Buyang Huanwu Decoction Ameliorates Damage of Erectile Tissue and Function Following Bilateral Cavernous Nerve Injury.

OBJECTIVE: To verify the effect of Buyang Huanwu Decoction (BHD) in ameliorating erectile dysfunction (ED) after radical prostatectomy (RP). METHODS: The composition of BHD was verified by ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS/MS) analysis. Bilateral cavernous nerve crush injury (BCNI) in rats was used to mimic the neurovascular injury occurring after RP. By the envelope method, forty rats were randomly divided into 4 groups as follows: sham (cavernous nerves exposed only), model (BCNI), low-dosage BHD [LBHD, 12.8 g/(kg·d)], and high-dosage BHD [HBHD, 51.2 g/(kg·d)] groups, 10 rats in each group, feeding for 3 weeks respectively. Erectile function was evaluated by measuring intracavernosal pressure (ICP). Changes in the histopathology of corpus cavernosum (CC) were examined by hematoxylin-eosin staining. Meanwhile, the fibrosis of CC was measured by Masson's trichrome staining and Western blot was used to detect the expressions of collagen I, transforming growth factor beta 1 (TGF- ß 1) and α-smooth muscle actin (α-SMA). Apoptosis index was detected by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) and Western blot for determining the expressions of B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X (Bax). The oxidative stress in the CC were assessed by the superoxide dismutase (SOD), malondialdehyde (MDA) and reactive oxygen species (ROS) levels. The proteins expression of c-Jun N-terminal kinase (JNK) and c-Jun were detected by Western blot. In addition, the expression of α-SMA and p-c-Jun in the CC was observed by double immunofluorescence staining. RESULTS: The UPLC-QTOF-MS/MS analysis showed that BHD contained calycosin-7-O- ß -D-glucoside, ononin, calycosin and formononetin. Compared with the model group, LBHD and HBHD treatment improved the ICP and the circumference, area, and weight of CC (P<0.05 or P<0.01). Furthermore, LBHD and HBHD treatments increased CC smooth muscle content and decreased apoptosis index (P<0.05 or P<0.01). LBHD and HBHD also elevated SOD and expression level of α -SMA and Bcl-2, and reduced MDA and ROS levels, as well as expression of TGF- ß 1, collagen I, Bax, p-c-JNK, p-JNK in the CC compared with the model group (P<0.05 or P<0.01). The double immunofluorescence staining showed that the fluorescence degree of p-c-Jun in both LBHD and HBHD treatment groups was significantly reduced, whereas the α -SMA expression increased (P<0.05 or P<0.01). CONCLUSIONS: BHD can improve ED of rats with BCNI, which is related to inhibiting fibrosis, apoptosis, and oxidative stress of CC. The ROS/JNK/c-Jun signaling pathway may play an important role in the process.

Neuroprotective effect of Hongjing I granules on erectile dysfunction in a rat model of bilateral cavernous nerve injury.

Neurogenic erectile dysfunction (NED) is an inevitable postoperative disease of cavernous nerve injury which will lead to various pathophysiological changes in the corpus cavernosum and dorsal penile nerve caused by radical prostatectomy (RP). Although serval years of clinical application of HJIG I granules (HJIG), an innovative formulation, has demonstrated its reliable clinical efficacy against NED, the mechanism of HJIG remains unclear. This study aimed to assess the neuroprotective effect of HJIG, to repair damaged nerves in a rat model of bilateral cavernous nerve injury (BCNI) in vivo and their effects on neurites of major pelvic ganglia (MPG) regeneration and Schwann cells (SCs) proliferation in vitro. Rats were divided into five groups randomly: normal control (NC), BCNI-induced ED model (M), M + low-dose HJIG (HL), M + medium-dose HJIG (HM), and M + high-dose HJIG (HH). All groups were treated with normal saline or the relevant drug for 28 consecutive days after a standard NED animal model. Our data revealed that administration of HJIG improved NED that was detected by intracavernous pressure (ICP) in a dose-dependent manner. The haematoxylin-eosin (HE) and Immunofluorescence (IF) staining demonstrated that HJIG ameliorate the shape of penis and induced the protein synthesis of GAP43, NF200, S100, and nNOS. NF200 and S100 level were also detected by western blotting. Moreover, HJIG (0.78 mg/mL) markedly increased SCs viability and promoted neurites regeneration of MPG. These findings provide new insights into the NED therapy by HJIG.

Effect of HongJing I in Treating Erectile Function and Regulating RhoA Pathway in a Rat Model of Bilateral Cavernous Nerve Injury.

HongJing I (HJI), a traditional Chinese herbal formula, has been confirmed to be effective for the clinical treatment of erectile dysfunction (ED). However, the mechanism of action of HJI remains unclear. Here, we aimed to investigate the effect and underlying mechanisms of HJI against ED in a rat model of bilateral cavernous nerve injury (BCNI). Rats were divided into five groups: normal control (NC), BCNI-induced ED model (M), M + low-dose HJI (HL), M + medium-dose HJI (HM), and M + high-dose HJI (HH). All groups were treated with normal saline or the relevant drug for 28 consecutive days after inducing BCNI-ED. At the end of the treatment period, the intracavernous pressure (ICP) was recorded, and histological examination was conducted using Masson's trichrome staining. Immunofluorescence staining and western blotting were applied to detect the changes in fibrosis protein and Ras homolog A (RhoA), Rho-associated protein kinase 1 (ROCK1), and ROCK2 expression. We found that HJI effectively improved the ICP in the treatment groups. In addition, RhoA, ROCK1, and ROCK2 expression levels were increased upon BCNI-ED induction, and HJI successfully inhibited cavernosum fibrosis and the activation of RhoA/ROCK2 signaling. Overall, these results suggest that the effects of HJI in attenuating ED may be caused, at least in part, by the suppression of RhoA/ROCK2 signaling and alleviation of fibrosis. However, the precise mechanism surrounding this requires further investigation in future studies.

[Inhibitory effect of salidroside on H2O2-induced down-regulation of Cx43 expression in corpus cavernosum smooth muscle cells in rats].

OBJECTIVE: To explore the regulatory effect of salidroside on H2O2-induced decrease in the expression of the connexin43 (Cx43) protein in corpus cavernosum smooth muscle cells (CCSMC). METHODS: Rat CCSMCs were isolated, primarily cultured in vitro and identified by immunocytochemical assay. The optimum concentration of H2O2 for intervention was determined by detecting its effect on the viability of the CCSMCs and used in the treatment of the CCSMCs for different lengths of time, and meanwhile salidroside was applied at 16 µg/ml (low dose) or 64 µg/ml (high dose) for intervention. Finally, the expressions of the Cx43 protein in the CCSMCs of different groups of rats were determined by Western blot. RESULTS: The CCSMCs grew normally, with a positive rate of over 90%. At 1, 2 and 4 hours of treatment with H2O2 at the optimum concentration of 200 µmol/L, the expression of Cx43 in the CCSMCs was significantly decreased as compared with that in the blank control group (P < 0.01), even more significantly at 4 hours than at 1 and 2 (P < 0.01). Intervention with high-dose salidroside, however, markedly inhibited the down-regulation of the Cx43 expression (P < 0.05), which showed no statistically significant difference from that in the normal control group (P = 0.322 2). CONCLUSIONS: Salidroside can suppress H2O2-induced decrease in the expression of the Cx43 protein in rat CCSMCs.

[Sonic hedgehog signaling pathway and erectile dysfunction: Advances in studies].

Sonic hedgehog (Shh) is an important regulator of penile erectile function in adult males, and abnormal Shh signals may be involved in the mechanisms of ED. Current studies on the relationship of the Shh signaling pathway with ED are mainly concentrated on neurogenic ED caused by bilateral cavernous nerve injury, diabetes-induced endocrinological ED, and senile ED. This review focuses on the changes of the Shh signaling pathway in different types of ED and clarifies the mechanisms of the Shh signaling pathway regulating ED, hoping to give some inspiration to further related studies.

[henotypic modulation of corporal cavernosum smooth muscle cells and erectile dysfunction: Advances in studies].

Erectile dysfunction (ED) is closely related with the phenotypic modulation of corporal cavernosum smooth muscle cells (CCSMC), a transitional tendency of CCSMCs switching from the contractile phenotype to the synthetic or proliferative phenotype. The molecular markers of contractile CCSMCs include α-SMA, SMMHC, Calponin, Smoothelin, and Desmin, while those of synthetic or proliferative CCSMCs involve Vimentin, Osteopontin, and Collagen I. Current studies show that phenotypic transformation of CCSMCs is related to the pathophysiological processes of different types of ED, such as bilateral cavernous nerve injury-induced ED, diabetes mellitus-associated ED, arterial ED, hypertension-associated ED, and so on. In addition, such external factors as hypoxia, platelet-derived growth factor, and tobacco combustion gas may directly affect rats or CCSMCs and consequently lead to phenotypic conversion of CCSMCs. This article presents a systematic review of the studies on the correlation of phenotypic transition of CCSMCs with ED.