Adipose tissue-derived stem cell therapy for erectile dysfunction in rats: a systematic review and meta-analysis

Hou, Quanliang; Ge, Mengying; Zhang, Cheng-Da; Tian, Dean; Wang, Lianke; Tian, Huizi; Wang, Wenhua; Zhang, Weidong

doi:10.1007/s11255-017-1590-2

Cited by 17 publications

(15 citation statements)

References 57 publications

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“…There have been major advances in ED research over the past decade (25), but DMED remains difficult to treat. Stem cell therapy has been proposed as a viable treatment strategy, and some clinical and preclinical trials have been conducted in a few related areas (26,27). A small number of studies have examined the use of ADSCs and BMSCs in the treatment of DMED (28-30) but, to the best of our knowledge, there is currently no report comparing the effects of ADSCs and BMSCs on DMED.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the therapeutic effects of adipose‑derived and bone marrow mesenchymal stem cells on erectile dysfunction in diabetic rats

Chen

Zhu²,

Wang

et al. 2019

Int J Mol Med

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The aim of the present study was to compare the effects of adipose-derived mesenchymal stem cell (ADSC) and bone marrow mesenchymal stem cell (BMSC) transplantation into the corpora cavernosa of diabetic rats with erectile function. ADSCs and BMSCs were isolated and identified by flow cytometry. Rats with streptozocin-induced diabetes were screened using apomorphine to obtain a rat model of diabetic erectile dysfunction, followed by transplantation of ADSCs and BMSCs into the corpora cavernosa. Two weeks later, the rats were again injected with apomorphine, the intracavernous pressure (ICP) and mean arterial pressure (MAP) of the penile tissue were measured, and the corpus cavernosum tissues were harvested. Angiogenic endothelial nitric oxide synthase (eNOS) expression was detected by western blotting and immunofluorescence analysis. The blood vessels in the corpus cavernosum were observed following hematoxylin and eosin (H&E) staining, and the expression of collagen was detected by Sirius Red staining. The cellular ultrastructure was examined by transmission electron microscopy. Intracavernous injection of ADSCs significantly increased ICP and ICP/MAP. Western blotting and immunofluorescence results revealed that ADSC treatment improved the expression of eNOS in the penile tissue of diabetic rats. The H&E staining results demonstrated that ADSC treatment promoted revascularization of the corpus cavernosum, and the results of Sirius Red staining revealed that ADSC treatment reduced penile collagen in diabetic rats. Transmission electron microscopy examination revealed that the ultrastructure of the tissues in the ADSC-treated group was more complete compared with that in the untreated diabetic model group. In conclusion, ADSCs were found to be more effective compared with BMSCs in treating diabetes-related erectile dysfunction.

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Section: Discussionmentioning

confidence: 99%

Comparison of the therapeutic effects of adipose‑derived and bone marrow mesenchymal stem cells on erectile dysfunction in diabetic rats

Chen

Zhu²,

Wang

et al. 2019

Int J Mol Med

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“…The combination of stem cells + PDE5 inhibitor therapy appears to have the greatest effect [159]. Consistent outcomes among the studies were increase in the ICP/MAP ratio, levels of neuronal nitric oxide synthase, cavernous smooth muscle content, ratio of cavernous smooth muscle to collage, and cGMP levels [160]. Furthermore, stem cells modified by growth or neurotrophic factors prior to implantation appeared to exert the greatest benefit [160].…”

Section: Stem Cell Therapymentioning

confidence: 90%

“…Consistent outcomes among the studies were increase in the ICP/MAP ratio, levels of neuronal nitric oxide synthase, cavernous smooth muscle content, ratio of cavernous smooth muscle to collage, and cGMP levels [160]. Furthermore, stem cells modified by growth or neurotrophic factors prior to implantation appeared to exert the greatest benefit [160]. Although there are many processing steps to refine and standardize, this approach remains a riveting endeavor in the arena of penile rehabilitation.…”

Section: Stem Cell Therapymentioning

confidence: 94%

“…Furthermore, Lin et al reported that adipose-derived stem cells (ADSCs) injected into the corpora cavernosa migrated within days to the bone marrow and then to the MPG [158]. Subsequent work has been reexamined in multiple systematic reviews and meta-analyses, reiterating the efficacy of these methods in 12 studies, n = 319 rats and 20 studies, n = 248 rats, respectively [159,160]. The combination of stem cells + PDE5 inhibitor therapy appears to have the greatest effect [159].…”

Section: Stem Cell Therapymentioning

confidence: 99%

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Preventing Erectile Dysfunction after Radical Prostatectomy: Nerve-Sparing Techniques, Penile Rehabilitation, and Novel Regenerative Therapies

Whalen¹

2019

Prostatectomy

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Erectile dysfunction is a known and much-dreaded functional consequence of radical prostatectomy. Dr. Patrick Walsh pioneered the nerve-sparing radical retropubic prostatectomy in the early 1980s, which has mitigated the morbidity of this surgery. Postoperative potency rates range widely from 20 to 80%, however, and depend on myriad factors including age, preoperative potency, and degree of nerve-sparing during surgery. Over the past four decades several developments have continued to offer hope to patients and clinicians alike, including refined understanding of cavernosal nerve neuroanatomy, beneficial modifications in surgical technique, as well as the advent of robotic surgery. Furthermore, multiple pre-and post-operative penile rehabilitation techniques using mechanotherapy and pharmaceuticals have also improved functional recovery. This paper examines erectile dysfunction as a consequence of radical prostatectomy, including the physiology of erections, the pathophysiology of post-operative erectile dysfunction, novel surgical techniques to enhance neurovascular bundle preservation, and penile rehabilitation strategies involving hyperbaric oxygen, neuroprotective pharmaceuticals, dehydrated human amnion-chorion membrane allografts, and mesenchymal stem cell therapy.

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“…Up until now, two meta-analyses have been reported on the efficacy of stem cell therapy in the ED rat model (13, 14). Hou et al (13) had analyzed the effect of ADSCs on ED induced by various causes, including diabetes mellitus, CNI, cigarette smoking, tunica albuginea, and radiation.…”

Section: Introductionmentioning

confidence: 99%

Adipose Tissue-Derived Stem Cell Therapy for Cavernous Nerve Injury-Induced Erectile Dysfunction in the Rat Model: A Systematic Review and Meta-Analysis Using Methodological Quality Assessment

Park

Jeong

Park

et al. 2019

IJSC

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Background and Objectives Few studies were evaluated the effect of blindness on outcome in animal models, though a potential effect of blinding has been reported in clinical trials. We evaluated the effects of adipose tissue-derived stem cells (ADSCs) on cavernous nerve injury (CNI)-induced erectile dysfunction (ED) in the rat and examined how proper blinding of the outcome assessor affected treatment effect. Methods and Results We searched in Pubmed, EMBASE, Cochrane and Web of Science databases from inception to January 2019. We included CNI animal model, randomized controlled experiments, and ADSC intervention. Erectile function and structural changes were assessed by intracavernous pressure and mean arterial pressure (ICP/MAP) ratios, neuronal nitric oxide synthase (nNOS) levels, cavernous smooth muscle and collagen (CSM/collagen) ratios, and cyclic guanosine monophosphate (cGMP). Results Nineteen studies were included in the final meta-analysis. The ICP/MAP ratio of the ADSC treatment group increased compared to the control group (SMD=1.33, 95%CI: 1.11~1.56, I 2 =72%). The nNOS level (SMD=2.29, 95%CI: 1.74~2.84, I 2 =75%), CSM/collagen (SMD=2.57, 95%CI: 1.62~3.52; I 2 =85%), and cGMP (SMD=2.96, 95%CI: 1.82~4.10, I 2 =62%) were also increased in the ADSC treatment group. Preplanned subgroup analysis was conducted to explore the source of heterogeneity. Five studies with blinded outcome assessment were significantly less effective than the unblinded studies (SMD=1.33, 95%CI: 0.86~1.80; SMD=1.81, 95%CI: 1.17~2.46, respectively). Conclusions ADSCs might be effective in improving erectile function and structural change in CNI-induced ED. However, non-blinded outcome assessors might cause detection bias and overestimate treatment efficacy. Therefore, the ADSC efficacy must be further evaluated with a rigorous study design to avoid bias.

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Adipose tissue-derived stem cell therapy for erectile dysfunction in rats: a systematic review and meta-analysis

Abstract: The adequate data indicated that ADSC therapy recovered erectile function and regenerated cavernous structures in ED rats, and ADSCs modified by some growth and neurotrophic factors accelerated the recovery of erectile function and cavernous structures in ED rats.

Cited by 17 publications

References 57 publications

Comparison of the therapeutic effects of adipose‑derived and bone marrow mesenchymal stem cells on erectile dysfunction in diabetic rats

Comparison of the therapeutic effects of adipose‑derived and bone marrow mesenchymal stem cells on erectile dysfunction in diabetic rats

Preventing Erectile Dysfunction after Radical Prostatectomy: Nerve-Sparing Techniques, Penile Rehabilitation, and Novel Regenerative Therapies

Adipose Tissue-Derived Stem Cell Therapy for Cavernous Nerve Injury-Induced Erectile Dysfunction in the Rat Model: A Systematic Review and Meta-Analysis Using Methodological Quality Assessment

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