Intracavernous Injection of Platelet-Rich Plasma Therapy Enhances Erectile Function and Decreases the Mortality Rate in Streptozotocin-Induced Diabetic Rats.

Chun-Hou Liao,Jai-Hong Cheng,Wang-Ying Lin,Kuo-Chiang Chen,Yi-No Wu,Shiu-Dong Chung,Bo-He Chen,Chellappan Praveen Rajneesh,Han-Sun Chiang,Kau-Han Lee

doi:10.3390/ijms23063017

Abstract

Erectile dysfunction (ED) is an agonizing complication of diabetes mellitus (DM) and it is challenging to treat ED in DM patients. Platelet-rich plasma (PRP) is a unique therapeutic strategy comprising intrinsic growth factors. An attempt was made to explore the potentiality of the PRP treatment in DM-induced ED rats in various groups (control, DM-non-ED, DM-ED, and DM-ED treated with PRP). Streptozotocin (STZ) was used to induce DM in rats. The blood glucose levels of the DM rats were maintained at >300 mg/dl. In the 18-week experiment, survival rate, body weight, intracavernous pressure (ICP) variations, and arterial blood pressure were analyzed. The tissue restoration results were validated by histological, immunofluorescence, and transmission electron microscopic analysis. PRP treatment of DM-ED rats significantly increased all parameters of erectile function compared to pre-treatment of PRP and DM-ED treated with vehicle. The histological results revealed that PRP treatment substantially enhanced the regeneration of myelinated nerves and decreased the atrophy of corporal smooth muscle. Notably, the PRP treatment immensely enhanced the survival rate in post-surgery DM-ED rats. These results indicated certain benefits of PRP treatment in delaying damage and preventing post-surgery complications in DM patients. Hence, PRP treatment is a novel multifactorial strategy for DM-ED patients.

Highlights

Erectile dysfunction (ED) is a predominant sexual dysfunction and is considered a key factor of functional incapability in sexual intercourse
After the first intracavernous pressure (ICP) measurement at 18 weeks, an overall slight decrease in body weight and a gentle gain back to stable body weight was observed in diabetes mellitus (DM) rats
This study provided positive evidence that Platelet-rich plasma (PRP) was a multifunctional treatment for ED in STZ-induced DM rats, including a decrease in mortality of STZ toxicity and hyperglycemia, increase in wound healing of post-surgery, recovery of ICP, smooth muscles atrophy prevention, and nerves regeneration

Summary

Introduction

Erectile dysfunction (ED) is a predominant sexual dysfunction and is considered a key factor of functional incapability in sexual intercourse. The healthy nitrergic nerves, endothelium, and smooth muscles are the major components that play a vital role in the process [1]. Several factors such as drugs and surgery induce ED [2,3], and it has been emphasized as a common chronic complication of diabetes mellitus (DM) [4–7]. The DM-induced ED is mainly triggered by the hyperglycemic condition, which leads to an overproduction of free radicals to increase oxidative stress and inflammation, thereby resulting in endothelial dysfunction of the corpus cavernosum [10,11]. Other complications such as vasculopathy, neuropathy, and endothelial dysfunction in DM patients lead to a more severe state of ED, making it more challenging to treat DM-ED than ED of non-diabetic patients [8,9]

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