have both anticancer and renoprotective properties. The objective of this study was to determine whether ammonium tetrathiomolybdate (TM), a copper chelator used to treat cancer and disorders of copper metabolism, may offer protection against cisplatin-induced AKI. In this study, we demonstrated that TM treatment had antioxidative effects and mitigated cisplatin-induced AKI both in vivo and in vitro. Mechanically, TM inhibited NRF2 ubiquitination, which activated the NRF2 pathway in HK-2 cells and promoted the expression of target genes. It should be noted that the protective effect conferred by TM against cisplatin was compromised by the knockdown of the NRF2 gene. Furthermore, TM selectively activated the NRF2 pathways in the liver and kidney. The current study provided evidence for additional clinical applications of TM by showing that it activates NRF2 and has a favorable therapeutic impact on cisplatin-induced AKI.