madman
Super Moderator
Abstract
Erectile dysfunction (ED) is a common clinical condition that mainly affects men aged over 40 years. Various causes contribute to the progression of ED, including pelvic nerve injury, diabetes, metabolic syndrome, age, Peyronie’s disease, smoking,and psychological disorders. Current treatments for ED are limited to symptom relief and do not address the root cause. Stem cells, with their powerful ability to proliferate and differentiate, are a promising approach for the treatment of male ED and are gradually gaining widespread attention. Current uses for treating ED have been studied primarily in experimental animals,with most studies observing improvements in erectile quality as well as improvements in erectile tissue. However, research on stem cell therapy for human ED is still limited. This article summarizes the recent literature on basic stem cell research on ED, including cavernous nerve injury, aging, diabetes, and sclerosing penile disease, and describes mechanisms of action and therapeutic effects of various stem cell therapies in experimental animals. Stem cells are also believed to interact with host tissue in a paracrine manner, and improved function can be supported through both implantation and paracrine factors. To date, stem cells have shown some preliminary promising results in animal and human models of ED.
2 Stem Cells in the Treatment of ED Resulting from Cavernous Nerve Injury
3 Stem Cells in the ED of Diabetes and Metabolic Syndrome
4 Stem Cells in Aging‑Associated ED
5 Stem Cells in the ED of Peyronie’s Disease and Corpus Cavernous Injury
6 Stem Cell Applications in Human Clinical Trials
7 Conclusions
Stem cell therapy is potentially safe and effective in the treatment of ED and remains a promising area of research. Significant results have been achieved through numerous preclinical studies, with stem cells improving erectile function by differentiating into neural cells, smooth muscle cells,and endothelial cells on the one hand, and enhancing erec‑tile function by promoting angiogenesis and anti-fibrosis and anti-apoptosis through paracrine effects on the other hand.
However, stem cells still have many unresolved challenges in the treatment of ED. The relevant mechanisms in humans have not yet been fully elucidated, and the future direction of cell therapy still requires large-scale human studies. Meanwhile, many issues must still be resolved to achieve the safety, efficacy, and specific mechanisms of action of stem cells in treatment. Previous studies have reported that MSC can penetrate into prostate cancer cells, including prostate tissue to promote tumorigenesis and progression [93]. It is also meaningful to explore the origin of stem cells. Current research has found that both autologous and exogenous stem cells can improve erectile function, but the choice is worth exploring. Autologous stem cells are easy to obtain and safe, and can overcome the antigenicity problem of cell transplantation. Recently, it was found that allogeneic transplantation of ADSC secreted cytokines to regulate T cell and natural killer cells, thus avoiding immune rejection [12]. Autologous transplantation is not indicated in elderly patients and those with cancer [94]. These unresolved issues may include determining the optimal treatment protocol to address the immunogenicity and heterogeneity of stem cells, and evaluating the high cost and low efficiency of their application. Other issues may include small sample sizes, lack of blinding, and so on. Secondly, the types of stem cells, injectable doses, duration of treatment, and end‑points for evaluation of therapeutic effects have not yet been determined, coupled with ethical, legal, and social issues affecting the widespread use of stem cell therapy.
We believe that in the near future, more phase II and phase III clinical trials will be conducted to generate a high level of evidence, further clarify the specific mechanism of action, reduce the drawbacks of high cost and inefficiency,and fully prepare for the translation of stem cell therapy for ED from preclinical studies to clinical application.
Erectile dysfunction (ED) is a common clinical condition that mainly affects men aged over 40 years. Various causes contribute to the progression of ED, including pelvic nerve injury, diabetes, metabolic syndrome, age, Peyronie’s disease, smoking,and psychological disorders. Current treatments for ED are limited to symptom relief and do not address the root cause. Stem cells, with their powerful ability to proliferate and differentiate, are a promising approach for the treatment of male ED and are gradually gaining widespread attention. Current uses for treating ED have been studied primarily in experimental animals,with most studies observing improvements in erectile quality as well as improvements in erectile tissue. However, research on stem cell therapy for human ED is still limited. This article summarizes the recent literature on basic stem cell research on ED, including cavernous nerve injury, aging, diabetes, and sclerosing penile disease, and describes mechanisms of action and therapeutic effects of various stem cell therapies in experimental animals. Stem cells are also believed to interact with host tissue in a paracrine manner, and improved function can be supported through both implantation and paracrine factors. To date, stem cells have shown some preliminary promising results in animal and human models of ED.
2 Stem Cells in the Treatment of ED Resulting from Cavernous Nerve Injury
3 Stem Cells in the ED of Diabetes and Metabolic Syndrome
4 Stem Cells in Aging‑Associated ED
5 Stem Cells in the ED of Peyronie’s Disease and Corpus Cavernous Injury
6 Stem Cell Applications in Human Clinical Trials
7 Conclusions
Stem cell therapy is potentially safe and effective in the treatment of ED and remains a promising area of research. Significant results have been achieved through numerous preclinical studies, with stem cells improving erectile function by differentiating into neural cells, smooth muscle cells,and endothelial cells on the one hand, and enhancing erec‑tile function by promoting angiogenesis and anti-fibrosis and anti-apoptosis through paracrine effects on the other hand.
However, stem cells still have many unresolved challenges in the treatment of ED. The relevant mechanisms in humans have not yet been fully elucidated, and the future direction of cell therapy still requires large-scale human studies. Meanwhile, many issues must still be resolved to achieve the safety, efficacy, and specific mechanisms of action of stem cells in treatment. Previous studies have reported that MSC can penetrate into prostate cancer cells, including prostate tissue to promote tumorigenesis and progression [93]. It is also meaningful to explore the origin of stem cells. Current research has found that both autologous and exogenous stem cells can improve erectile function, but the choice is worth exploring. Autologous stem cells are easy to obtain and safe, and can overcome the antigenicity problem of cell transplantation. Recently, it was found that allogeneic transplantation of ADSC secreted cytokines to regulate T cell and natural killer cells, thus avoiding immune rejection [12]. Autologous transplantation is not indicated in elderly patients and those with cancer [94]. These unresolved issues may include determining the optimal treatment protocol to address the immunogenicity and heterogeneity of stem cells, and evaluating the high cost and low efficiency of their application. Other issues may include small sample sizes, lack of blinding, and so on. Secondly, the types of stem cells, injectable doses, duration of treatment, and end‑points for evaluation of therapeutic effects have not yet been determined, coupled with ethical, legal, and social issues affecting the widespread use of stem cell therapy.
We believe that in the near future, more phase II and phase III clinical trials will be conducted to generate a high level of evidence, further clarify the specific mechanism of action, reduce the drawbacks of high cost and inefficiency,and fully prepare for the translation of stem cell therapy for ED from preclinical studies to clinical application.
