Stem cell therapy and diabetic erectile dysfunction: A critical review

Abstract

Erectile dysfunction (ED) has been identified as one of the most frequent chronic complications of diabetes mellitus (DM). The prevalence of ED is estimated to be about 67.4% in all DM cases worldwide. The pathophysiological process leading to ED involves endothelial, neurological, hormonal, and psychological factors. In DM, endothelial and neurological factors play a crucial role. Damages in the blood vessels and erectile tissue due to insulin resistance are the hallmark of ED in DM. The current treatments for ED include phosphodiesterase-5 inhibitors and penile prosthesis surgery. However, these treatments are limited in terms of just relieving the symptoms, but not resolving the cause of the problem. The use of stem cells for treating ED is currently being studied mostly in experimental animals. The stem cells used are derived from adipose tissue, bone, or human urine. Most of the studies observed an improvement in erectile quality in the experimental animals as well as an improvement in erectile tissue. However, research on stem cell therapy for ED in humans remains to be limited. Nevertheless, significant findings from studies using animal models indicate a potential use of stem cells in the treatment of ED.

A study of diabetes‐induced erectile dysfunction treated with human umbilical cord mesenchymal stem cells

“…Stem cells have the ability to differentiate into specialized cells and may reverse the damage to the penile tissue (Pakpahan et al, 2021). In our present study, we found that hUC-MSC treatment restored the erectile…”

“…Currently, the available options in DMED therapy can only ameliorate the symptoms. Stem cells have the ability to differentiate into specialized cells and may reverse the damage to the penile tissue (Pakpahan et al, 2021). In our present study, we found that hUC‐MSC treatment restored the erectile function of diabetic rats by improving corpora cavernosa fibrosis and endothelial function.…”

The management of erectile dysfunction in men with diabetes mellitus unresponsive to phosphodiesterase type 5 inhibitors

“…Stems cells have multiple characteristics that could improve ED in diabetic patients, such as differentiation in multiple cell lines, self‐regeneration and multiplying capability 102 . Most of the evidence on stem cells regarding ED is based on animal models of diabetic ED where there were improvements in functional and structural changes 103 …”

“…Stem cells are undifferentiated cells that can differentiate into several cell lineages and are classified depending on their origin and potency.Stems cells have multiple characteristics that could improve ED indiabetic patients, such as differentiation in multiple cell lines, selfregeneration and multiplying capability 102. Most of the evidence on stem cells regarding ED is based on animal models of diabetic ED where there were improvements in functional and structural changes 103. A limited number of human studies exist investigating the use of stem cells in DM with ED, but overall, the results are promising.Mirzaei et al104 conducted an RCT comprising 20 patients with DM not responding to conventional treatments where autologous mesenchymal stem cells were used.…”

Recent advances in stem cell therapy for erectile dysfunction: a narrative review

“…Restorative therapies for ED include stem cell therapy (SCT), platelet-rich plasma therapy (PRP), low-intensity extracorporeal shockwave therapy (Li-ESWT), low-intensity pulsed ultrasound therapy (LIPUS) [12,13], nanomedicine, and gene therapy [14]. SCT has shown promise in both animal models and humans [15]. Two significant breakthroughs in stem cell research are multipotent embryonic stem cells (ES cells) and induced stem cells (iPS cells), both of which have similar trans-differentiation potentials [16] [17].…”