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Jeon SH. et al., 2020: Combined treatment with extracorporeal shockwaves therapy and an herbal formulation for activation of penile progenitor cells and antioxidant activity in diabetic erectile dysfunction.

Jeon SH, Bae WJ, Zhu GQ, Tian W, Kwon EB, Kim GE, Hwang SY, Lee KW, Cho HJ, Ha US, Hong SH, Lee JY, Kim SW.
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Catholic Integrative Medicine Research Institute, The Catholic University of Korea, Seoul, Republic of Korea.
KEMIMEDI, Seoul, Korea.

Abstract

Background: A Korean herbal formulation named KH-204 was reported to have an antioxidant effect in our previous study. We hypothesized that Low-intensity extracorporeal shockwave therapy (Li-ESWT) combined with KH-204 would accelerate the treatment of erectile dysfunction (ED) by enhancing antioxidant. We investigated the synergistic effect of Li-ESWT and KH-204 for ED and explored the mechanism.

Methods: Human umbilical vein endothelial cells (HUVEC) were treated with KH-204 and LI-ESWT in vitro. Fifty 5-week-old male Sprague Dawley rats received an intraperitoneal injection of 5-ethynyl-20-deoxyuridine (EdU) which can label live cells, and were randomly divided into five groups: (I) normal; (II) diabetes mellitus-associated erectile dysfunction (DMED); (III) DMED + KH-204; (IV) DMED + Li-ESWT; and (V) DMED + KH-204/Li-ESWT. Li-ESWT treatment was repeated three times a week every other day for four weeks in group 4 and 5. Meanwhile, rats in group 3 and 5 were orally fed 400 mg/kg of KH-204 daily for 1 month. Following a 1-week washout period, penile tissues were evaluated by immunostaining and Western blotting.

Results: KH-204 combined with Li-ESWT improved intracavernosal pressure (ICP) in DMED rats. Li-ESWT/KH-204 stimulated HUVEC tube formation and promoted proliferation. Li-ESWT drove progenitor cells to migrate to penile tissue and KH-204 protected penile progenitor cells in the corpus cavernosum. Oxidative stress was relieved by KH-204/Li-ESWT. Treatment with KH-204/Li-ESWT protected penile progenitor cells, which were recruited to the corpus cavernosum by Li-ESWT, from apoptosis via its antioxidant activity. KH-204/Li-ESWT protected penile tissue from oxidative stress by improving the expression of nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1), increasing superoxide dismutase (SOD), decreasing 8-hydroxy-20-deoxyguanosine (8-OHdG), and reducing apoptosis. KH-204/Li-ESWT promoted stromal derived factor-1 (SDF-1) and platelet endothelial cell adhesion molecule-1 (PECAM-1) in DMED rats.

Conclusions: KH-204 protected penile progenitor cells, which were recruited to the corpus cavernosum by Li-ESWT, from apoptosis via its antioxidant activity. The combination of Li-ESWT and KH-204 as a synergy therapy could be a potential and effective treatment for DMED.
Transl Androl Urol. 2020 Apr;9(2):416-427. doi: 10.21037/tau.2020.01.23. PMID: 32420147. FREE ARTICLE.

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Comments 1

Hans-Göran Tiselius on Friday, 07 August 2020 09:03

This is an experimental animal study from which the conclusion was drawn that a Korean herbal formulation (KH204), with antioxidant properties, in combination with Li-ESWT increased the intra-cavernous pressure in rats with diabetes ED. Whether the demonstrated decreased apoptosis will be clinically useful remains to be shown.

This article might provide useful reading for urologists who want to go in depth on the physiological and biochemical properties in ED.

Hans-Göran Tiselius

This is an experimental animal study from which the conclusion was drawn that a Korean herbal formulation (KH204), with antioxidant properties, in combination with Li-ESWT increased the intra-cavernous pressure in rats with diabetes ED. Whether the demonstrated decreased apoptosis will be clinically useful remains to be shown. This article might provide useful reading for urologists who want to go in depth on the physiological and biochemical properties in ED. Hans-Göran Tiselius
Sunday, 03 March 2024