Future Treatment Aspects of Erectile Dysfunction: Gene Therapy and Tissue Engineering in Visual Studio .NET

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duces erectile responses in the mouse J Urol 2002;167 No 4 Suppl, 238:933 Chang S, Hypolite JA, Changolkar A, et al Diabetes associated erectile dysfunction: role of endothelin and Rho kinase J Urol 2002;167 No 4 Suppl 237:932 Wilkes N, White S, Rajasekaran M PDE-V inhibitors synergizes Rho-kinase antagonism and enhances erectile response in male hypertensive rats J Urol 2003; 169:No 4 Suppl, 360:1346 Zheng Y, Chang S, Wein AJ, et al Upregulation of Rho kinase in a human corpus cavernosum smooth muscle cell line in response to hypoxia J Urol 2004;171 Suppl, 376: Abstr 1429 Mills TM, Chitaley K, Lewis RW Vasoconstriction in erectile physiology Int J Impotence Res 2001;13 Suppl 5:S29 S34 Wilkes N, White S, Cosgrove DJ, Rajasekaran M Y27632, an inhibitor of Rho-kinase, improves erectile response in male hypertensive rats J Urol 2002;167 No 4 Suppl, 238:935 Dai Y, Chitaley K, Webb RC, et al Topical application of a Rho-kinase inhibitor in rats causes penile erection Int J Impotence Res 2004;16:294 298
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25 Bischoff E, Schramm M, Straub A, et al BAY 41-2272 a stimulator of soluble guanylyl cyclase induces NOdependent penile erection in vivo Int J Impotence Res 2002;14 Suppl 3,S43:BSP 10 26 Brioni JD, Nakane M, Hsieh GC, et al Activators of soluble guanylate cyclase for the treatment of male erectile dysfunction Int J Impotence Res 2002; 14:8 14 27 Kalsi JS, Rees RW, Hobbs AJ, et al Bay 41-2272, a novel nitric oxide independent soluble guanylate cyclase activator,relaxes human and rabbit corpus cavernosum in vitro J Urol 2003;169:761 766 28 Kalsi JS, Ralph DJ, Madge DJ, et al A comparative study of sildena l, NCX-911 and BAY 41-2272 on the anococcygeus muscle of diabetic rats Int J Impotence Res 2004;16:479 485 29 Chitaley K, Webb RC, Mills TM The ups and downs of Rho-kinase and penile erection: upstream regulators and downstream substrates of Rho-kinase and their potential role in the erectile response Int J Impotence Res 2003;15:105 109 30 Sjunnesson J, Hedlund P, Mizusawa H, Andersson K-E Inhibition of Rho-associated kinases by Y-27632 pro-
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Future Treatment Aspects of Erectile Dysfunction: Gene Therapy and Tissue Engineering
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Introduction
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Gene therapy in urology initially focused on urinary tract malignancies such as bladder and prostate cancer However, in the last half decade new research endeavors in tissue engineering, and gene and cell-based therapies, have become more widespread for the treatment of erectile dysfunction (ED) Tissue engineering aims to replace complete tissues or organs, while gene and cell-based therapies act at the cellular level to improve speci c cellular and enzymatic functions [1]
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Various surgical techniques have been developed to restore genital abnormalities, eg epispadias, micropenis, penile carcinoma, genital trauma, corporal brosis, and Peyronie s disease In many of these cases there is a limited amount of cavernosal tissue and surgeons have relied on prosthetic devices to recover the patient s erectile function [2] Reconstruction of normal erectile tissue using autologous cells, derived from the patient s own body, is an intriguing concept for the treatment of this severe form of ED Atala and colleagues have proposed a tissue regeneration approach that involves patching isolated cells to support structures that possess suitable surface chemistry for guiding cell reorganization and growth [3] Initial experiments were performed in order to determine the feasibility of creating corporal smooth muscle and endothelial cells in vivo, using cultured human corporal smooth muscle cells seeded onto
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biodegradable polymers [4] Their results were con rmed with human corporal smooth muscle and endothelial cells seeded on acellular matrices processed from donor rabbit corpora cavernosa [5] Three and six months after implanting these tissue-engineered constructs into the corpora cavernosa of the animals from which the respective cells had been harvested, animals with tissue-engineered corporal segments exhibited much better functional and morphologic results compared to unseeded control animals, as assessed by cavernosography, cavernosometry, mating behavior, cell-speci c immunochemistry, and Western blot analyses Currently, this group has been working on engineering corporal tissue for the purposes of phallic reconstruction, and tunical tissue for reconstruction of severe cases of Peyronie s disease
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