Chakra Mohamad Abou, Bailly Hugo, Klampke Fabian, Boaz Johann, Jida Mouatasem, Yassine Ahmad Abou, McElree Ian M, Moussa Mohamad
Department of Urology, Lebanese University, Beirut, Lebanon.
Department of Urology, Vivantes Klinikum, Berlin, Germany.
Asian J Urol. 2024 Oct;11(4):530-544. doi: 10.1016/j.ajur.2023.07.005. Epub 2024 Mar 11.
This systematic review aimed to analyze animal and human trial data to better understand the efficacy of stem cell therapy (SCT) for erectile dysfunction (ED) and the obstacles that may hinder its application in this field.
We searched electronic databases, including PubMed and Scopus, for published studies with the Medical Subject Heading terms of "erectile dysfunction" (AND) "stem cell therapy" (OR) "erectile dysfunction" (AND) "clinical trial of stem cell therapy" (OR) "stem cell therapy" (AND) "sexual dysfunction". The search was limited to English-language journals and full papers only. The initial search resulted in 450 articles, of which 90 relevant to our aims were included in the analysis.
ED is a multifactorial disease. Current treatment options rely on pharmacotherapy as well as surgical options. Patients may have side effects or unsatisfactory results following the use of these treatment options. SCT may restore pathophysiological changes leading to ED rather than treating the symptoms. It has been evaluated in animal models and shown promising results in humans. Results confirm that SCT does improve erectile function in animals with different types of SC use. In humans, evidence showed promising results, but the trials were heterogeneous and limited mainly by a lack of randomization and the small sample size. Many challenges could limit future research in this field, including ethical dilemmas, regulation, patient recruitment, the cost of therapy, and the lack of a standardized SCT regimen. Repairing and possibly replacing diseased cells, tissue, or organs and eventually retrieving normal function should always be the goals of any therapy, and this can only be guaranteed by SCT.
SCT is a potential and successful treatment for ED, particularly in patients who are resistant to the classic therapy. SCT may promote nerve regeneration and vascular cell regeneration, not only symptomatic treatment.
本系统评价旨在分析动物和人体试验数据,以更好地了解干细胞疗法(SCT)治疗勃起功能障碍(ED)的疗效以及可能阻碍其在该领域应用的障碍。
我们在包括PubMed和Scopus在内的电子数据库中搜索已发表的研究,其医学主题词为“勃起功能障碍”(AND)“干细胞疗法”(OR)“勃起功能障碍”(AND)“干细胞疗法临床试验”(OR)“干细胞疗法”(AND)“性功能障碍”。搜索仅限于英文期刊和全文。初步搜索产生了450篇文章,其中90篇与我们的目标相关,被纳入分析。
ED是一种多因素疾病。目前的治疗选择依赖于药物治疗以及手术治疗。使用这些治疗方法后,患者可能会出现副作用或效果不理想。SCT可能恢复导致ED的病理生理变化,而不是治疗症状。它已在动物模型中进行了评估,并在人体中显示出有希望的结果。结果证实,使用不同类型干细胞的SCT确实能改善动物的勃起功能。在人体中,证据显示出有希望的结果,但试验存在异质性,主要局限于缺乏随机化和样本量小。许多挑战可能会限制该领域未来的研究,包括伦理困境、监管、患者招募、治疗成本以及缺乏标准化的SCT方案。修复并可能替换患病的细胞、组织或器官,最终恢复正常功能,应该始终是任何治疗的目标,而这只有通过SCT才能保证。
SCT是治疗ED的一种潜在且成功的方法,特别是对于对经典疗法耐药的患者。SCT可能促进神经再生和血管细胞再生,而不仅仅是对症治疗。