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Peyronie's Disease

Peyronie's Disease

Peyronie’s disease (PD) is characterized by a fibrous, inelastic lesion of the tunica albuginea. It is believed to occur as a result of aberrant penile wound healing in genetically susceptible individuals.

In response to microtraumas to the penis, tissue inhibitors of metalloproteinases (TIMPs); a pro-fibrotic substance; and transforming growth factor-beta (TGF-β1); a pro-inflammatory cytokine; are released. This inflammatory response leads to the formation of fibrous inelastic plaque(s) within the bilayer of the tunica albuginea resulting in Peyronie’s disease [1,2].

 

There are two distinct phases of the disease; the acute phase and the chronic phase. The acute phase is characterized by active inflammation, penile pain and evolving deformity of the erect penis [3]. The chronic phase is characterized by stable curvature, pain resolution and the palpation of a hard, palpable plaque [4].

Surgical options are suitable in correcting the deformity and aiding the ability to resume sexual function. However, they leave the patient with dissatisfaction due to loss of length of the phallus, residual deformity or erectile dysfunction. To date, nonsurgical treatment modalities have focused on disrupting these processes by attempting to balance out the pro-fibrotic substances with anti-fibrotic substances such as matrix metalloproteinases (MMPs) -1, -2, -3 and -9 which are responsible for collagen degradation. Disease management of this nature can allow patients to avoid the morbidities associated with surgical intervention and still achieve improved functional and aesthetic outcomes.

 

How Our Products Can Treat Peyronie’s Disease

We use products derived from the umbilical cord tissues of human babies in all our therapy programs - Wharton's Jelly MSCs (wjMSCs). In both animal and human studies, MSCs of different sources have been found to be able to:

  • improve penile curvature [5].
  • reduce the size or resolve existing plaque(s) [5].
  • reduce total elastin (elastosis) [6].
  • reduce the production of collagen type III [6].
  • improve blood flow (determined by measuring intra-cavernous pressure to mean arterial pressure (ICP/MAP) upon cavernous nerve stimulation) [6,7].
  • prevent plaque / fibrosis development [6,7].
  • improve erectile function [6,7].
  • decrease production of matrix metalloproteinases (MMPs) -1, -2, -3 and -9 [7].
  • migrate to sites of injury (chemotaxis) [8,9,10].
  • communicate with and alter nearby cells (paracrine effect) [11,12,13].
  • encourage your cells to self-repair (autocrine effect) [11,14,15]
  • prevent rejection by regulating the immune system (immunomodulation) [9, 10,16,17,18,19,20,21].
  • incapable of forming tumours [9,19,22,23,24].

 

Treating Peyronie’s Disease

There is currently only one human clinical trial exploring the use of adipose tissue MSCs in the treatment of Peyronie’s disease. adMSc will be harvested and isolated from the patient’s own (autologous) adipose tissues (adMSCs). 20 participants will be injected in the corpora cavernosa and dorsal penile artery. The results have yet to be made public [25].

In 2013, a collaborative study between the Nova Southeastern University College of Osteopathic Medicine and Z Urology (a urology care clinic) in Florida injected 5 patients with chorionic placenta-derived MSCs (pmMSC). At the beginning of the study, 1 patient had 3 Peyronie plaques, 3 patients had 2 plaques each and 1 patient had a single plaque (a total of 10 plaques). Penile curvature varied from 0° to 120°, baseline peak systolic velocity (PSV) ranged from 14.1 to 25.5 cm/s and end-diastolic velocity (EDV) ranged from 0.1 to 4.3 cm/s. Up to 2mL of the diluted pmMSC solution was injected in and around the plaques. Patients were re-evaluated at 6 weeks, 3 months and 6 months post-treatment.

At the 6-week evaluation, penile curvature had decreased by 14.29% to 100% in 4 patients with curvature; Patient 3 had no initial curvature and thus demonstrated no change. Plaque volume had decreased from 45.83% to 100%, with reductions greater than 90% in 4 out of 5 patients at the 3-month evaluation. At the end of 6 months of evaluations, PSV range had increased to 50.5 to 67.1 cm/s, however, EDV values had improved only slightly, not reaching a statistical significance. 7 out of 10 plaques had disappeared completely; with decreases close to 100%. Penile curvature had improved dramatically; with 30° to 120° of improvement in the patients with curvature. The results suggest that MSCs may be beneficial and effective as a non-surgical treatment option for PD [5].   

That same year, researchers at the University Vita-Salute San Raffaele, Italy, divided 27 male Sprague-Dawley rats into 3 groups. Group 1 served as the control/sham group and did not have Peyronie's disease (PD). Group 2 and Group 3, however, were injected with transforming growth factor-beta (TGF-β1) to induce PD in the subjects. They were then treated as follows:

  • Group 1: no PD / no treatment.
  • Group 2: PD / no treatment. 
  • Group 3: PD / treated with 1 million human adipose-derived MSCs (adMSCs).

5 weeks later, the study found that intra-cavernous pressure to mean arterial pressure (ICP/MAP) ratio had significantly improved in Group 3 when compared with Group 2:

  • Group 2: Ratio of 0.37.
  • Group 3: Ratio of 0.59.

This indicated increased blood flow and significantly improved erectile function.

Group 2 had developed areas of fibrosis and elastosis with a significant upregulation of collagen III and elastin protein expression. Human adMSCs were able to prevent fibrosis and elastosis in Group 3 rats. The study concluded that injection of human adMSCs into the tunica albuginea (TA) during the active phase of PD may prevent the formation of fibrosis and elastosis in the TA and corpus cavernosum [6].

In 2014, researchers from Tulane University School of Medicine, New Orleans repeated the Italian clinical trial with 24 male Sprague-Dawley rats divided into 4 equal groups of 6 each. They were then treated as follows:

  • Group 1: no PD / no treatment.
  • Group 2: PD / no treatment. 
  • Group 3: PD / treated with 0.5 million rat adipose-derived MSCs (adMSCs) - disease prevention group.
  • Group 4: PD / treated with 0.5 million rat adipose-derived MSCs (adMSCs) - disease treatment group.

Group 3 (prevention) was treated 1 day after the TGF-β1 injection while Group 4 (treatment) was treated only 30 days after the TGF-β1 injection.

45 days after disease onset, the study found that intra-cavernous pressure to mean arterial pressure (ICP/MAP) ratio was significantly higher in Group 3 (prevention) and Group 4 (treatment) than in Group 2 (no treatment). This indicated increased blood flow and significantly improved erectile function. They concluded that adMSCs had prevented and/or reduced Peyronie's-like changes by decreasing the expression of tissue inhibitor of metalloproteinase (TIMPs) and stimulating expression and activity of matrix metalloproteinases (MMPs); an active defence mechanism against PD [26]. This study documented the preventive and therapeutic benefits of adMSCs on penile fibrosis and erectile function in an animal model of PD [7].

 

Cyrona’s Program

Achieving high standards in our work is of paramount importance to us. Depending on a patient’s needs, we combine our premium grade Passage 2 wjMSCs with physiotherapy, occupational therapy, speech and language therapy and/or rehabilitative medicine. 

Learn more about our Products and Programs.

 

Why Choose Cyrona?

  • Latest cellular research and technology.
  • Unique, tailored therapy outlines.
  • Products that meet international standards.
  • Microbiology & clinical team with extensive experience in advanced medicine.
  • Board-certified physicians geared toward patient safety.
  • Fact-based information from clinical studies and trials.
  • No outlandish promises of a one-stop-cure or false improvement rates.

 

Therapy Packages

All our therapy packages come inclusive of:

 

INTERNATIONAL PATIENTS

  • Premium grade Passage 2 wjMSCs.
  • Treatment by qualified specialist(s).
  • Certificate of Analysis (CoA).
  • Airport transfer.
  • Transportation to & from therapy session(s).
  • Accommodation.
  • Hospital room for therapy.

 

LOCAL PATIENTS

  • Premium grade Passage 2 wjMSCs.
  • Treatment by qualified specialist(s).
  • Certificate of Analysis (CoA).
  • Transportation to & from therapy session(s).
  • Hospital room for therapy.

 

How Do We Proceed

All our therapies are charged based on the number of wjMSCs and supplementary infusions required for the patient’s specific condition. As no two people are alike, our specialists review each patient’s medical reports before tailoring a therapy catered to addressing his or her individual needs.

You may chat with one of our Customer Care Representatives or send an e-mail detailing the patient’s condition to one of our Liaison Officers. It would expedite the process if you can provide us with:

  • Imaging results (MRI scan / CT scan / X-Ray).
  • Haematology reports (blood test).
  • Doctor’s assessment reports.
  • Pictures or videos of the patient (if relevant).

Upon getting in touch with us, a Liaison Officer evaluates and assigns the case to the specialist best equipped to treat the condition. A therapy, unique only to the patient, is drawn up and a price quoted accordingly.

Should you decide to proceed with therapy, our specialists require that all patients have Cancer Marker Screening performed in their country of residence before travelling to us for therapy. If the patient has had Cancer Marker Screening within the last 3 months, you may e-mail those results to us. In the event that the patient’s Cancer Marker Screening results are not satisfactory, our specialists will refuse to proceed with therapy. It is for this reason that we request that patients have Cancer Marker Screening performed in their country of residence prior to travelling to us.

One week prior to arrival, a deposit payment is required in order to arrange accommodation and transportation.

Full payment is required to be made one-day prior to therapy commencement.

Post-treatment, our specialist will provide the patient with a post-treatment protocol as well as what to expect on his or her journey towards a better, and hopefully, healthier new life.

 

Kindly get in touch with us for the sources listed throughout this article.

 

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