Becher Edgardo F, Toblli Jorge E, Castronuovo Cynthia, Nolazco Carlos, Rosenfeld Claudio, Grosman Halina, Vazquez Elba, Mazza Osvaldo N
Division of Urology, Hospital de Clínicas "José de San Martín," University of Buenos Aires, Buenos Aires, Argentina;.
Laboratory of Experimental Medicine, Hospital Alemán, Buenos Aires, Argentina.
J Sex Med. 2009 Jun;6(6):1587-1593. doi: 10.1111/j.1743-6109.2009.01239.x. Epub 2009 Mar 30.
Radical pelvic surgery is a major cause of erectile dysfunction due to iatrogenic cavernous nerve damage. Endothelial nitric oxide synthase, which generates nitric oxide (NO) in the cavernosal tissues, localizes to specialized plasma membrane invaginations known as caveolae. Growing evidence suggests that caveolae are major components of signal trafficking and that stimuli that affect the concentration of the main structural protein of caveolae, caveolin-1 influence NO signaling.
To evaluate caveolin-1 expression as a marker of cavernous tissue damage and determine the impact of early sildenafil administration on caveolin-1 expression in animal models of partial and total surgical penile denervation.
Thirty-six rats were divided into six groups (N = 6 per group) that received bilateral or unilateral penile denervation or sham surgery, with and without sildenafil 10 mg daily for 7 weeks.
Sections were taken from the proximal middle portion of the penis of all animals. Cavernous tissue was delineated by the tunica albuginea, then the extent of immunostaining for the following parameters was quantitated to determine (i) cavernous smooth muscle layer in the cavernous space expressed as the percentage of alpha-smooth muscle actin (alpha-SMA) positive immunostaining per area and (ii) caveolin-1 expressed as a percentage of area.
A marked decrease in both caveolin-1 and alpha-SMA expression in cavernous smooth muscle tissue and in the endothelium of rats was noted after a bilateral and unilateral neurotomy. Specimens from animals receiving sildenafil exhibited higher mean immunostaining values for both proteins in cavernous tissue. The differences were statistically significant compared with groups receiving the same surgical treatment without sildenafil.
Caveolin-1 and alpha-SMA expression in cavernous tissue is significantly reduced by pelvic nerve injury, and the loss is related to the extent of the neural damage. Early administration of sildenafil elicits caveolin-1 expression, which appears to preserve cavernous tissue.
根治性盆腔手术是医源性海绵体神经损伤导致勃起功能障碍的主要原因。内皮型一氧化氮合酶在海绵体组织中生成一氧化氮(NO),定位于称为小窝的特殊质膜内陷处。越来越多的证据表明,小窝是信号转导的主要成分,影响小窝主要结构蛋白小窝蛋白-1浓度的刺激会影响NO信号传导。
评估小窝蛋白-1表达作为海绵体组织损伤标志物的情况,并确定早期给予西地那非对部分和完全手术性阴茎去神经动物模型中小窝蛋白-1表达的影响。
36只大鼠分为6组(每组N = 6),接受双侧或单侧阴茎去神经或假手术,其中一半每天给予10 mg西地那非,持续7周。
从所有动物阴茎近端中部取材。用白膜勾勒出海绵体组织,然后对以下参数的免疫染色程度进行定量,以确定(i)海绵体间隙中的海绵体平滑肌层,以每单位面积α-平滑肌肌动蛋白(α-SMA)阳性免疫染色的百分比表示,以及(ii)小窝蛋白-1,以面积百分比表示。
双侧和单侧神经切断术后,大鼠海绵体平滑肌组织和内皮中小窝蛋白-1和α-SMA的表达均显著降低。接受西地那非治疗的动物标本在海绵体组织中这两种蛋白的平均免疫染色值更高。与接受相同手术治疗但未使用西地那非的组相比,差异具有统计学意义。
盆腔神经损伤可显著降低海绵体组织中小窝蛋白-1和α-SMA的表达,且这种损失与神经损伤程度有关。早期给予西地那非可诱导小窝蛋白-1表达,这似乎能保护海绵体组织。