Skip to main content
Top
Published in: Current Urology Reports 2/2016

01-02-2016 | Regenerative Medicine (A Atala, Section Editor)

Adipose Tissue-Derived Stem Cells for the Treatment of Erectile Dysfunction

Authors: Ahmet Gokce, Taylor C. Peak, Asim B. Abdel-Mageed, Wayne J. Hellstrom

Published in: Current Urology Reports | Issue 2/2016

Login to get access

Abstract

Although a spectrum of options is available for erectile dysfunction (ED) treatment, ED in diabetics, post-prostatectomy patients, and those with Peyronie’s disease (PD) may be more severe in degree and less likely to respond to conventional medical therapies. Unfortunately, there have been limited breakthroughs in therapeutic options for severe ED during the past decade. However, one of the more fascinating strategies in preclinical development to treat ED is stem cell transplantation. Depending on the cell type, recent research has demonstrated that with transplantation, these stem cells can exert a paracrine effect on surrounding penile tissues and differentiate into smooth muscle, endothelium, and neurons. Adipose tissue-derived stem cells (ADSCs) have become a valuable resource because of their abundance and ease of isolation. It is evident that ADSCs may provide a realistic, therapeutic modality for the treatment of ED. In this review, we will cover the literature that has evaluated ADSCs in the treatment of ED.
Literature
1.
go back to reference Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. 2010;57(5):804–14.CrossRefPubMed Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. 2010;57(5):804–14.CrossRefPubMed
2.
go back to reference Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol. 1994;151(1):54–61.PubMed Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol. 1994;151(1):54–61.PubMed
3.
go back to reference Costa C, Soares R, Castela A, Adaes S, Hastert V, Vendeira P, et al. Increased endothelial apoptotic cell density in human diabetic erectile tissue—comparison with clinical data. J Sex Med. 2009;6(3):826–35.CrossRefPubMed Costa C, Soares R, Castela A, Adaes S, Hastert V, Vendeira P, et al. Increased endothelial apoptotic cell density in human diabetic erectile tissue—comparison with clinical data. J Sex Med. 2009;6(3):826–35.CrossRefPubMed
4.
go back to reference Magheli A, Burnett AL. Erectile dysfunction following prostatectomy: prevention and treatment. Nat Rev Urol. 2009;6(8):415–27.CrossRefPubMed Magheli A, Burnett AL. Erectile dysfunction following prostatectomy: prevention and treatment. Nat Rev Urol. 2009;6(8):415–27.CrossRefPubMed
5.
go back to reference Gokce A, Wang JC, Powers MK, Hellstrom WJ. Current and emerging treatment options for Peyronie’s disease. Res Rep Urol. 2013;5:17–27. England.PubMedCentralPubMed Gokce A, Wang JC, Powers MK, Hellstrom WJ. Current and emerging treatment options for Peyronie’s disease. Res Rep Urol. 2013;5:17–27. England.PubMedCentralPubMed
6.
go back to reference Jordan GH. The use of intralesional clostridial collagenase injection therapy for Peyronie’s disease: a prospective, single-center, non-placebo-controlled study. J Sex Med. 2008;5:180–7. United States.CrossRefPubMed Jordan GH. The use of intralesional clostridial collagenase injection therapy for Peyronie’s disease: a prospective, single-center, non-placebo-controlled study. J Sex Med. 2008;5:180–7. United States.CrossRefPubMed
7.
go back to reference Martin GR. Isolation of a pluripotent cell line from early mouse embryos cultured in medium conditioned by teratocarcinoma stem cells. Proc Natl Acad Sci U S A. 1981;78(12):7634–8.PubMedCentralCrossRefPubMed Martin GR. Isolation of a pluripotent cell line from early mouse embryos cultured in medium conditioned by teratocarcinoma stem cells. Proc Natl Acad Sci U S A. 1981;78(12):7634–8.PubMedCentralCrossRefPubMed
8.
go back to reference Evans MJ, Kaufman MH. Establishment in culture of pluripotential cells from mouse embryos. Nature. 1981;292(5819):154–6.CrossRefPubMed Evans MJ, Kaufman MH. Establishment in culture of pluripotential cells from mouse embryos. Nature. 1981;292(5819):154–6.CrossRefPubMed
9.
go back to reference Thomson JA, Itskovitz-Eldor J, Shapiro SS, Waknitz MA, Swiergiel JJ, Marshall VS, et al. Embryonic stem cell lines derived from human blastocysts. Science. 1998;282(5391):1145–7.CrossRefPubMed Thomson JA, Itskovitz-Eldor J, Shapiro SS, Waknitz MA, Swiergiel JJ, Marshall VS, et al. Embryonic stem cell lines derived from human blastocysts. Science. 1998;282(5391):1145–7.CrossRefPubMed
10.
go back to reference Takahashi K, Yamanaka S. Induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by defined factors. Cell. 2006;126(United States):663–76.CrossRefPubMed Takahashi K, Yamanaka S. Induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by defined factors. Cell. 2006;126(United States):663–76.CrossRefPubMed
11.
go back to reference Volarevic V, Ljujic B, Stojkovic P, Lukic A, Arsenijevic N, Stojkovic M. Human stem cell research and regenerative medicine—present and future. Br Med Bull. 2011;99:155–68. England.CrossRefPubMed Volarevic V, Ljujic B, Stojkovic P, Lukic A, Arsenijevic N, Stojkovic M. Human stem cell research and regenerative medicine—present and future. Br Med Bull. 2011;99:155–68. England.CrossRefPubMed
12.
go back to reference Jones DL, Wagers AJ. No place like home: anatomy and function of the stem cell niche. Nat Rev Mol Cell Biol. 2008;9:11–21. England.CrossRefPubMed Jones DL, Wagers AJ. No place like home: anatomy and function of the stem cell niche. Nat Rev Mol Cell Biol. 2008;9:11–21. England.CrossRefPubMed
13.•
go back to reference Kiefer JC. Primer and interviews: the dynamic stem cell niche. Dev Dyn. 2011;240(3):737–43. This article provides an excellent overview of how stem cells interact with their cellular microenvironment.CrossRefPubMed Kiefer JC. Primer and interviews: the dynamic stem cell niche. Dev Dyn. 2011;240(3):737–43. This article provides an excellent overview of how stem cells interact with their cellular microenvironment.CrossRefPubMed
14.
15.
go back to reference Alwaal A, Zaid UB, Lin CS, Lue TF. Stem cell treatment of erectile dysfunction. Adv Drug Deliv Rev. 2014. Alwaal A, Zaid UB, Lin CS, Lue TF. Stem cell treatment of erectile dysfunction. Adv Drug Deliv Rev. 2014.
16.••
go back to reference Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng. 2001;7(2):211–28. This was the landmark study that discovered the ADSCs and defined their regenerative potential.CrossRefPubMed Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng. 2001;7(2):211–28. This was the landmark study that discovered the ADSCs and defined their regenerative potential.CrossRefPubMed
17.
go back to reference Casteilla L, Planat-Benard V, Laharrague P, Cousin B. Adipose-derived stromal cells: their identity and uses in clinical trials, an update. World J Stem Cells. 2011;3(4):25–33.PubMedCentralCrossRefPubMed Casteilla L, Planat-Benard V, Laharrague P, Cousin B. Adipose-derived stromal cells: their identity and uses in clinical trials, an update. World J Stem Cells. 2011;3(4):25–33.PubMedCentralCrossRefPubMed
18.
go back to reference Housman TS, Lawrence N, Mellen BG, George MN, Filippo JS, Cerveny KA, et al. The safety of liposuction: results of a national survey. Dermatol Surg. 2002;28:971–8. United States.PubMed Housman TS, Lawrence N, Mellen BG, George MN, Filippo JS, Cerveny KA, et al. The safety of liposuction: results of a national survey. Dermatol Surg. 2002;28:971–8. United States.PubMed
19.
go back to reference Lin G, Banie L, Ning H, Bella AJ, Lin CS, Lue TF. Potential of adipose-derived stem cells for treatment of erectile dysfunction. J Sex Med. 2009;6 Suppl 3:320–7. United States.PubMedCentralCrossRefPubMed Lin G, Banie L, Ning H, Bella AJ, Lin CS, Lue TF. Potential of adipose-derived stem cells for treatment of erectile dysfunction. J Sex Med. 2009;6 Suppl 3:320–7. United States.PubMedCentralCrossRefPubMed
20.••
go back to reference Lin G, Garcia M, Ning H, Banie L, Guo YL, Lue TF, et al. Defining stem and progenitor cells within adipose tissue. Stem Cells Dev. 2008;17(6):1053–63. The authors were able to define the location of ADSCs within adipose tissue.PubMedCentralCrossRefPubMed Lin G, Garcia M, Ning H, Banie L, Guo YL, Lue TF, et al. Defining stem and progenitor cells within adipose tissue. Stem Cells Dev. 2008;17(6):1053–63. The authors were able to define the location of ADSCs within adipose tissue.PubMedCentralCrossRefPubMed
21.
go back to reference Rodbell M. Metabolism of isolated fat cells. I. Effects of hormones on glucose metabolism and lipolysis. J Biol Chem. 1964;239:375–80.PubMed Rodbell M. Metabolism of isolated fat cells. I. Effects of hormones on glucose metabolism and lipolysis. J Biol Chem. 1964;239:375–80.PubMed
22.
23.
go back to reference Ning H, Liu G, Lin G, Yang R, Lue TF, Lin CS. Fibroblast growth factor 2 promotes endothelial differentiation of adipose tissue-derived stem cells. J Sex Med. 2009;6:967–79. United States.PubMedCentralCrossRefPubMed Ning H, Liu G, Lin G, Yang R, Lue TF, Lin CS. Fibroblast growth factor 2 promotes endothelial differentiation of adipose tissue-derived stem cells. J Sex Med. 2009;6:967–79. United States.PubMedCentralCrossRefPubMed
24.
go back to reference Rodriguez LV, Alfonso Z, Zhang R, Leung J, Wu B, Ignarro LJ. Clonogenic multipotent stem cells in human adipose tissue differentiate into functional smooth muscle cells. Proc Natl Acad Sci U S A. 2006;103:12167–72. United States.PubMedCentralCrossRefPubMed Rodriguez LV, Alfonso Z, Zhang R, Leung J, Wu B, Ignarro LJ. Clonogenic multipotent stem cells in human adipose tissue differentiate into functional smooth muscle cells. Proc Natl Acad Sci U S A. 2006;103:12167–72. United States.PubMedCentralCrossRefPubMed
25.
go back to reference Ning H, Lin G, Lue TF, Lin CS. Neuron-like differentiation of adipose tissue-derived stromal cells and vascular smooth muscle cells. Differentiation. 2006;74:510–8. England.CrossRefPubMed Ning H, Lin G, Lue TF, Lin CS. Neuron-like differentiation of adipose tissue-derived stromal cells and vascular smooth muscle cells. Differentiation. 2006;74:510–8. England.CrossRefPubMed
26.•
go back to reference Albersen M, Fandel TM, Lin G, Wang G, Banie L, Lin CS, et al. Injections of adipose tissue-derived stem cells and stem cell lysate improve recovery of erectile function in a rat model of cavernous nerve injury. J Sex Med. 2010;7;3331–40. United States: 2010 International Society for Sexual Medicine. This study demonstrated that both ADSCs and the stem cell lysate could improve erectile function in a post-prostatectomy rat model. Albersen M, Fandel TM, Lin G, Wang G, Banie L, Lin CS, et al. Injections of adipose tissue-derived stem cells and stem cell lysate improve recovery of erectile function in a rat model of cavernous nerve injury. J Sex Med. 2010;7;3331–40. United States: 2010 International Society for Sexual Medicine. This study demonstrated that both ADSCs and the stem cell lysate could improve erectile function in a post-prostatectomy rat model.
27.•
go back to reference Fandel TM, Albersen M, Lin G, Qiu X, Ning H, Banie L, et al. Recruitment of intracavernously injected adipose-derived stem cells to the major pelvic ganglion improves erectile function in a rat model of cavernous nerve injury. Eur Urol. 2012;61:201–10. Switzerland: 2011 European Association of Urology. Published by Elsevier B.V. The study elucidated the mechanism by which intracavernously injected stem cells migrate toward the major pelvic ganglion to aid in neuroregeneration. Fandel TM, Albersen M, Lin G, Qiu X, Ning H, Banie L, et al. Recruitment of intracavernously injected adipose-derived stem cells to the major pelvic ganglion improves erectile function in a rat model of cavernous nerve injury. Eur Urol. 2012;61:201–10. Switzerland: 2011 European Association of Urology. Published by Elsevier B.V. The study elucidated the mechanism by which intracavernously injected stem cells migrate toward the major pelvic ganglion to aid in neuroregeneration.
28.
go back to reference Song KM, Jin HR, Park JM, Choi MJ, Kwon MH, Kwon KD, et al. Intracavernous delivery of stromal vascular fraction restores erectile function through production of angiogenic factors in a mouse model of cavernous nerve injury. J Sex Med. 2014;11(8):1962–73.CrossRefPubMed Song KM, Jin HR, Park JM, Choi MJ, Kwon MH, Kwon KD, et al. Intracavernous delivery of stromal vascular fraction restores erectile function through production of angiogenic factors in a mouse model of cavernous nerve injury. J Sex Med. 2014;11(8):1962–73.CrossRefPubMed
29.•
go back to reference Castiglione F, Hedlund P, Van der Aa F, Bivalacqua TJ, Rigatti P, Van Poppel H, et al. Intratunical injection of human adipose tissue-derived stem cells prevents fibrosis and is associated with improved erectile function in a rat model of Peyronie’s disease. Eur Urol. 2013;63(3):551–60. This study was the first to test stem cell therapy in an animal model of Peyronie’s disease.PubMedCentralCrossRefPubMed Castiglione F, Hedlund P, Van der Aa F, Bivalacqua TJ, Rigatti P, Van Poppel H, et al. Intratunical injection of human adipose tissue-derived stem cells prevents fibrosis and is associated with improved erectile function in a rat model of Peyronie’s disease. Eur Urol. 2013;63(3):551–60. This study was the first to test stem cell therapy in an animal model of Peyronie’s disease.PubMedCentralCrossRefPubMed
30.
go back to reference Wei X, Du Z, Zhao L, Feng D, Wei G, He Y, et al. IFATS collection: the conditioned media of adipose stromal cells protect against hypoxia-ischemia-induced brain damage in neonatal rats. Stem Cells. 2009;27:478–88. United States.CrossRefPubMed Wei X, Du Z, Zhao L, Feng D, Wei G, He Y, et al. IFATS collection: the conditioned media of adipose stromal cells protect against hypoxia-ischemia-induced brain damage in neonatal rats. Stem Cells. 2009;27:478–88. United States.CrossRefPubMed
31.
go back to reference Gokce A, Abd Elmageed ZY, Lasker GF, Bouljihad M, Kim H, Trost LW, et al. Adipose tissue-derived stem cell therapy for prevention and treatment of erectile dysfunction in a rat model of Peyronie’s disease. Andrology. 2014;2(2):244–51.CrossRefPubMed Gokce A, Abd Elmageed ZY, Lasker GF, Bouljihad M, Kim H, Trost LW, et al. Adipose tissue-derived stem cell therapy for prevention and treatment of erectile dysfunction in a rat model of Peyronie’s disease. Andrology. 2014;2(2):244–51.CrossRefPubMed
32.
go back to reference Gokce A, Abd Elmageed ZY, Lasker GF, Bouljihad M, Braun SE, Kim H, et al. intratunical injection of genetically modified adipose tissue-derived stem cells with human interferon alpha-2b for treatment of erectile dysfunction in a rat model of tunica albugineal fibrosis. J Sex Med. 2015;12(7):1533–44.CrossRefPubMed Gokce A, Abd Elmageed ZY, Lasker GF, Bouljihad M, Braun SE, Kim H, et al. intratunical injection of genetically modified adipose tissue-derived stem cells with human interferon alpha-2b for treatment of erectile dysfunction in a rat model of tunica albugineal fibrosis. J Sex Med. 2015;12(7):1533–44.CrossRefPubMed
33.
go back to reference Ma L, Yang Y, Sikka SC, Kadowitz PJ, Ignarro LJ, Abdel-Mageed AB, et al. Adipose tissue-derived stem cell-seeded small intestinal submucosa for tunica albuginea grafting and reconstruction. Proc Natl Acad Sci U S A. 2012;109(6):2090–5.PubMedCentralCrossRefPubMed Ma L, Yang Y, Sikka SC, Kadowitz PJ, Ignarro LJ, Abdel-Mageed AB, et al. Adipose tissue-derived stem cell-seeded small intestinal submucosa for tunica albuginea grafting and reconstruction. Proc Natl Acad Sci U S A. 2012;109(6):2090–5.PubMedCentralCrossRefPubMed
34.
go back to reference Qiu X, Villalta J, Ferretti L, Fandel TM, Albersen M, Lin G, et al. Effects of intravenous injection of adipose-derived stem cells in a rat model of radiation therapy-induced erectile dysfunction. J Sex Med. 2012;9(7):1834–41.PubMedCentralCrossRefPubMed Qiu X, Villalta J, Ferretti L, Fandel TM, Albersen M, Lin G, et al. Effects of intravenous injection of adipose-derived stem cells in a rat model of radiation therapy-induced erectile dysfunction. J Sex Med. 2012;9(7):1834–41.PubMedCentralCrossRefPubMed
35.
go back to reference Garcia MM, Fandel TM, Lin G, Shindel AW, Banie L, Lin CS, et al. Treatment of erectile dysfunction in the obese type 2 diabetic ZDF rat with adipose tissue-derived stem cells. J Sex Med. 2010;7(1 Pt 1):89–98.PubMedCentralCrossRefPubMed Garcia MM, Fandel TM, Lin G, Shindel AW, Banie L, Lin CS, et al. Treatment of erectile dysfunction in the obese type 2 diabetic ZDF rat with adipose tissue-derived stem cells. J Sex Med. 2010;7(1 Pt 1):89–98.PubMedCentralCrossRefPubMed
36.
go back to reference Das ND, Song KM, Yin GN, Batbold D, Kwon MH, Kwon KD, et al. Xenogenic transplantation of human breast adipose-derived stromal vascular fraction enhances recovery of erectile function in diabetic mice. Biol Reprod. 2014;90:66. United States.CrossRefPubMed Das ND, Song KM, Yin GN, Batbold D, Kwon MH, Kwon KD, et al. Xenogenic transplantation of human breast adipose-derived stromal vascular fraction enhances recovery of erectile function in diabetic mice. Biol Reprod. 2014;90:66. United States.CrossRefPubMed
37.
go back to reference Wang X, Liu C, Li S, Xu Y, Chen P, Liu Y, et al. Hypoxia precondition promotes adipose-derived mesenchymal stem cells based repair of diabetic erectile dysfunction via augmenting angiogenesis and neuroprotection. PLoS One. 2015;10:e0118951. United States.PubMedCentralCrossRefPubMed Wang X, Liu C, Li S, Xu Y, Chen P, Liu Y, et al. Hypoxia precondition promotes adipose-derived mesenchymal stem cells based repair of diabetic erectile dysfunction via augmenting angiogenesis and neuroprotection. PLoS One. 2015;10:e0118951. United States.PubMedCentralCrossRefPubMed
38.
go back to reference Liu G, Sun X, Bian J, Wu R, Guan X, Ouyang B, et al. Correction of diabetic erectile dysfunction with adipose derived stem cells modified with the vascular endothelial growth factor gene in a rodent diabetic model. PLoS One. 2013;8:e72790. United States.PubMedCentralCrossRefPubMed Liu G, Sun X, Bian J, Wu R, Guan X, Ouyang B, et al. Correction of diabetic erectile dysfunction with adipose derived stem cells modified with the vascular endothelial growth factor gene in a rodent diabetic model. PLoS One. 2013;8:e72790. United States.PubMedCentralCrossRefPubMed
39.
go back to reference Piao S, Kim IG, Lee JY, Hong SH, Kim SW, Hwang TK, et al. Therapeutic effect of adipose-derived stem cells and BDNF-immobilized PLGA membrane in a rat model of cavernous nerve injury. J Sex Med. 2012;9(8):1968–79.CrossRefPubMed Piao S, Kim IG, Lee JY, Hong SH, Kim SW, Hwang TK, et al. Therapeutic effect of adipose-derived stem cells and BDNF-immobilized PLGA membrane in a rat model of cavernous nerve injury. J Sex Med. 2012;9(8):1968–79.CrossRefPubMed
40.
go back to reference Lee SH, Kim IG, Jung AR, Shrestha KR, Lee JH, Park KD, et al. Combined effects of brain-derived neurotrophic factor immobilized poly-lactic-co-glycolic acid membrane with human adipose-derived stem cells and basic fibroblast growth factor hydrogel on recovery of erectile dysfunction. Tissue Eng Part A. 2014;20(17–18):2446–54.PubMedCentralCrossRefPubMed Lee SH, Kim IG, Jung AR, Shrestha KR, Lee JH, Park KD, et al. Combined effects of brain-derived neurotrophic factor immobilized poly-lactic-co-glycolic acid membrane with human adipose-derived stem cells and basic fibroblast growth factor hydrogel on recovery of erectile dysfunction. Tissue Eng Part A. 2014;20(17–18):2446–54.PubMedCentralCrossRefPubMed
41.
go back to reference Lin CS, Xin ZC, Wang Z, Deng C, Huang YC, Lin G, et al. Stem cell therapy for erectile dysfunction: a critical review. Stem Cells Dev. 2012;21(3):343–51.PubMedCentralCrossRefPubMed Lin CS, Xin ZC, Wang Z, Deng C, Huang YC, Lin G, et al. Stem cell therapy for erectile dysfunction: a critical review. Stem Cells Dev. 2012;21(3):343–51.PubMedCentralCrossRefPubMed
Metadata
Title
Adipose Tissue-Derived Stem Cells for the Treatment of Erectile Dysfunction
Authors
Ahmet Gokce
Taylor C. Peak
Asim B. Abdel-Mageed
Wayne J. Hellstrom
Publication date
01-02-2016
Publisher
Springer US
Published in
Current Urology Reports / Issue 2/2016
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-015-0569-8

Other articles of this Issue 2/2016

Current Urology Reports 2/2016 Go to the issue

Urothelial Cancer (A Sagalowsky, Section Editor)

Prognostic Genetic Signatures in Upper Tract Urothelial Carcinoma

Regenerative Medicine (A Atala, Section Editor)

Silk Fibroin Scaffolds for Urologic Tissue Engineering

Kidney Diseases (G Ciancio, Section Editor)

Irreversible Electroporation (IRE) in Renal Tumors