Abstract

Low Intensity Extracorporeal Shock Wave Therapy (Li-ESWT) has been employed for many years to treat ED yet its mechanism of action remains poorly defined. We have previously demonstrated that the therapeutic effects from Li-ESWT may be partially related to the activation of endogenous progenitor/stem cells and we are endeavoring to further describe these pathways. To determine the mechanism by which Li-ESWT activates endogenous stem cells by interrogating histone 3 phosphorylation, which occurs only during the mitotic phase of the cell cycle. Male Sprague-Dawley (SD) rats were treated with 5-ethynyl-2'-deoxyuridine (EdU) pulse followed by Li-ESWT, and cohort analysis was performed. Additionally, rat adipose derived stem cells (RADSCs) and rat penile cavernous smooth muscle cells (RCSMCs) were also treated with Li-ESWT. Fifty male SD rats at 12 weeks old were grouped into three cohorts: 1). Sham; 2). Sub-acute: the animals underwent bilateral cavernous nerve injury (BCNI) then were separated into control and Li-ESWT groups. One week after BCNI, the Li-ESWT group were injected with EdU (50mg/kg, i.p) 30 minutes before Li-ESWT (0.02mJ/mm2, 3 Hz, 300 pulses). One week later, ICP/MAP were measured. 3). Chronic: the animals underwent BCNI then grouped into control and Li-ESWT groups. One week after BCNI, the animals were treated with Li-ESWT (0.02mJ/mm2, 3 Hz, 300 pulses) twice a week for 4 weeks. EdU was injected 30 min before the first and last Li-ESWT. One week after the last Li-ESWT, ICP/MAP were measured. The penile erectile tissues and major pelvic ganglion (MPG) were harvested for histological study to assess smooth muscle/collagen content and endothelium content in the corpora cavernosa. EdU as marker of cell activation and phosphorylated histone 3 (H3P) as marker of the mitotic phase of the cell cycle were also assessed. To confirm the effect of Li-ESWT on the phosphorylation of H3 in vitro, RADSCs and RCSMCs were treated with Li-ESWT (0.02mJ/mm2, 3 Hz, 100 pulses), and EdU incorporation rate and the expression of H3P was assessed.

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