富血小板血浆对双侧海绵体神经损伤大鼠模型勃起功能的神经保护作用。
The neuroprotective effect of platelet-rich plasma on erectile function in bilateral cavernous nerve injury rat model.
机构信息
School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
出版信息
J Sex Med. 2012 Nov;9(11):2838-48. doi: 10.1111/j.1743-6109.2012.02881.x. Epub 2012 Aug 20.
INTRODUCTION
Neurogenic erectile dysfunction resulting from cavernous nerve (CN) injury is a major complication caused by radical prostatectomy. The use of platelet-rich plasma (PRP) on the nerve-injured site has shown promising results for the nerve regeneration. However, the effects of PRP injection in corpus cavernosum after bilateral CN injury have never been investigated.
AIM
To assess the neuroprotective effect of PRP injection in corpus cavernosum after bilateral CN injury.
METHODS
Male Sprague-Dawley rats were randomly divided into three groups: Group I underwent sham operation, while the remaining two groups underwent bilateral CN crush. Crush injury groups were treated at the time of injury with an application of PRP or normal saline only injection in the corpus cavernosum, respectively. Four weeks later, erectile function (EF) was assessed by CN electrosimulation, and CNs as well as penile tissue were collected for histology.
MAIN OUTCOME MEASURES
Intracavernous pressure (ICP) monitored during electrical stimulation of CNs; myelinated axons number of CNs and dorsal penile nerve; collagen type change, number of apoptotic cells, and mRNA expression of caspase-3 and transforming growth factor-β1 (TGF-β1) in the corpus cavernosum.
RESULTS
Four weeks after surgery, in the vehicle-only group, the functional evaluation showed a lower mean maximal ICP than that in the sham group (P < 0.05). PRP treatments resulted in significant recovery of EF, as compared with the vehicle-only group (P < 0.05). Histologically, the PRP-treated group had a significant preservation of myelinated axons of CNs compared with the vehicle-only group (P < 0.05) and reduced the apoptotic index. The mRNA expression of TGF-β1 in the corpus cavernosum tissue was significantly decreased in the PRP group compared with the vehicle-only group (P < 0.05).
CONCLUSIONS
PRP injection in the corpus cavernosum increased the number of myelinated axons and facilitated recovery of EF in the bilateral CN injury rat model.
简介
由于海绵体神经（CN）损伤导致的神经性勃起功能障碍是根治性前列腺切除术的主要并发症。在受损神经部位使用富含血小板的血浆（PRP）已显示出促进神经再生的良好效果。然而，双侧 CN 损伤后在海绵体中注射 PRP 的效果尚未得到研究。
目的
评估双侧 CN 损伤后海绵体中 PRP 注射的神经保护作用。
方法
雄性 Sprague-Dawley 大鼠随机分为三组：I 组行假手术，其余两组行双侧 CN 挤压伤。挤压伤组在损伤时分别应用 PRP 或生理盐水仅注射于海绵体。4 周后，通过 CN 电刺激评估勃起功能（EF），并收集 CN 及阴茎组织进行组织学检查。
主要观察指标
CN 电刺激时监测海绵体中的腔内压（ICP）；CN 的有髓轴突数量和阴茎背神经；胶原类型变化、凋亡细胞数量以及海绵体中 caspase-3 和转化生长因子-β1（TGF-β1）的 mRNA 表达。
结果
术后 4 周，在仅用载体组，功能评估显示平均最大 ICP 低于假手术组（P<0.05）。与仅用载体组相比，PRP 治疗组 EF 显著恢复（P<0.05）。组织学上，与仅用载体组相比，PRP 处理组 CN 的有髓轴突保存明显（P<0.05），且凋亡指数降低。与仅用载体组相比，PRP 组海绵体组织中 TGF-β1 的 mRNA 表达明显降低（P<0.05）。
结论
在双侧 CN 损伤大鼠模型中，海绵体中注射 PRP 增加了有髓轴突的数量，促进了 EF 的恢复。
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