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. 2022 Mar 10;23(6):3017.
doi: 10.3390/ijms23063017.

Intracavernous Injection of Platelet-Rich Plasma Therapy Enhances Erectile Function and Decreases the Mortality Rate in Streptozotocin-Induced Diabetic Rats

Chun-Hou Liao  1   2 , Kau-Han Lee  3 , Shiu-Dong Chung  4   5   6 , Kuo-Chiang Chen  2   7 , Chellappan Praveen Rajneesh  2 , Bo-He Chen  2 , Jai-Hong Cheng  8   9   10 , Wang-Ying Lin  2 , Han-Sun Chiang  11   12 , Yi-No Wu  2
Affiliations

Intracavernous Injection of Platelet-Rich Plasma Therapy Enhances Erectile Function and Decreases the Mortality Rate in Streptozotocin-Induced Diabetic Rats

Chun-Hou Liao et al. Int J Mol Sci. .

Abstract

Erectile dysfunction (ED) is an agonizing complication of diabetes mellitus (DM) and it is challenging to treat ED in DM patients. Platelet-rich plasma (PRP) is a unique therapeutic strategy comprising intrinsic growth factors. An attempt was made to explore the potentiality of the PRP treatment in DM-induced ED rats in various groups (control, DM-non-ED, DM-ED, and DM-ED treated with PRP). Streptozotocin (STZ) was used to induce DM in rats. The blood glucose levels of the DM rats were maintained at >300 mg/dl. In the 18-week experiment, survival rate, body weight, intracavernous pressure (ICP) variations, and arterial blood pressure were analyzed. The tissue restoration results were validated by histological, immunofluorescence, and transmission electron microscopic analysis. PRP treatment of DM-ED rats significantly increased all parameters of erectile function compared to pre-treatment of PRP and DM-ED treated with vehicle. The histological results revealed that PRP treatment substantially enhanced the regeneration of myelinated nerves and decreased the atrophy of corporal smooth muscle. Notably, the PRP treatment immensely enhanced the survival rate in post-surgery DM-ED rats. These results indicated certain benefits of PRP treatment in delaying damage and preventing post-surgery complications in DM patients. Hence, PRP treatment is a novel multifactorial strategy for DM-ED patients.

Keywords: diabetes mellitus; erectile dysfunction; neuroregeneration; platelet-rich plasma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Graph showing the changes in body weight and blood glucose level of the normal control and experimental rats. (A) Graph showing the body weight changes of rats in each group and their respective control. (B) Graph showing the variations in the blood glucose levels of the rats in each group and their respective control. The body weight was recorded since the rats were six weeks old, and the streptozotocin (STZ) was also induced simultaneously, following blood sugar tested on the next week (7 weeks old). DM-non-ED, STZ-induced diabetes mellitus (DM) without erectile dysfunction (ED); DM-ED, STZ-induced DM with ED and treated with saline; DM-ED + PRP, STZ-induced DM with ED and treated with platelet-rich-plasma.
Figure 2
Figure 2
The graphical representation of the decreased mortality rate due to platelet-rich plasma (PRP) treatment. (A) Indicating mortality rate of rats after streptozotocin (STZ) induction until 12 weeks. (B) Showing the survival rate of the rats after the first ICP measurement and follow-up experiments. (C) Histogram showing the comparison among rats belonging to DM-non-ED, DM + ED, and DM + ED + PRP treatment. DM-ED, STZ-induced diabetes mellitus (DM) with erectile dysfunction (ED) and treated with saline (n = 20); DM-ED + PRP, STZ-induced DM with ED and treated with PRP (n = 10); vehicle-treated n = 12.
Figure 3
Figure 3
The erectile function parameters were compared after 12 weeks of streptozotocin (STZ) induction. (A) Recordings of intracavernous pressure (ICP) and blood pressure (BP) in control, DM non-ED, and DM-ED rats. (n ≥ 8) DM-non ED, STZ-induced diabetes mellitus (DM) without erectile dysfunction (ED); DM-ED, STZ-induced DM with ED and treated with saline. (B) The quantitative results of an erectile function parameter (Mean arterial pressure, ICP, and AUC) were calculated for each group (control, DM non-ED, and DM-ED rats). * p < 0.05 when compared with control, # p < 0.05 when compared with DM-non ED. (AUC—area under the curve; ICP—Intracavernous pressure; MAP—mean arterial pressure).
Figure 4
Figure 4
The erectile function parameters were compared after four weeks of platelet-rich plasma (PRP) or saline treatment. (A) Recordings of intracavernous pressure (ICP) and blood pressure (BP) in control, DM-ED, and DM-ED + PRP rats. Control, DM-ED, streptozotocin (STZ)-induced DM with ED and treated with saline; DM-ED + PRP, STZ-induced DM with ED and treated with PRP. (B) The quantitative results of an erectile function parameter (Mean arterial pressure, ICP, and AUC) were calculated for each group (control, DM-ED, and DM-ED + PRP rats). * p < 0.05 when compared with control, # p < 0.05 when compared with DM-ED. (AUC—area under the curve; ICP—Intracavernous pressure; MAP—mean arterial pressure).
Figure 5
Figure 5
The illustration shows the comparison of erectile function parameters of streptozotocin (STZ)-induced diabetes mellitus (DM) rats. Pre-treatment, after 12 weeks of STZ-induced DM, 18 weeks old (n = 8); vehicle, STZ-induced DM with erectile dysfunction (ED) and treated with saline, and ICP test performed after saline treatment for four weeks (24 weeks old) (n = 7); platelet-rich-plasma (PRP) treatment, STZ-induced DM with ED and treated with PRP, and ICP test performed after PRP treatment for four weeks (24 weeks old) (n = 8). * p < 0.05 when compared with PRP treatment. (AUC—area under the curve; ICP—Intracavernous pressure; MAP—mean arterial pressure).
Figure 6
Figure 6
Micrograph showing the hematoxylin and eosin staining and Masson’s trichrome staining of the corpus cavernosum (40× magnification). DM-non ED, streptozotocin (STZ)-induced diabetes mellitus (DM) without erectile dysfunction (ED); DM-ED, STZ-induced DM with ED and treated with saline; DM-ED + PRP, STZ-induced DM with ED and treated with platelet-rich-plasma. Red colour demarcated area magnified into 200×.
Figure 7
Figure 7
(A) Image showing the Immunofluorescence results of α-smooth muscle actin (α-SMA); (B) expression of α-SMA in the corpus cavernosum. DM-non ED, streptozotocin (STZ)-induced diabetes mellitus (DM) without erectile dysfunction (ED); DM-ED, STZ-induced DM with ED and treated with saline; DM-ED + PRP, STZ-induced DM with ED and treated with platelet-rich-plasma. * p < 0.05 when compared with control, # p < 0.05 when compared with DM-ED.
Figure 8
Figure 8
Transmission electron microscopy (TEM) of the caveolae in 2500× (A) and 40,000× (B) magnifications of the red-coloured demarcated area from (A). DM-ED = streptozotocin (STZ)-induced diabetes mellitus (DM) with erectile dysfunction (ED) and treated with saline; DM-ED + PRP, STZ-induced DM with ED and treated with platelet-rich-plasma. (Scale: (A): 5 µm; (B): 0.2 µm).
Figure 9
Figure 9
Transmission electron microscopy (TEM) of the cavernous nerve in 5000× (A) and 30,000× (B) magnifications of the red-coloured demarcated area from (A). DM-ED, streptozotocin (STZ)-induced diabetes mellitus (DM) with erectile dysfunction (ED) and treated with saline; DM-ED + PRP, STZ-induced DM with ED and treated with platelet-rich-plasma. (Scale: (A): 2 µm; (B): 0.2 µm).
Figure 10
Figure 10
Timeline indicating the experimental schedule of the normal control and DM-ED rats. (TEM-transmission electron microscope; ED-erectile dysfunction; ICP-intracavernous pressure; STZ-streptozotocin; PRP-plasma rich plasma).
See this image and copyright information in PMC

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