Reviewing the evidence for shockwave- and cell-based regenerative therapies in the treatment of erectile dysfunction

Erectile dysfunction (ED) is both a common and complex disease process. Existing ED treatments do not always achieve adequate results. There is clinical interest in employing regenerative therapies, including low-intensity extracorporeal shockwave therapy (Li-ESWT), platelet rich plasma (PRP), and stem cell therapy (SCT), in the treatment of ED as adjunct or alternative treatments. Here, we present evidence for emerging shockwave- and cell-based regenerative therapies for the treatment of ED following a thorough review of the existing PubMed literature pertaining to Li-ESWT, PRP, and SCT in relation to the treatment of ED. Li-ESWT causes microtrauma in tissue that hypothetically upregulates angiogenesis and recruits stem cells. Several large-scale systematic reviews and meta-analyses have reported that Li-ESWT improved ED in humans. Additionally, evidence has commenced to show that Li-ESWT may be effective against two recognized and complex etiologies of ED: diabetic and neurogenic. PRP delivers an autologous sample rich in growth factors to damaged tissue. Animal model studies have demonstrated improved erectile function recovery as well as preservation of cavernous nerve axons. Studies with PRP in humans are limited. SCT utilizes the regenerative potential of stem cells for healing of damaged tissue. In the treatment of ED, SCT has been used in the setting of diabetic and post-prostatectomy ED. Results of human studies are varied, although SCT treatments did result in increased erectile rigidity with some patients recovering the ability to achieve penetration. While these regenerative therapies show potential to augment the current treatment regimen for ED, there is a paucity of evidence to support the safety and efficacy of these treatments. Further research is necessary to define the role of these alternative therapies in the treatment of ED.

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Revisiting the Regenerative Therapeutic Advances Towards Erectile Dysfunction

Cells ◽

10.3390/cells9051250 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1250

Author(s):

Ming-Che Liu ◽

Meng-Lin Chang ◽

Ya-Chun Wang ◽

Wei-Hung Chen ◽

Chien-Chih Wu ◽

...

Keyword(s):

Stem Cells ◽

Erectile Dysfunction ◽

Platelet Rich Plasma ◽

Therapeutic Interventions ◽

Surgical Approaches ◽

Differentiation Potential ◽

And Migration ◽

The Individual ◽

Preclinical And Clinical Studies ◽

Regenerative Therapies

Erectile dysfunction (ED) is an inability to attain or maintain adequate penile erection for successful vaginal intercourse, leading to sexual and relationship dissatisfaction. To combat ED, various surgical and non-surgical approaches have been developed in the past to restore erectile functions. These therapeutic interventions exhibit significant impact in providing relief to patients; however, due to their associated adverse effects and lack of long-term efficacy, newer modalities such as regenerative therapeutics have gained attention due to their safe and prolonged efficacy. Stem cells and platelet-derived biomaterials contained in platelet-rich plasma (PRP) are thriving as some of the major therapeutic regenerative agents. In recent years, various preclinical and clinical studies have evaluated the individual, as well as combined of stem cells and PRP to restore erectile function. Being rich in growth factors, chemokines, and angiogenic factors, both stem cells and PRP play a crucial role in regenerating nerve cells, myelination of axons, homing and migration of progenitor cells, and anti-fibrosis and anti-apoptosis of damaged cavernous nerve in corporal tissues. Further, platelet-derived biomaterials have been proven to be a biological supplement for enhancing the proliferative and differentiation potential of stem cells towards neurogenic fate. Therefore, this article comprehensively analyzes the progresses of these regenerative therapies for ED.

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What is the clinical applicability of regenerative therapies in dentistry?

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720170002000113112 ◽

2017 ◽

Vol 65 (4) ◽

pp. 359-367 ◽

Cited By ~ 1

Author(s):

Giulia Tarquinio DEMARCO ◽

Laura Borges KIRSCHNICK ◽

Luis Bayardo WATSON ◽

Marcus Cristian MUNIZ CONDE ◽

Flávio Fernando DEMARCO ◽

...

Keyword(s):

Stem Cells ◽

Dental Pulp ◽

Platelet Rich Plasma ◽

Blood Clot ◽

Collagen Scaffold ◽

Bone Tissue Regeneration ◽

Promising Alternative ◽

Organ Regeneration ◽

Regenerative Therapies

ABSTRACT Regenerative therapies have been widely developed in dentistry and it is important to incorporate dentists’ knowledge of these new therapies into the dental clinic routine. This study reviewed the literature on regenerative therapies and clinical applications. Tissue engineering has contributed to changes in the paradigm of restorative health sciences. Its pillars underpin the techniques of tissue and organ regeneration. Despite the majority of studies in this field being in vitro, a range of preclinical studies and methodologies has been formed using these principles and they are already being used on humans. The use of platelet-rich plasma and platelet-rich fibrin in surgery as natural scaffolds for the reestablishment of bone and periodontal tissue are often reported in the literature and clinical trials using this approach have shown promising results. Stem cells from autologous dental pulp have been successfully applied in bone tissue regeneration using natural collagen scaffold in humans. In addition, revascularization of the root canal already appears in the literature as a promising alternative to apexification. The principle behind this therapy is the use of the blood clot as a scaffold and the migration of stem cells of the apical papilla to regenerate the dental pulp organ. Final considerations: Although still in the early stages, regenerative therapies can now be used in dental practice. Knowledge of the principles governing these therapies should be understood by the dentist for use in clinical practice.

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One health in regenerative medicine: report on the second Havemeyer symposium on regenerative medicine in horses

Regenerative Medicine ◽

10.2217/rme-2019-0143 ◽

2020 ◽

Vol 15 (6) ◽

pp. 1775-1787

Author(s):

Lisa Ann Fortier ◽

Laurie Ruth Goodrich ◽

Iris Ribitsch ◽

Lauren Virginia Schnabel ◽

David Owen Shepard ◽

...

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Regenerative Medicine ◽

Platelet Rich Plasma ◽

Stromal Vascular Fraction ◽

Human Patient ◽

Tenogenic Differentiation ◽

Autologous Conditioned Serum ◽

Regenerative Medicines ◽

Regenerative Therapies

Regenerative medicine is commonly used in human and equine athletes. Potential therapies include culture expanded stem cells, stromal vascular fraction of adipose tissue, platelet-rich plasma, bone marrow concentrate, or autologous conditioned serum. The purpose of this manuscript is to disseminate findings from a workshop on the development of translational regenerative medicine in the equine field. Five themes emerged: stem cell characterization and tenogenic differentiation; interactions between mesenchymal stem cells, other cells and the environment; scaffolds and cell packaging; blood- and bone marrow-based regenerative medicines; clinical use of regenerative therapies. Evidence gained through the use of regenerative medicine applications in the horse should continue to translate to the human patient, bringing novel regenerative therapies to both humans and horses.

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Combination Therapy Using Adipose-Derived Stem Cells And Low-Intensity Extracorporeal Shockwave Therapy On Erectile Dysfunction In Streptozotocin-Induced Diabetic Rats

10.21203/rs.2.13432/v1 ◽

2019 ◽

Author(s):

Dankang Li ◽

Yongchao Ge ◽

Quanliang Hou ◽

Wenhua Wang ◽

Chengda Zhang ◽

...

Keyword(s):

Stem Cells ◽

Erectile Dysfunction ◽

Treatment Group ◽

Erectile Function ◽

Combined Treatment ◽

Adipose Derived Stem Cells ◽

Model Group ◽

Extracorporeal Shockwave Therapy ◽

Shockwave Therapy ◽

Low Intensity

Abstract Background：Diabetes mellitus (DM) is an important risk factor for erectile dysfunction (ED). Adipose-derived stem cells (ADSCs) and low-intensity extracorporeal shockwave therapy (LI-ESWT) are two emerging therapies for ED. The efficacy of ADSCs combined LI-ESWT in the treatment of diabetes induced erectile dysfunction (DMED) was not completely elucidated. This study aim to investigate combined therapeutic efficacy of ADSCs and LI-ESWT in rat model of DMEDand whether they have interaction.Methods：Rats were randomly divided into 5 groups: control, erectile dysfunction group (ED), ADSCs treatment group(ADSCs), LI-ESWT treatment group (LI-ESWT) and ADSCs combined with LI-ESWT treatment (ADSCs+LI-ESWT). After 4 weeks, erectile function was assessed using intracavernous pressure (ICP) and mean arterial pressure (MAP), after that performed immunohistochemistry (IH).Results：Finally, a total of 98 rats completed the experiment. The ICP/MAP of five groups under the voltage stimulation of 10V was significantly different (P>0.05). ICP/MAP in ADSC group, LI-ESWT group and combined treatment group was significantly higher than that of ED model group; ICP/MAP in combined treatment group was higher than ADSC group and LI-ESWT group. Interaction between LI-ESWT and ADSCs therapy was not statistically significant (P＞0.05).The expression of -smooth muscle actin (-SMA), nerve nitricoxide synthase (nNOS) and von Willebrand factor (vWF) in ADSCs treatment group, LI-ESWT group and combined treatment group was higher than those in ED model group (P < 0.05).Conclusions：Both ADSCs and LI-ESWT therapy can improve the erectile function of rats. The combination of these two methods present better effect on ED than used individually. There is no positive interaction between ADSCs therapy and LI-ESWT. Both ADSCs and LI-ESWT can enhance the expression of α-SMA, nNOS and vWF in corpus cavernosum of ED rats.

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Effect of Low-Energy Shockwave Therapy Versus Platelets Rich Plasma Therapy in Patients with Erectile Dysfunction

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i32a31730 ◽

2021 ◽

pp. 168-172

Author(s):

Kumail Sajjad ◽

Muhammad Sohail ◽

Hafiz Abdul Momin ◽

Raja Asim Shafique ◽

Muhammad Nazir ◽

...

Keyword(s):

Erectile Dysfunction ◽

Platelet Rich Plasma ◽

Self Esteem ◽

Low Energy ◽

Plasma Therapy ◽

Shockwave Therapy ◽

Group A ◽

Group B ◽

Near Future ◽

Phosphodiesterase 5

Phosphodiesterase 5 inhibitors (PDE5Is) and low-energy shock wave therapy (LESWT) have created a revolution in the treatment of erectile dysfunction (ED). However, they are not able to restore the actual changes in the penis. An emerging new therapy called platelet-rich plasma (PRP) is believed to be more beneficial in treating ED. The objective of this study is to evaluate and compare the efficacy of LESWT and PRP in treating ED. A total of sixty participants of pathological ED was included in the study and divided into two groups. Group A received the LESWT, whereas Group B received the PRP. The benefits were measured by the International Index of Erectile Function (IIEF), an erection hardness score (EHS) and Self-Esteem And Relationship (SEAR) questionnaires. The results of this analysis demonstrated a larger effect in treatment group B in percentage terms, but there were no statistical differences in the two groups. In the near future, PCP may be a new modality for treating ED, especially PDE5I non-respondents with organic ED. However, more extensive preclinical and applied research needs to be conducted.

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Imaging techniques for sacroiliac joint injections

10.1093/med/9780197607947.003.0010 ◽

2021 ◽

pp. 115-120

Author(s):

Jacqueline Weisbein

Keyword(s):

Computed Tomography ◽

Stem Cells ◽

Sacroiliac Joint ◽

Image Guidance ◽

Platelet Rich Plasma ◽

Imaging Techniques ◽

Image Guided ◽

Computed Tomography Fluoroscopy ◽

Regenerative Therapies ◽

Joint Injections

Injections into the sacroiliac joint for both diagnostic and therapeutic purposes have become commonplace. There have been advances in the use of regenerative therapies other than prolotherapy, such as platelet-rich plasma and stem cells. Prior to the introduction of image-guided techniques, blind injections were performed. However, data have consistently shown that without image guidance, injections failed to be accurately placed within the joint. Therefore, the use of image guidance, whether by computed tomography, fluoroscopy, or ultrasound, is imperative to ensure accurate placement of the injectate. This chapter discusses these three types of imaging techniques for sacroiliac joint injections.

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Molecular Genetics of Glaucoma: Subtype and Ethnicity Considerations

Genes ◽

10.3390/genes12010055 ◽

2020 ◽

Vol 12 (1) ◽

pp. 55

Author(s):

Ryan Zukerman ◽

Alon Harris ◽

Alice Verticchio Vercellin ◽

Brent Siesky ◽

Louis R. Pasquale ◽

...

Keyword(s):

Large Scale ◽

Complex Disease ◽

Open Angle Glaucoma ◽

Treatment Options ◽

Disease Process ◽

Angle Closure ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Tremendous Progress ◽

Geographic Differences

Glaucoma, the world’s leading cause of irreversible blindness, is a complex disease, with differential presentation as well as ethnic and geographic disparities. The multifactorial nature of glaucoma complicates the study of genetics and genetic involvement in the disease process. This review synthesizes the current literature on glaucoma and genetics, as stratified by glaucoma subtype and ethnicity. Primary open-angle glaucoma (POAG) is the most common cause of glaucoma worldwide, with the only treatable risk factor (RF) being the reduction of intraocular pressure (IOP). Genes associated with elevated IOP or POAG risk include: ABCA1, AFAP1, ARHGEF12, ATXN2, CAV1, CDKN2B-AS1, FOXC1, GAS7, GMDS, SIX1/SIX6, TMCO1, and TXNRD2. However, there are variations in RF and genetic factors based on ethnic and geographic differences; it is clear that unified molecular pathways accounting for POAG pathogenesis remain uncertain, although inflammation and senescence likely play an important role. There are similar ethnic and geographic complexities in primary angle closure glaucoma (PACG), but several genes have been associated with this disorder, including MMP9, HGF, HSP70, MFRP, and eNOS. In exfoliation glaucoma (XFG), genes implicated include LOXL1, CACNA1A, POMP, TMEM136, AGPAT1, RBMS3, and SEMA6A. Despite tremendous progress, major gaps remain in resolving the genetic architecture for the various glaucoma subtypes across ancestries. Large scale carefully designed studies are required to advance understanding of genetic loci as RF in glaucoma pathophysiology and to improve diagnosis and treatment options.

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Prospects for Stem Cell-Based Regenerative Therapies in India

StemJournal ◽

10.3233/stj-210002 ◽

2021 ◽

pp. 1-11

Author(s):

Dinesh Boopalan ◽

Ramanan Pandian ◽

Gokul Kesavan

Keyword(s):

Stem Cells ◽

Stem Cell ◽

Cell Therapy ◽

Stem Cell Therapy ◽

Large Scale ◽

Phase 1 ◽

Current Status ◽

Beta Thalassemia ◽

Novel Coronavirus ◽

Regenerative Therapies

Stem cells offer a promising therapeutic strategy to not only treat several incurable diseases but also regenerate damaged tissues. The current global boom in the field of stem cell and regenerative therapies had led to India becoming a global hotspot for stem cell-based therapies. In this review, we assess the current status of stem cell therapy trials in India and show that the bone marrow-derived stem cells, like mesenchymal stem/stromal cells (MSCs), are predominantly used. Phase 1 and 2 clinical trials have also used MSCs to alleviate symptoms of severe novel coronavirus infections. Recent breakthroughs in gene editing technologies, combined with stem cell therapy, can be effectively harnessed to devise large-scale and affordable treatments for haematological diseases that are highly prevalent in India, like beta-thalassemia and sickle cell diseases. Innovations in stem cell therapy in India can make treatments more affordable to address the needs of in-country patients.

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