Amniotic fluid stem cell therapy improves erectile function in a diabetic rat model.

Abstract

BACKGROUND: Current treatments for diabetic erectile dysfunction, such as phosphodiesterase type 5 inhibitors, penile injection, or vacuum erection devices, primarily offer symptomatic relief and do not address the underlying pathophysiology, which involves neural, vascular, and smooth muscle degeneration. OBJECTIVES: This study aimed to evaluate the therapeutic potential of amniotic fluid-derived stem cells in a rat model of diabetic erectile dysfunction by assessing their impact on erectile function and penile tissue regeneration. METHODS: Male Sprague‒Dawley rats were divided into control, diabetic, and amniotic fluid-derived stem cell-treated diabetic groups. Diabetes was induced using streptozotocin (60 mg/kg). Five weeks after intracavernous injection of amniotic fluid-derived stem cells (1 × 10cells per rat), erectile function, penile nerves, endothelial cells, and smooth muscle cells were evaluated through intracavernous pressure measurements, histological analyses, and cellular senescence assessments using class III β-tubulin (TUBB3), rat endothelial cell antigen, and α-smooth muscle actin markers, respectively, along with β-galactosidase staining. RESULTS: Amniotic fluid-derived stem cell treatment significantly improved erectile function in diabetic rats, as evidenced by increased intracavernous pressure/mean arterial pressure ratios than untreated diabetic rats (p = 0.0307). Immunofluorescence revealed restoration of neuronal and endothelial markers, while α-smooth muscle actin expression increased and β-galactosidase activity decreased, indicating enhanced smooth muscle integrity and reduced cellular senescence. CONCLUSION: Intracavernous amniotic fluid-derived stem cell therapy effectively restores erectile function and mitigates tissue damage in diabetic rats by promoting neurovascular regeneration and reducing senescence, highlighting amniotic fluid-derived stem cells as a promising regenerative therapy for diabetic erectile dysfunction and supporting further pre-clinical and clinical investigations.