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BackgroundErectile dysfunction (ED) is the most common type of sexual dysfunction, which seriously affects male reproductive health. Recently, stem cell therapy and low‐intensity pulsed ultrasound (LIPUS) have been applied in the treatment of ED, but the specific mechanism is still unclear.ObjectivesThe study aims to investigate the effect and underlying mechanism of further LIPUS treatment on the basis of bone marrow mesenchymal stem cells (BMSCs) transplantation in the treatment of ED rats.Materials and methodsWe established a cavernosa injury‐induced ED rat model and injected BMSCs into the penile corpus cavernosum with or without LIPUS treatment every other day for three times. The survival rate of BMSCs, value of ICP/MAP, blood flow, the endothelial content, and expression of CD31 and ɑ‐SMA in the rat penis were investigated. Transcriptome analyses and in vitro assays of cell proliferation, migration, and tube formation were also performed.ResultsThe results showed that LIPUS treatment significantly promoted the survival rate of BMSCs in the rat penis after 1, 7, and 14 days of final treatment. The values of ICP/MAP and blood flow in rats treated with BMSCs were significantly increased compared to the control group, and the values were further enhanced in rats treated with BMSCs plus LIPUS. The endothelial content and CD31 and ɑ‐SMA mRNA and protein expression in the BMSCs plus LIPUS group were remarkably higher than in other groups, indicating improved endothelial vascular function. Transcriptome analyses found that insulin‐like growth factor binding protein‐3 (IGFBP3) was remarkably downregulated in the BMSCs plus LIPUS group compared to the other two groups. In in vitro assays, LIPUS intervention significantly increased BMSCs proliferation and HUVECs migration, and HUVECs angiogenesis was improved after IGFBP3 siRNA transfection.ConclusionsBMSCs transplantation combined with LIPUS treatment could improve erectile function in ED rats via downregulation of IGFBP3, which might be a proposed optimized strategy for the ED treatment.
BackgroundErectile dysfunction (ED) is the most common type of sexual dysfunction, which seriously affects male reproductive health. Recently, stem cell therapy and low‐intensity pulsed ultrasound (LIPUS) have been applied in the treatment of ED, but the specific mechanism is still unclear.ObjectivesThe study aims to investigate the effect and underlying mechanism of further LIPUS treatment on the basis of bone marrow mesenchymal stem cells (BMSCs) transplantation in the treatment of ED rats.Materials and methodsWe established a cavernosa injury‐induced ED rat model and injected BMSCs into the penile corpus cavernosum with or without LIPUS treatment every other day for three times. The survival rate of BMSCs, value of ICP/MAP, blood flow, the endothelial content, and expression of CD31 and ɑ‐SMA in the rat penis were investigated. Transcriptome analyses and in vitro assays of cell proliferation, migration, and tube formation were also performed.ResultsThe results showed that LIPUS treatment significantly promoted the survival rate of BMSCs in the rat penis after 1, 7, and 14 days of final treatment. The values of ICP/MAP and blood flow in rats treated with BMSCs were significantly increased compared to the control group, and the values were further enhanced in rats treated with BMSCs plus LIPUS. The endothelial content and CD31 and ɑ‐SMA mRNA and protein expression in the BMSCs plus LIPUS group were remarkably higher than in other groups, indicating improved endothelial vascular function. Transcriptome analyses found that insulin‐like growth factor binding protein‐3 (IGFBP3) was remarkably downregulated in the BMSCs plus LIPUS group compared to the other two groups. In in vitro assays, LIPUS intervention significantly increased BMSCs proliferation and HUVECs migration, and HUVECs angiogenesis was improved after IGFBP3 siRNA transfection.ConclusionsBMSCs transplantation combined with LIPUS treatment could improve erectile function in ED rats via downregulation of IGFBP3, which might be a proposed optimized strategy for the ED treatment.
Background: Erectile Dysfunction (ED) is a common sexual disorder among men aged 20 years and over. It is predominantly characterized by alterations in the key physiological pathways regulating erectile function, such as nitric oxide and Ras homolog gene family member A (RhoA)/Rho-associated protein kinase (ROCK). Beyond these pathways, multiple molecular signaling networks are involved in ED pathogenesis. Objective: This review aims todescribe the major signal transduction pathways that impact erectile function and contribute to the introduction of the pathogenesis of ED. Methods: A literature review of ED was performed from 2000 to 2023 using PubMed, Scopus, and Embase. “ED” and “related signaling pathway”, “molecular mechanisms” terms were used. Results: Further basic and clinical studies are required to define the underlying molecular mechanisms of ED. The signaling pathways that were not affected by phosphodiesterase type 5 inhibitors (PDE5i) may be the reason for the reduced efficacy of this first-line treatment option in a variety of conditions. Conclusion: There is still a need for a deeper description of the molecular mechanisms in terms of fibrosis, angiogenesis, apoptosis, inflammation, oxidative stress, autophagy, and hypoxia to identify new possible targets underlying the pathogenesis of ED. This comprehensive review expounds on the principal signaling pathways, offering valuable insights that may catalyze the development of innovative and enhanced therapies for managing ED.
Objective: The aim of this study was to construct a multicompartment synchronous rotating bioreactor (MCSRB) for batch-production of homogenized adipose-derived stem cell (ADSC) microspheres and treat neurogenic erectile dysfunction (ED). background: Erectile dysfunction due to cavernous nerve injury is commonly associated with pelvic site surgery1, particularly radical prostatectomy, which is one of the most common first-line treatments for men with limited and locally progressive prostate cancer, with a probability of 14-82% of causing erectile dysfunction after surgery, severely affecting patients' quality of life. For this neurogenic erectile dysfunction, the traditional first-line treatment with phosphodiesterase type 5 (PDE5) inhibitors is ineffective and has side effects such as headache, dizziness, and indigestion; thus, there is an urgent need to find a new alternative therapy. In recent years, with the rise of stem cell therapy, the application of stem cells to the treatment of erectile dysfunction has attracted extra attention. Zhang et al. showed that a cytokine secreted by adipose tissue-derived stem cells has a neurotrophic effect on cavernous nerve regeneration. It has also been shown that intravenous infusion of bone marrow-derived mesenchymal stem cells (MSCs) attenuates erectile dysfunction after cavernous nerve injury in rats. However, because of the loose pore-like structure of the penile corpus cavernosum, stem cells injected via the corpus cavernosum carry the risk of cell escape, leading to pulmonary embolism; thus, this issue of safety and limited treatment due to cell escape warrants intensive study. It has been shown that culturing MSCs into 3D stem cell microspheres can significantly activate their paracrine function, which is important for improving the therapeutic potential of MSCs, while Xu's study showed that stem cell microspheres can increase cell retention in the cavernous body and reduce the risk of pulmonary embolism. Previous studies have found that stem cell microspheres can enhance paracrine, anti-inflammatory, and anti-apoptotic functions. Currently, there are many methods for 3D sphere formation of stem cells, such as the suspension droplet method, micropatterning method and microfluidic method, but all of these methods have deficiencies, such as low yield, low recovery of culture medium and the need for special equipment. The multicompartment synchronized rotating bioreactor is a device designed and developed by our team to culture MSC microspheres in 3D. During our experiments, we found that the dynamic culture of 3D stem microspheres using the MCSRB is very simple and convenient, and the design of multiple compartments scales well, which can greatly improve the efficiency and reduce the time of determining the optimal conditions during culture, and significantly improves MSC paracrine function. Therefore, in this study, we investigated whether the dynamic culture of dry 3D microspheres in this bioreactor could effectively restore erectile function and pathological changes in rats with cavernous nerve injury. Methods: Firstly, an MCSRB was constructed using a centrifugal device and hinged trays. Secondly, influence factors (density, rotational speed) on the formation of ADSC-spheroids were explored. Finally, a neurogenic ED model was established to verify the effectiveness and safety of ADSC-spheroids for ED treatment. objective: To investigate the therapeutic effects of dynamically cultured rat adipose stem cell (ADSC) microspheres in a multicompartment synchronous rotating bioreactor (MCSRB) in rats with bilateral cavernous nerve injury-induced erectile dysfunction. Results: An MCSRB promoted ADSCs to gather microspheres, most of which were 90-130 μm in diameter. Supernatant from three-dimensional culture led to a significant increase in cytokine expression in ADSCs and migration rate in human umbilical vein endothelial cells (HUVECs) compared to control groups. The erectile function and pathological changes of the penis were improved in the ADSC-spheroids treatment group compared to the traditional ADSCs treatment group (p < 0.01). Conclusion: Efficient, batch, controlled and homogenized production of ADSC stem cell microspheres, and effective improvement of erectile dysfunction in neurogenic rats can be achieved using the MCSRB device. conclusion: Treatment with 3D ADSC microspheres dynamically cultured in MCSRBs significantly improved erectile dysfunction in neurogenic rats with erectile dysfunction and contributed to the recovery of tissue damage, demonstrating the value of scaled-up culture and the potential clinical application of stem cell microspheres.
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