细胞因子治疗勃起功能障碍的研究进展

Updated cytokine therapy of erectile dysfunction

细胞因子与勃起功能障碍(ED)密切相关。研究发现,4类相关细胞因子和ED发生与治疗有关。促进血管再生的细胞因子可以改善血管内皮功能,促进内皮再生从而改善勃起功能;促进神经再生的细胞因子通过保护海绵体神经改善勃起功能;保护平滑肌功能的细胞因子通过促进平滑肌表达,抑制阴茎纤维化改善勃起功能;炎症相关的细胞因子通过作用于平滑肌上相应受体松弛平滑肌改善勃起功能。与5型磷酸二酯酶(PDE-5)抑制剂相比,细胞因子治疗ED更有针对性。但是,目前的实验模型大多数为大鼠且缺乏大样本的研究,限制了细胞因子进一步应用于临床。所以,虽然血管内皮生长因子(VEGF)、胰岛素样生长因子1(IGF-1)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)等可以显著改善ED动物的勃起功能,但是需要大型动物实验和大样本的实验进一步证实其治疗效果和安全性。

Four types of cytokines are found to be related to the pathogenesis and treatment of ED. The cytokines capable of promoting angiogenesis can improve vascular endothelial function, promote endothelial regeneration and thus improve erectile function, those capable of promoting nerve regeneration can improve erectile function by protecting cavernous nerves, those capable of protecting the smooth muscle function can improve erectile function by promoting the smooth muscle expression and inhibiting penile fibrosis, and those inflammation-related cytokines can induce penile erection by acting on the corresponding receptor relaxing smooth muscle. Compared with PDE-5 inhibitors, cytokines are more targeted for the treatment of ED. However, current studies are mostly dependent on rat models and lack of large sample sizes, which has restricted further clinical application of cytokines. Although VEGF, IGF-1, BDNF and NGF can significantly improve the erectile function of ED rats, experiments with larger samples and larger animals are needed to further confirm their efficacy and safety.