| Background Erectile dysfunction(ED)is one of the most common symptoms affecting the quality of life of middle-aged men.At present,the efficacy of drug therapy for some refractory ED is poor.Drug therapy can only relieve symptoms and can't change the pathological state of ED.Adipose tissue-derived stem cells(ADSCs)and low-intensity shock wave therapy(LI-ESWT)are new therapies for ED.Over the recent decade,these two treatment methods have been greatly developed.Neither ADSC nor LI-ESWT can cure ED and make the erection function to normal levels,though these two therapies have achieved a good efficacy on ED in subclinical studies.Subclinical studies have shown that these two methods have a similar mechanism for the treatment of ED,which can improve the pathological state of ED.Considering the commonality of the two method,we discussed the efficacy of ADSC combined with LI-ESWT in the treatment of ED in rats.Objective To evaluate the efficacy of ADSC combined with LI-ESWT in the treatment of ED,to explore the interaction between ADSC and LI-ESWT,and to elucidate the mechanism of ADSC combined with LI-ESWT in the treatment of ED.Methods The inguinal fat from male 4-week-old SD(Sprague Dawley)rats with specific pathogen free(specific pathogen free,SPF)bacteria were used in ADSC culture.The growth curve of ADSC was determined by MTT(thiazolyl blue tetrazolium bromide)methods.Adipogenic and osteogenic differentiation were used to identify ADSCs.One hundred and fifty male 8-week-old male SD rats were randomly divided into two groups: normal control group underwent any treatment;interaction analysis group was intraperitoneally injected with STZ to construct type-?diabetes model.Diabetic rats were subjected to apomorphine(APO)test.The rats with negative APO test were randomly divided into four groups: ED control group was given intracavernous injection phosphate buffer saline(PBS);ADSC treatment group was given intracavernous injection of ADSCs suspension;LI-ESWT treatment group was given cavernous shock wave treatment;ADSC combined with LI-ESWT treatment group was given cavernous shock wave treatment after 1 day injection for ADSCs.After 4weeks of intervention,rats in each group were measured the intracavernous pressure(ICP)and mean arterial pressure(MAP)to evaluate the therapeutic effect and analyze the interaction between LI-ESWT and ADSC.The IH(immunohistochemistry)experiments of middle of the penis were performed to explore the possible therapeutic mechanisms.Results1.ADSC had strong proliferation ability and can differentiate into adipocytes and osteoblasts.2.A total of 98 rats were enrolled in the study,19 in the normal control group,19 in the ED control group,20 in the ADSC group,19 in the LI-ESWT group,and 21 in the combined treatment group.ICP/MAP between in five groups under the stimulation of 10 V was 0.69±0.096,0.25±0.096,0.44±0.13,0.42±0.14 and0.55±0.082,a significant difference observed(P<0.05).ICP/MAP in ADSC group,LI-ESWT group and combined treatment group was significantly higher than that of ED model group;ICP/MAP in combined treatment group was higher than that of ADSC group and LI-ESWT group.Interaction between LI-ESWT and ADSC group was not statistically significant(P=0.212).Spearman correlation coefficient of rat blood glucose levels and ICP/MAP was-0.316(P < 0.05).3.The expression of ?-SMA,n NOS and v WF in ADSC treatment group,LI-ESWT group and combined treatment group was higher than those in ED model group(P < 0.05).ConclusionsBoth ADSC and LI-ESWT therapy can improve the erectile function of rats.The combination of the two methods had better effect on ED than single use and there was no interaction between ADSC therapy and LI-ESWT. |
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