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Adipose-derived stem cell therapy restores erectile function and promotes endogenous stem cell recruitment in a rat model of cavernous nerve injury

International Journal of Impotence Research (2025)Cite this article

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Abstract

Erectile dysfunction following non-nerve-sparing prostatectomy is prevalent. Although adipose-derived stem cells (ASCs) have shown therapeutic potential for erectile dysfunction, the underlying mechanisms remain unclear. To investigate the therapeutic effects of exogenous stem cells and their recruitment of endogenous stem cells in the context of postprostatectomy erectile dysfunction, we established a bilateral cavernous nerve injury (BCNI) rat model. The rats were divided into the sham surgery, BCNI + PBS, and BCNI+ASCs groups. Intracavernous pressure/mean arterial pressure ratios were compared between groups. In vivo imaging revealed ASC retention in the corpora cavernosa. Penile histomorphology and smooth muscle content were evaluated via Hematoxylin‒eosin and Masson staining. Immunohistochemistry, western blotting, and immunofluorescence were employed to quantify α-SMA, nNOS, caspase-3, vWF, Bax, Bcl-2, and SDF-1 levels and endogenous stem cell recruitment. Compared with the PBS control group, the ASC-treated group presented increased α-SMA, nNOS, and vWF expression and smooth muscle content, as well as reduced caspase-3, Bax, and Bcl-2 levels. Endogenous stem cell recruitment was observed in ASC-treated rats. Our findings demonstrate that exogenous ASCs injection suppresses apoptosis, enhances endothelial function, recruits endogenous stem cells, and alleviates erectile dysfunction in BCNI models. This study elucidates ASC-mediated mechanisms involved in erectile dysfunction recovery, providing insights for clinical translation.

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Fig. 1: ASCs extraction and identification.
Fig. 2: The residence time of ASCs in penile tissues and erectile function were detected.
Fig. 3: Histomorphology and marker expression profile of the penis cavernous body in rats.
Fig. 4: Detection of apoptosis levels.
Fig. 5: Recruitment of endogenous stem cells.

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Data availability

All data generated or analyzed during this study are included in this published article. The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This work was supported by grants from the National Natural Science Foundation of China (82171612, 82301820), the Science and Technology Projects in Guangzhou (2023A03J0789, 2025A04J5127), and the President Foundation of Nanfang Hospital, Southern Medical University (2021B014).

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  1. These authors contributed equally: HY He, SB Duan, BL He.

Authors and Affiliations

  1. Department of Urology, Nanfang Hospital, Southern Medical University, North of Guangzhou Avenue 1838#, Guangzhou, Guangdong, 510515, China

    HY He, SB Duan, BX Lu, JQ Luo, ZQ Liao, HB Zhang, AY Wei & SH He

  2. 11th Floor, Inpatient Department, Luohu People’s Hospital, No.47 Youyi Road, Luohu District, Shenzhen, China

    BL He

  3. Department of Urology, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, 510000, China

    XC Zhou

  4. Department of Urology, Foresea Life Insurance Guangzhou General Hospital, Guangzhou, Guangdong, 511340, China

    AY Wei

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HB Zhang and AY Wei designed experiments and helped write the manuscript. HY He, BL He and SH He performing data curation and conducting formal analysis. ZQ Liao, SB Duan, BX Lu, JQ Luo, HY He, BL He and SH He conducted the investigation. XC Zhou, HB Zhang and AY Wei provided resources. HB Zhang, SH He and AY Wei provided supervision. HY He and HB Zhang wrote the original draft of the manuscript.

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Correspondence to HB Zhang, AY Wei or SH He.

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The authors declare no competing interests.

Ethics

All experimental protocols were approved by the Medical Ethics Committee of Nanfang Hospital, Southern Medical University and were performed in accordance with the Declaration of Helsinki of the World Medical Association. All procedures were approved by the Medical Ethics Committee of Nangfang Hospital, Southern Medical University and were performed in accordance with the Guide for the Care and Use of Laboratory Animals.

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He, H., Duan, S., He, B. et al. Adipose-derived stem cell therapy restores erectile function and promotes endogenous stem cell recruitment in a rat model of cavernous nerve injury. Int J Impot Res (2025). https://doi.org/10.1038/s41443-025-01162-y

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