Application of Stem Cell in Human Erectile Dysfunction – A Systematic Review

Abstract

Introduction Erectile dysfunction is a health problem that arises from various conditions and causes an impaired quality of life with a significant health burden. Regenerative and stem cell therapies are some of the potential treatments for erectile dysfunction. This study aimed to review the available information in the literature regarding the use of stem cells in the treatment of erectile dysfunction. Methods This study is a systematic review conducted based on the PubMed, Google Scholar, Cochrane, and DOAJ databases. Literature searching was conducted in English and included articles from 2000 to 2020. Results The result was a total of 318 articles. Following the elimination process, 9 articles remained in the final analysis. The analyzed studies included 164 patients with erectile dysfunction with various medical conditions. Several stem cell types have been used for treating erectile dysfunction, including mesenchymal stem cell, placental matrix-derived stem cell, mesenchymal stem cell-derived exosome, adipose-derived stem cell, bone marrow-derived mononuclear stem cell, and umbilical cord blood stem cell. Generally, stem cell therapy showed a good efficacy and safety profile, although not enough studies on the protocol, dosage, and mechanism of action. Conclusion Stem cell therapy has a good therapeutic potential in erectile dysfunction, the available data from the literature could be the base of usage of stem cells in the treatment of erectile dysfunction although need more research for broader usage.

Erectile Dysfunction: Treatments, Advances and New Therapeutic Strategies

“…The majority of studies that have used these regenerative treatments for ED have been made with stem cells of different type (e.g., mesenchymal stem cells, placental-matrixderived stem cells, mesenchymal-stem-cell-derived exosomes, adipose-derived stem cells, bone-marrow-derived mononuclear stem cells, umbilical cord tissue or blood stem cells, and urine derived stem cells) ( [202][203][204][205][206][207][208][209][210][211][212][213] and references therein). In these studies, different animals, mainly rat models of ED, have been used.…”

Regenerative Therapy in Sexual Medicine: The Hard Facts

“…11 However, more recent studies favor the paracrine role as the main mechanism. 9 Although there is a limited number of credible studies looking at this modality to date, a recent systematic review analyzed 9 articles that focused on the role of SCT in ED. Importantly, the selected articles were all clinical studies utilizing human subjects.…”

“…Importantly, the selected articles were all clinical studies utilizing human subjects. 9 There was significant variation in follow-up period, subtype of MSCs used, and assessment tools utilized to grade treatment response; most of the studies had a follow-up period of 9 months and most studies used the IIEF score to assess response. 9 Overall, there was a positive response to SCT seen with improved IIEF and IIEF-5 scores, and a handful of the included studies also demonstrated improved peak systolic velocity.…”

“…These multipotent cells are able to self-renew as well as differentiate into several different tissues. 9 The literature additionally highlights that injections with stromal vascular fraction are also utilized, which is a less refined adipose extract that contains endothelial precursor cells, regulatory T-cells, macrophages, smooth muscle cells, pericytes, preadipocytes, and MSCsdalthough there have not been studies comparing the efficacies of isolated MSCs vs stromal vascular fraction. 10 While the exact mechanism of action by which SCT improves erectile function has yet to be determined, pathways involving either paracrine signaling via secretion of cytokines and growth factors or direct local engraftment are thought to play a primary role.…”

“…These improvements were of 3 points, 6 points, and 41 cm/s, respectively. 9 However, in addition to the variability of study design, there were significant limitations in detailing the specific treatment regimen used in each studydspecifically regarding the source of MSCs, preparation, dosage, and confounding/ concomitant therapies. 9 Additionally, the cost per treatment is quite considerabledeach injection may cost up to $10,000.…”