Albersen Maarten, Lin Ching-Shwun, Lue Tom
Laboratory for Experimental Urology, Gene and Stem Cells Applications, Department of Development and Regeneration, University of Leuven, Leuven, Belgium.
Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA.
Arab J Urol. 2013 Sep;11(3):237-44. doi: 10.1016/j.aju.2013.05.005. Epub 2013 Sep 12.
Erectile dysfunction (ED) is the most common sexual disorder that men report to healthcare providers, and is the male sexual dysfunction that has been most investigated. Current treatments for ED focus on relieving the symptoms of ED and therefore tend to provide a temporary solution rather than a cure or reversing the cause. Recently, therapies based on stem cells (SCs) have had an increasing attention for their potential to restore erectile function. Preclinical studies showed that these cells might reverse the pathophysiological changes leading to ED, rather than treating the symptoms of ED. This review is intended to provide an overview of contemporary reports on the use of SCs to treat ED.
We made an extensive search for reports on SC-based therapy for the management of ED, published in English between 1966 and 2013, using the search engines SciVerse-sciencedirect, SciVerse-scopus, Google Scholar and Pubmed, with the search terms 'erectile dysfunction', 'stem cells', 'multipotent stromal cells', 'adipose (tissue) derived stem cells', 'bone-marrow derived stem cells', 'animal model', 'diabetes', 'ageing', 'Peyronie's Disease' and 'cavernous nerve injury'.
Fifty-four papers were identified and contributed, either as an original research report or review thereof, to this review. Several preclinical studies addressed SC-based therapies for the recovery of erectile function caused by a variety of both chronic and acute conditions. Overall, these studies showed beneficial effects of SC therapy, while evidence on the mechanisms of action of SC therapy varied between studies. One clinical trial investigated the short-term effects of SC therapy in diabetic patients with ED. Two more clinical trials are currently recruiting patients.
The rapidly expanding and highly promising body of preclinical work on SC-based medicine providing a potential cure for ED, rather than merely symptom relief, is indicative of the increasing interest in regenerative options for sexual medicine over the past decade. Clinical trials are currently recruiting patients to test the preclinical results in men with ED.
勃起功能障碍(ED)是男性向医疗服务提供者报告的最常见性功能障碍,也是研究最多的男性性功能障碍。目前治疗ED的方法侧重于缓解其症状,因此往往只能提供临时解决方案,而非治愈或逆转病因。最近,基于干细胞(SCs)的疗法因其恢复勃起功能的潜力而受到越来越多关注。临床前研究表明,这些细胞可能逆转导致ED的病理生理变化,而非治疗ED症状。本综述旨在概述关于使用SCs治疗ED的当代报道。
我们使用搜索引擎SciVerse-sciencedirect、SciVerse-scopus、谷歌学术和PubMed,以“勃起功能障碍”“干细胞”“多能基质细胞”“脂肪(组织)来源干细胞”“骨髓来源干细胞”“动物模型”“糖尿病”“衰老”“佩罗尼氏病”和“海绵体神经损伤”为检索词,广泛搜索1966年至2013年期间以英文发表的关于基于SCs治疗ED的报道。
共识别出54篇论文,并作为原始研究报告或其综述为本综述做出贡献。多项临床前研究探讨了基于SCs的疗法对各种慢性和急性疾病导致的勃起功能恢复的作用。总体而言,这些研究显示了SCs治疗的有益效果,而关于SCs治疗作用机制的证据在不同研究中有所不同。一项临床试验研究了SCs治疗对糖尿病性ED患者的短期影响。另外两项临床试验目前正在招募患者。
基于SCs的医学的临床前工作迅速扩展且前景广阔,有望治愈ED而非仅仅缓解症状,这表明在过去十年中,性医学对再生疗法的兴趣日益增加。目前临床试验正在招募患者,以在ED男性中测试临床前研究结果。