Department of Urology, University of California, San Francisco, CA 94143-0738, USA.
Nat Rev Urol. 2010 Mar;7(3):143-52. doi: 10.1038/nrurol.2010.8. Epub 2010 Feb 16.
Erectile dysfunction is a prevalent condition that leads to significant morbidity and distress, not just for affected men but also for their partners. Very few currently available treatments ameliorate the underlying causes of the disorder and 'cure' the disease state. Much recent effort has been focused on the development of gene and cell-based approaches to rectify the molecular and tissue defects responsible for ED. Gene therapy has been investigated in animal models as a means to restore normal function to the penis; at this time, however, only one human trial has been published in the peer-reviewed literature. Recent gene therapy studies have focused on the modulation of enzymes associated with the NOS/cGMP pathway, and supplementation of trophic factors, peptides and potassium channels. Stem cell therapy has been a topic of interest in more recent years but there are currently very few published reports in animal models and none in human men. Although stem cell therapy offers the potential for restoration of functional tissues, legitimate concerns remain regarding the long-term fate of stem cells. The long-term safety of both gene and stem cell therapy must be thoroughly investigated before large-scale human studies can be considered.
勃起功能障碍是一种普遍存在的疾病,不仅会给受影响的男性,也会给他们的伴侣带来严重的发病和痛苦。目前很少有治疗方法可以改善这种疾病的根本原因并“治愈”这种疾病状态。最近,人们非常关注基因和细胞治疗方法的发展,以纠正导致 ED 的分子和组织缺陷。基因治疗已在动物模型中进行了研究,作为恢复阴茎正常功能的一种手段;然而,目前在同行评议文献中仅发表了一项人类试验。最近的基因治疗研究集中在调节与 NOS/cGMP 途径相关的酶,以及补充营养因子、肽和钾通道。近年来,干细胞治疗一直是一个热门话题,但目前在动物模型中发表的报告很少,在人类男性中则没有。尽管干细胞治疗为功能性组织的恢复提供了潜力,但人们仍然对干细胞的长期命运存在合理的担忧。在考虑进行大规模人体研究之前,必须彻底研究基因和干细胞治疗的长期安全性。