| Objective:Erectile dysfunction(ED),a common disease all over the world that typically affects men,is a problem getting or keeping an erection hard enough for satisfactory sexual performance,which seriously effects the quality of life of the afflicted men and their families.With the rising incidence of prostate cancer around the world,the ED patients after Radical Prostatectomy come with the injured cavernous nerves(CNs.However,these patients are unresponsive to oral phosphodiesterase type 5 inhibition(PDE5i),which is effective in most instances,and other approaches do as the same.With the development of stem cell(SC)technology,SC therapy is a promising new frontier for the treatment of those ED patients after RP and many studies demonstrated its therapeutic effects.Among numerous SC candidates,adipose derived stem cells(ADSC)become the best choice due to its characteristics.So aim of the study is to investigate the role of ADSC in ED with CNs injury.Methods:Perirenal fat tissue were cut from 10 cases with postoperative pathological diagnosis of renal cyst patients.ADSC were separated and refined from the fat tissue after digesting with collagenase I.ADSC were identified by flow cytometry.A total of 30 male SD rats(8 weeks)were randomly divided into three groups.The sham group only received an incision of abdomen.After satisfactory anesthesia,bilateral cavernous nerve(CNs)were isolated under the microscope,clamped with microscopic instrument for 2 minutes in CNs and ADSC group.ED of CNs damage model was established.ADSC group underwent injection of 20?l vehicle,which contains 5×105 ADSC;CNs group injected of 20?l PBS.Physiological recorder was used to measure the maximal ICP(intracavernosal pressure)and MAP(mean arterial pressure)before injection and after 8 weeks,and western blot was used to measure the expression of eNOS and nNOS protein in the penile tissue protein.Results:Human ADSC has been successfully isolated and refined,the survival ADSC was observed under inverted microscope as a triangle,fusiform,fiber,single layer growth.Flow cytometry analysis on ADSCs showed that the vast majority of cells possess a CD29+,CD44+,CD90+,CD105+,and CD34-,CD45-phenotype.The maximal ICP and MAP were measured during cavernous nerve electrostimulation in 8 weeks after injection.In Sham group the functional evaluation showed a maximal ICP 85.7±2.6 cmH20,which significant higher than that of CNs group37.2±7.4 cmH20(p<0.001).The ICP of CNs group were less than that of ADSC group 81.213.7 cmH20(p<0.001).In Sham group the ICP/MAP value75.4±5.9%was significantly over than CNs group39.1±4.0%(p<0.001).The ICP/MAP of CNs group were less than that of ADSC group 72.3±3.5%(p<0.001).Compared with Sham group and ADSC group,the expression of eNOS and nNOS protein in CNs ADSC group was significantly down-regulated.Conclusion:Human ADSC has been successfully extracted from human perirenal fat tissue,identified by the flow cytometry as ADSC.Human ADSC could restore erectile function in a rat model of bilateral CNs crush injury.Human ADSC may be used as a novel therapy for clinical postprostatectomy ED. |
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