Stem Cell Therapy for Diabetic Erectile Dysfunction in Rats: A Meta-Analysis.
Stem Cell Therapy for Diabetic Erectile Dysfunction in Rats: A Meta-Analysis.
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DOI：
10.1371/journal.pone.0154341
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Li M;Li H;Ruan Y;Wang T;Liu J
干细胞治疗是治疗糖尿病勃起功能障碍的一种新方法。许多相关的动物研究已经评估了这种疗法在大鼠身上的疗效。这项荟萃分析的目的是比较不同干细胞疗法的疗效，评估影响因素，并确定糖尿病ED的最佳干细胞治疗策略。我们检索了2015年9月30日之前发表的关于干细胞治疗糖尿病大鼠ED疗效的研究，检索词为PubMed、Web of Science和EBSCO。随机效应荟萃分析用于评估干细胞治疗的结果。根据这些研究的不同特点，进行亚组分析。比较两组海绵体内压与平均动脉压之比及海绵体结构的变化。这项荟萃分析纳入了10项研究，共302只大鼠。这些研究的综合分析表明，干细胞治疗对改善糖尿病大鼠的勃起功能是有益的(SMD4.03，95%CI=3.224.84，P<；0.001)。干细胞治疗组血管内皮细胞和血管内皮细胞含量均明显高于对照组。内皮型一氧化氮合酶(ENOS)和神经元型一氧化氮合酶(NNOS)的表达、血管内皮细胞生长因子(VEGF)分泌和血管内皮细胞生长因子(VEGF)的分泌也明显增加。此外，干细胞处理减少了细胞的凋亡率。亚群分析表明，修饰的干细胞比未修饰的干细胞更有效。结果证实，干细胞治疗能明显改善糖尿病大鼠的勃起功能。一些特异性的修饰，特别是结合生长因子的基因修饰，可以提高干细胞治疗的效果。干细胞治疗有可能成为治疗糖尿病ED的有效策略。
Stem cell therapy is a novel method for the treatment of diabetic erectile dysfunction (ED). Many relative animal studies have been done to evaluate the efficacy of this therapy in rats. This meta-analysis was performed to compare the efficacy of different stem cell therapies, to evaluate the influential factors and to determine the optimal stem cell therapeutic strategy for diabetic ED. We searched the studies analyzing the efficacy of stem cell therapy for diabetic ED in rats published before September 30, 2015 in PubMed, Web of Science and EBSCO. A random effects meta-analysis was conducted to assess the outcomes of stem cell therapy. Subgroup analysis was also performed by separating these studies based on their different characteristics. Changes in the ratio of intracavernous pressure (ICP) to mean arterial pressure (MAP) and in the structure of the cavernous body were compared. 10 studies with 302 rats were enrolled in this meta-analysis. Pooled analysis of these studies showed a beneficial effect of stem cell therapy in improving erectile function of diabetic rats (SMD 4.03, 95% CI = 3.22 to 4.84, P< 0.001). In the stem cell therapy group, both the smooth muscle and endothelium content were much more than those in control group. There was also significant increase in the expression of endothelial nitric oxide synthase (eNOS) and neuronal nitric oxide synthase (nNOS), the ratio of smooth muscle to collagen, as well as the secretion of vascular endothelial growth factor (VEGF). Besides, apoptotic cells were reduced by stem cell treatment. The subgroup analysis indicated that modified stem cells were more effective than those without modification. Our results confirmed that stem cell therapy could apparently improve the erectile function of diabetic rats. Some specific modification, especially the gene modification with growth factors, could improve the efficacy of stem cell therapy. Stem cell therapy has potential to be an effective therapeutic strategy for diabetic ED.