Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA.
Baylor College of Medicine, Department of Urology, Houston, TX, USA.
Sex Med Rev. 2019 Apr;7(2):313-320. doi: 10.1016/j.sxmr.2018.04.001. Epub 2018 Jun 28.
Stem cell therapy using stromal vascular fraction (SVF) is a promising treatment modality. SVF is comprised of a mixture of adipose-derived stem cells, endothelial precursor cells, and immune modulatory cells that act synergistically to facilitate angiogenesis and epithelial cell differentiation. This makes SVF an attractive option for men's sexual disorders that require reconstitution of vasculature and endothelial lining, namely erectile dysfunction (ED) and Peyronie's disease (PD).
The objective of this study was to compare and contrast the available literature regarding the use of SVF in the treatment of male sexual dysfunction.
A literature review was performed in PubMed with the keywords "stromal vascular fraction" and/or "erectile dysfunction" and/or "Peyronie's disease" and/or "sexual dysfunction."
The main outcome measure for preclinical studies was erectile function, as measured by changes in intracavernous pressures, and results of histopathologic analysis of corporal tissue. Clinical endpoint analysis in humans included various patient questionnaires.
For ED, there were 5 preclinical studies included in the analysis, with 1 Phase 1 clinical trial in humans. Major limitations of both the preclinical and clinical studies included the absence of SVF component analysis, and short duration of follow-up. Despite a paucity of preclinical studies, there was a single clinical study assessing the efficacy of combination SVF and shock wave therapy in the treatment of PD. Limitations of this study included an absence of a control group and the use of subjective data.
Preclinical and clinical data in the use of SVF for the treatment of male sexual dysfunction is deficient. Even though multiple medicinal disciplines are studying the use of SVF on a myriad of pathologies, further investigative work elucidating the mechanism and potential adverse effects of SVF need to be performed before clinical trials are undertaken. Haney NM, Gabrielson A, Kohn TP, Hellstrom WJG. The Use of Stromal Vascular Fraction in the Treatment of Male Sexual Dysfunction: A Review of Preclinical and Clinical Studies. Sex Med Rev 2019;7:313-320.
使用基质血管成分（SVF）的干细胞疗法是一种很有前途的治疗方式。SVF 由脂肪来源的干细胞、内皮祖细胞和免疫调节细胞的混合物组成，这些细胞协同作用促进血管生成和上皮细胞分化。这使得 SVF 成为治疗需要重建血管和内皮衬里的男性性障碍的一种有吸引力的选择，例如勃起功能障碍（ED）和佩罗尼氏病（PD）。
本研究的目的是比较和对比关于 SVF 在男性性功能障碍治疗中的应用的现有文献。
在 PubMed 上使用“基质血管成分”和/或“勃起功能障碍”和/或“佩罗尼氏病”和/或“性功能障碍”等关键词进行文献回顾。
临床前研究的主要观察指标是勃起功能，通过测量海绵体内压的变化和对 corporal 组织的组织病理学分析结果来衡量。人体临床终点分析包括各种患者问卷调查。
对于 ED，分析中包括 5 项临床前研究和 1 项人体 1 期临床试验。临床前和临床研究的主要局限性包括缺乏 SVF 成分分析和随访时间短。尽管临床前研究较少，但有一项评估 SVF 与冲击波治疗联合治疗 PD 的疗效的单一临床研究。该研究的局限性包括缺乏对照组和使用主观数据。
SVF 治疗男性性功能障碍的临床前和临床数据不足。尽管多个医学学科正在研究 SVF 在多种病理中的应用，但在进行临床试验之前，需要进行进一步的研究工作，以阐明 SVF 的作用机制和潜在的不良反应。Haney NM、Gabrielson A、Kohn TP、Hellstrom WJG。基质血管成分在男性性功能障碍治疗中的应用：临床前和临床研究综述。性医学评论 2019；7：313-320。
