Erectile dysfunction (ED) is one of the most neglected complications of diabetes. Platelet-rich plasma (PRP) is an autologous concentrate prepared from the collected blood and contains a high concentration of platelet growth factors which induce angiogenesis and provide the nerve regeneration. Clopidogrel is a platelet inhibitor or thienopyridine class inhibitor of P2Y12 ADP platelet receptors. In this study, we aimed to determine the effect of intracavernous injection of PRP and clopidogrel on ED in streptozotocin (STZ)-induced diabetic rats. A total of thirty Sprague-Dawley rats was divided into two groups: control and STZ-induced diabetic (45mg/kg, 8wk). In vivo erectile responses were measured after intracavernosal injection of PRP or clopidogrel and their combination in anesthetized rats. The relaxant effect of Clopidogrel in corpus cavernosum (CC) was obtained from in vitro study. The protein expression of endothelial and neuronal markers (eNOS, nNOS), HIF-1α and VEGF in the penile tissue was determined by Western blotting. Diabetic rats displayed significantly reduced in vivo erectile responses and basal intracavernosal pressure after were partially restored by intracavernosal administration of PRP and clopidogrel. Interestingly, combined intracavernosal administration completely improved decreased in vivo erectile responses. Clopidogrel caused marked relaxation in diabetic and control rat CC. In the diabetic group, increased HIF-1α protein levels and decreased eNOS, nNOS and VEGF protein levels were prevented by the combined treatment. These results may contribute to new insights in the management of ED linked to diabetes and encourage the development of novel therapeutic strategies in regenerative medicine. Further studies should need to focus on expanding combinations of PRP and an antiplatelet agent useful for clinical outcomes in diabetic men with ED.
S. Gur: None. D. Yilmaz-Oral: None.