He Lei, Yu Tiannan, Xiao Ying, Huang Yeqing, Guan Yangbo, Zhao Fan, Ma Limin
Department of Urology, Affiliated Hospital of Nantong University, Nantong, China.
Medical College, Nantong University, Nantong, China.
Andrologia. 2022 Nov;54(10):e14538. doi: 10.1111/and.14538. Epub 2022 Aug 1.
Cavernous nerve injury is the main cause of erectile dysfunction (ED) after radical prostatectomy (RP). In our previous study, injection of adipose-derived stem cells (ADSCs) into the cavernosum can repair damaged cavernosum nerves and ED can be restored to a certain extent. In order to improve these therapeutic effects, we evaluated the efficacy of ADSCs co-modified with VEGF and Smad7 in a rat model. SD rats were randomly divided into six groups: a sham surgery group, and the five bilateral cavernous nerve injury (BCNI) groups were injected with ADSC or ADSCs genetically modified by VEGF (ADSC-V), Smad7 (ADSC-S), or VEGF&Smad7 (ADSC-V&S) or phosphate-buffered saline (PBS). The results indicated that the erectile function of the ADSC-V, ADSC-S, and ADSC-V&S groups was significantly recovered, and the erectile function of the ADSC-V&S group was more distinctly recovered as compared to the other groups. The same results are shown in the expression of neuronal nitric oxide synthase and the smooth muscle/collagen ratio of penile tissue comparing the ADSC-V&S group to the ADSC-V and ADSC-S group. These experimental data suggest that ADSCs co-overexpressed with VEGF and Smad7 can significantly improve erectile function after BCNI. This study provides new therapeutic thoughts for ED following RP.
海绵体神经损伤是根治性前列腺切除术后勃起功能障碍(ED)的主要原因。在我们之前的研究中,将脂肪来源干细胞(ADSCs)注射到海绵体内可修复受损的海绵体神经,ED可在一定程度上得到恢复。为了提高这些治疗效果,我们在大鼠模型中评估了经血管内皮生长因子(VEGF)和Smad7共修饰的ADSCs的疗效。将SD大鼠随机分为六组:假手术组,以及五个双侧海绵体神经损伤(BCNI)组,分别注射ADSC或经VEGF基因修饰的ADSCs(ADSC-V)、Smad7(ADSC-S)、VEGF和Smad7(ADSC-V&S)或磷酸盐缓冲盐水(PBS)。结果表明,ADSC-V组、ADSC-S组和ADSC-V&S组的勃起功能显著恢复,且与其他组相比,ADSC-V&S组的勃起功能恢复更为明显。比较ADSC-V&S组与ADSC-V组和ADSC-S组,阴茎组织中神经元型一氧化氮合酶的表达以及平滑肌/胶原蛋白比例也呈现相同结果。这些实验数据表明,VEGF和Smad7共过表达的ADSCs可显著改善BCNI后的勃起功能。本研究为根治性前列腺切除术后的ED提供了新的治疗思路。