Theodore C Crisostomo-Wynne, Alexandria M Hertz, Monica G Ferrini, Timothy C Brand, Shashikumar K Salgar
{"title":"Nutraceutical and low energy shockwave treatments improved sexual function recovery in a rat pelvic neurovascular injury model.","authors":"Theodore C Crisostomo-Wynne, Alexandria M Hertz, Monica G Ferrini, Timothy C Brand, Shashikumar K Salgar","doi":"10.1093/sexmed/qfaf001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pelvic trauma can have long-lasting debilitating effects, including severe erectile dysfunction (ED) in men. While there are effective treatments for ED, these treat the symptoms not the cause. Those who suffer from an acute traumatic injury to the neurovascular supply of penis, may benefit from regenerative therapy. COMP4 is an all-natural herbal compound (Muira puama, <i>Paullinia cupana</i>, Ginger, and L-Citrulline) has potential to enhance penile vascular/smooth muscle/neuronal regeneration via Nitric Oxide synthesis. Low energy shockwave (LESW) therapy promotes nerve regeneration/angiogenesis by activating stem/progenitor cells.</p><p><strong>Aim: </strong>To investigate the effects of the COMP4 and LESW for the treatment of ED in a rat pelvic trauma model.</p><p><strong>Methods: </strong>The experimental design included five groups (Lewis rats aged 10-12 weeks; n = 8/group): (1) Sham, (2) Injury control, (3) Peanut Butter (PNB; Vehicle) Control, (4) COMP4, and (5) COMP4 + LESW. Pelvic neurovascular injury (PNVI) was induced by performing bilateral cavernous nerve crush injury and internal pudendal bundle ligation under general anesthesia. One week after PNVI rats received COMP4 (45 mg/kg b.wt./day) orally via PNB and/or LESW (1000 pulses at 0.06 mJ/mm2, 3 Hz, three times per week to the pelvis around penis) for 6 weeks. After 1 week of washout period, erectile function (EF) was assessed via intracavernous pressure (ICP; mmHg) measurements; rats euthanized, penile tissues collected for analyses.</p><p><strong>Outcomes: </strong>COMP4 and LESW treatments improved EF recovery.</p><p><strong>Results: </strong>There was a significant (<i>P</i> < .01) improvement in EF (ICP) with COMP4 (153.6 ± 26.6) and COMP4 + LESW (174.1 ± 38.2) treatments compared to vehicle (PNB) control (109.4 ± 32.6). COMP4 + LESW treatment enhanced EF compared to COMP4 alone. The base level ICP before treatments (Group 2) was 117.3 ± 6 and was lower (<i>P</i> < .01) than sham (165 ± 43.8) and COMP4 & COMP4 + LESW treated rats. Masson's trichrome staining of corpus cavernosum penis demonstrated reduced (<i>P</i> < .001) smooth muscle-to-collagen (SM:C) ratio in injury and PNB controls compared to sham. COMP4 treatment following PNVI showed an increase (<i>P</i> < .05) in SM:C ratio. Adding LESW and COMP4 enhanced (<i>P</i> < .01) the SM:C ratio, suggesting a reduction in fibrosis. Western blot analysis revealed a significant increase in Endothelial Nitric Oxide Synthase and α-Smooth Muscle Actin (α-SMA) in the corpus cavernosum with COMP4 and COMP4 + LESW treatments compared to PNB control.</p><p><strong>Clinical implications: </strong>COMP4 and/or LESW can serve as an adjunct therapy to mitigate ED.</p><p><strong>Strengths and limitations: </strong>Identified novel treatment option to improve EF recovery. Unable to address in-depth cellular/molecular mechanisms.</p><p><strong>Conclusions: </strong>COMP4 and LESW treatments appear to be promising to improve clinical EF recovery in pelvic trauma.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 6","pages":"qfaf001"},"PeriodicalIF":2.6000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750428/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sexual Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/sexmed/qfaf001","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Pelvic trauma can have long-lasting debilitating effects, including severe erectile dysfunction (ED) in men. While there are effective treatments for ED, these treat the symptoms not the cause. Those who suffer from an acute traumatic injury to the neurovascular supply of penis, may benefit from regenerative therapy. COMP4 is an all-natural herbal compound (Muira puama, Paullinia cupana, Ginger, and L-Citrulline) has potential to enhance penile vascular/smooth muscle/neuronal regeneration via Nitric Oxide synthesis. Low energy shockwave (LESW) therapy promotes nerve regeneration/angiogenesis by activating stem/progenitor cells.
Aim: To investigate the effects of the COMP4 and LESW for the treatment of ED in a rat pelvic trauma model.
Methods: The experimental design included five groups (Lewis rats aged 10-12 weeks; n = 8/group): (1) Sham, (2) Injury control, (3) Peanut Butter (PNB; Vehicle) Control, (4) COMP4, and (5) COMP4 + LESW. Pelvic neurovascular injury (PNVI) was induced by performing bilateral cavernous nerve crush injury and internal pudendal bundle ligation under general anesthesia. One week after PNVI rats received COMP4 (45 mg/kg b.wt./day) orally via PNB and/or LESW (1000 pulses at 0.06 mJ/mm2, 3 Hz, three times per week to the pelvis around penis) for 6 weeks. After 1 week of washout period, erectile function (EF) was assessed via intracavernous pressure (ICP; mmHg) measurements; rats euthanized, penile tissues collected for analyses.
Outcomes: COMP4 and LESW treatments improved EF recovery.
Results: There was a significant (P < .01) improvement in EF (ICP) with COMP4 (153.6 ± 26.6) and COMP4 + LESW (174.1 ± 38.2) treatments compared to vehicle (PNB) control (109.4 ± 32.6). COMP4 + LESW treatment enhanced EF compared to COMP4 alone. The base level ICP before treatments (Group 2) was 117.3 ± 6 and was lower (P < .01) than sham (165 ± 43.8) and COMP4 & COMP4 + LESW treated rats. Masson's trichrome staining of corpus cavernosum penis demonstrated reduced (P < .001) smooth muscle-to-collagen (SM:C) ratio in injury and PNB controls compared to sham. COMP4 treatment following PNVI showed an increase (P < .05) in SM:C ratio. Adding LESW and COMP4 enhanced (P < .01) the SM:C ratio, suggesting a reduction in fibrosis. Western blot analysis revealed a significant increase in Endothelial Nitric Oxide Synthase and α-Smooth Muscle Actin (α-SMA) in the corpus cavernosum with COMP4 and COMP4 + LESW treatments compared to PNB control.
Clinical implications: COMP4 and/or LESW can serve as an adjunct therapy to mitigate ED.
Strengths and limitations: Identified novel treatment option to improve EF recovery. Unable to address in-depth cellular/molecular mechanisms.
Conclusions: COMP4 and LESW treatments appear to be promising to improve clinical EF recovery in pelvic trauma.
期刊介绍：
Sexual Medicine is an official publication of the International Society for Sexual Medicine, and serves the field as the peer-reviewed, open access journal for rapid dissemination of multidisciplinary clinical and basic research in all areas of global sexual medicine, and particularly acts as a venue for topics of regional or sub-specialty interest. The journal is focused on issues in clinical medicine and epidemiology but also publishes basic science papers with particular relevance to specific populations. Sexual Medicine offers clinicians and researchers a rapid route to publication and the opportunity to publish in a broadly distributed and highly visible global forum. The journal publishes high quality articles from all over the world and actively seeks submissions from countries with expanding sexual medicine communities. Sexual Medicine relies on the same expert panel of editors and reviewers as The Journal of Sexual Medicine and Sexual Medicine Reviews.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
