Hou Quan-Liang, Ge Meng-Ying, Zhang Cheng-da, Tian Dan-Dan, Wang Lian-Ke, Tian Hui-Zi, Wang Wen-Hua, Zhang Wei-Dong
Department of Epidemiology, College of Public Heath, Zhengzhou University, Zhengzhou, 450001, Henan, China.
School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA.
Int Urol Nephrol. 2017 Jul;49(7):1127-1137. doi: 10.1007/s11255-017-1590-2. Epub 2017 Apr 17.
We aimed to systematically assess the effect of adipose tissue-derived stem cell (ADSC) therapy and its influential factors on the treatment of erectile dysfunction (ED) in rats.
Two authors independently searched for published studies through PubMed and EMBASE from study inception until August 31, 2016. A meta-analysis was used to combine the effect estimate from the published studies. A subgroup analysis was performed to identify the effect of some influential factors. The pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated by a fixed-effects or random-effects model analysis.
Twenty studies with a total of 248 rats were included in this meta-analysis. The pooled analysis showed that ADSC therapy significantly increased the ratio of intracavernous pressure and mean arterial pressure (ICP/MAP; SMD 3.46, 95% CI 2.85-4.06; P < 0.001) compared to control therapy. The levels of neuronal nitric oxide synthase (nNOS; SMD 6.37, 95% CI 4.35-8.39; P < 0.001), the cavernous smooth muscle content (CSMC; SMD 3.65, 95% CI 2.65-4.65; P < 0.001), the ratio of cavernous smooth muscle and collagen (CSM/collagen; SMD 4.16, 95% CI 2.59-5.72; P < 0.001), and the cyclic guanosine monophosphate (cGMP; SMD 7.12, 95% CI 2.76-11.48; P = 0.001) were higher following ADSC therapy than following control therapy. Subgroup analysis showed that ADSCs modified by growth or neurotrophic factors significantly recovered erectile function (P < 0.001) compared with ADSC therapy.
The adequate data indicated that ADSC therapy recovered erectile function and regenerated cavernous structures in ED rats, and ADSCs modified by some growth and neurotrophic factors accelerated the recovery of erectile function and cavernous structures in ED rats.
我们旨在系统评估脂肪组织来源的干细胞（ADSC）疗法及其影响因素对大鼠勃起功能障碍（ED）治疗的效果。
两名作者从研究开始至2016年8月31日，通过PubMed和EMBASE独立检索已发表的研究。采用荟萃分析来合并已发表研究的效应估计值。进行亚组分析以确定一些影响因素的作用。通过固定效应或随机效应模型分析计算合并的标准化均数差（SMD）及其95%置信区间（CI）。
本荟萃分析纳入了20项研究，共248只大鼠。汇总分析显示，与对照治疗相比，ADSC疗法显著提高了海绵体内压与平均动脉压的比值（ICP/MAP；SMD 3.46，95%CI 2.85 - 4.06；P < 0.001）。与对照治疗相比，ADSC疗法后神经元型一氧化氮合酶（nNOS；SMD 6.37，95%CI 4.35 - 8.39；P < 0.001）、海绵体平滑肌含量（CSMC；SMD 3.65，95%CI 2.65 - 4.65；P < 0.001）、海绵体平滑肌与胶原蛋白的比值（CSM/胶原蛋白；SMD 4.16，95%CI 2.59 - 5.72；P < 0.001）以及环磷酸鸟苷（cGMP；SMD 7.12，95%CI 2.76 - 11.48；P = 0.001）水平更高。亚组分析表明，与ADSC疗法相比，经生长或神经营养因子修饰的ADSC能显著恢复勃起功能（P < 0.001）。
充分的数据表明，ADSC疗法可恢复ED大鼠的勃起功能并使海绵体结构再生，且经某些生长和神经营养因子修饰的ADSC能加速ED大鼠勃起功能和海绵体结构的恢复。
