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脐带血干细胞海绵体内移植治疗糖尿病性阳痿:7例初步报告

Treatment of diabetic impotence with umbilical cord blood stem cell intracavernosal transplant: preliminary report of 7 cases.

作者信息

Bahk Jong Yoon, Jung Jae Hun, Han Hoon, Min Seung Ki, Lee Youn Soo

机构信息

Gyeongsang National University Medical Graduate School, Jinju, Korea.

出版信息

Exp Clin Transplant. 2010 Jun;8(2):150-60.

Abstract

OBJECTIVES

Stem cells are characterized by self renewal and multipotent differentiation.We report the effects of intracavernosal transplant of human umbilical cord blood stem cells on diabetic erectile dysfunction.

MATERIALS AND METHODS

Seven type 2 diabetics who had failed to achieve an erection for at least 6 months despite medications, and who are currently awaiting penile prostheses, participated. All laboratory results were normal, except for impotence and diabetes mellitus. A total of 1.5 x 10(7) human umbilical cord blood stem cells were infused into the corpus cavernosum. No immunosuppressive measures were taken in any of the patients. International index of erectile function-5, SEP, GAQ, erection diary, blood glucose diary, and medication dosage were followed for 9 months.

RESULTS

The mean age was 69.5 years (range, 57-87 years). Morning erections were regained in 3 participants within 1 month, and for all except 1 by the third month, and maintained for more than 6 months. Rigidity increased as the result of stem cell therapy alone, but was insufficient for penetration. With the addition of PDE5 inhibitor before coitus, 2 achieved penetration and experienced orgasm, and maintained for more than 6 months; however, 1 participant could not achieved penetration at ninth month. All but 1 reported increased desire. During follow-up, 2 returned for prosthesis, 4 returned to a nonerectile condition at 9 months, and 1 maintained erection sufficient for coitus with medication until the 11th month. Blood glucose levels decreased by 2 weeks, and medication dosages were reduced in all but 1 subject for 4 to 7 months. Glycosylated hemoglobin levels improved after treatment for up to 3 to 4 months.

CONCLUSIONS

Human umbilical cord blood stem cell therapy has positive effects on erectile dysfunction and diabetes mellitus. Stem cells and unknown humoral factors of human umbilical cord blood stem cells mediate mechanism may contribute to these positive effects.

摘要

目的

干细胞具有自我更新和多能分化的特征。我们报告了人脐带血干细胞海绵体内移植对糖尿病性勃起功能障碍的影响。

材料与方法

7名2型糖尿病患者参与了研究,他们尽管接受了药物治疗,但至少6个月未能勃起,目前正在等待阴茎假体植入。除了阳痿和糖尿病外,所有实验室检查结果均正常。将总共1.5×10⁷人脐带血干细胞注入海绵体。所有患者均未采取免疫抑制措施。随访9个月,观察国际勃起功能指数-5、SEP、GAQ、勃起日记、血糖日记和药物剂量。

结果

平均年龄为69.5岁(范围57-87岁)。3名参与者在1个月内恢复了晨勃,除1人外,其他人在第三个月恢复晨勃,并持续了6个月以上。仅干细胞治疗使勃起硬度增加,但仍不足以进行性交。性交前加用PDE5抑制剂后,2人能够进行性交并达到性高潮,并持续了6个月以上;然而,1名参与者在第9个月仍无法进行性交。除1人外,所有人都报告性欲增强。随访期间,2人因植入假体而回来,4人在9个月时恢复到无勃起状态,1人在服用药物的情况下维持足以性交的勃起状态直至第11个月。血糖水平在2周内下降,除1名受试者外,其他所有人的药物剂量在4至7个月内减少。治疗后糖化血红蛋白水平改善,持续长达3至4个月。

结论

人脐带血干细胞治疗对勃起功能障碍和糖尿病有积极作用。干细胞和人脐带血干细胞未知的体液因子介导机制可能促成了这些积极作用。

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