Monday, 8 April 2013

Stem cells treat Peyronie's disease and restore erectile function

In a recent study on rats, researchers used grafts seeded with adult stem cells to treat Peyronie's disease and restore erectile function. The findings may one day help men with penis injuries, deformities, or severe Peyronie's disease, said the researchers.

Men with penis injuries or deformities often need penis reconstruction surgery (phalloplasty) for cosmetic purposes and/or to restore their sexual function. Sometimes, the procedure requires the use of a graft that can be either autologous (made of the patient's own tissue) or allogenic (e.g. from a cadaver). Unfortunately, the surgery may cause severe complications, like permanent erectile dysfunction.

To provide better results to his patient, Wayne Hellstrom an urologist from the Tulane University School of Medicine who performs phalloplasties on a regular basis, teamed up with researchers in California and China to build a better penis graft.

To do so, the researchers combined pig intestine grafts with adult stem cells harvested from the adipose (fat) tissue of rats. Then, they created a rodent model for Peyronie's disease by making incisions in the rodent penises which resulted in penile scar tissue.

The rats were then divided into four groups:
  • 8 rats had the scar tissue partially replaced with grafts seeded with stem cells
  • 8 rats had the scar tissue partially replaced with normal grafts
  • 8 rats had sham surgery (placebo surgery)
  • 8 rats had no surgery at all (control group)

Penis anatomy

Two months later, the rats had fully recovered and were examined by the researchers, who reported that the rats receiving the stem cell-grafts had less scarring and better erectile responses while their penises contained more neuronal and endothelial NOS, two enzymes crucial for penile erections. Furthermore, the mice receiving the stem cell grafts had higher amounts of VEGF, a signal protein produced that stimulates vasculogenesis and angiogenesis

"We were really excited and surprised that stem cells can create this much improvement." said urologist Asim Abdel-Mageed, a co-author of the study.

"This study suggests that SIS-ADSC grafting can be successfully used for TA reconstruction procedures and can restore erectile function." an extract from the study.

Hellstrom and his team now plan to test the grafts in primates and hopefully in human patients.

"Peyronie's affects 3% to 9% of adult males and causes a lot of psychological distress. If we can improve what we have now, it seems like the logical thing to do" said Hellstrom.

Phalloplasty refers to the construction (or reconstruction) of a penis by surgery. The operation is carried out for cosmetic purposes, to  patients with congenital anomalies (like micropenis), to female-to-male transsexual patients and to patients who have lost their penis.

Ma L, Yang Y, Sikka SC, Kadowitz PJ, Ignarro LJ, Abdel-Mageed AB, & Hellstrom WJ (2012). Adipose tissue-derived stem cell-seeded small intestinal submucosa for tunica albuginea grafting and reconstruction. Proceedings of the National Academy of Sciences of the United States of America, 109 (6), 2090-5 PMID: 22308363

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