The studies with adipose-derived stem/stromal cells therapeutic development of erectile dysfunction

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INTRODUCTION AND OBJECTIVES : Diabetic patients are more refractory to the treatment with phosphodiesterase type 5 inhibitors(PDE-5I) because of severe damage in their cavernous body. We have previously reported that acute administration of Adrenomedullin(AM) into the cavernous body enhances erectile function in rats. During the screening of cytokines that adipose tissue-derived stem cells(ASC) produce, we found that ASC produced AM especially when ASC were cultured in medium containing growth factors for vascular endothelial cells(VEC). In this study, we examined whether AM would be implicated in ASCinduced restoration of erectile function.METHODS : ASC isolated from the subcutaneous adipose tissue of a Wister rat was cultured for one week in either EBM or EGM medium which contains vascular endothelial cell growth factor such as VEGF-A, IGF with 5% FBS. Streptozotocin(STZ) was injected into a male Wister rat. Stem cells cultured using the two methods above were injected into the corpu … More s spongiosum penis of the model rat and a normal rat in the ninth week after STZ administration. The mean arterial blood pressure(MAP) and the intracavernosal pressure(ICP) were measured. We used lentivirus(LV) expressing rat AM siRNA and AdAM, and examined whether AM produced by ASC played pivotal roles in ASC-induced restoration of erectile function. RESULTS : 1. ASC administration restores ICP ; Administration of ASC significantly increased ICP/MAP and AUC. 2. ASC administration restores the structure of cavernous body ; When ASC were injected, the trabeculae of cavernous body became larger and were distributed more densely. 3. ASC produce AM ; The ASC secreted AM in the culture medium in a time-dependent fashion. When ASC were infected with LV that expresses AM siRNA and cultured for 1 week, AM secretion by ASC was significantly suppressed. 4. Effects of AM knockdown and forced expression of AM ; ASC were infected with LV expressing AM siRNA(LV_AMsiRNA) or its negtive control NC siRNA(LV_NC siRNA), cultured for 1 week, and injected in the cavernous body. When ASC were infected with LV_NC siRNA, ASC significantly restored erectile function, as assessed by ICP/MAP and AUC. In contrast, when ASC were infected with LV_AM siRNA, ASC-induced restoration of ICP/MAP and AUC was significantly diminished. CONCLUSIONS : These results suggested that ASC have potentials to restore erectile function and that AM produced by ASC when cultured especially in EGM plays a major role in the restoration of erectile function Less