The Pathogenesis of Peyronie's Disease: A State of Altered Wound Healing

De Young, L; Bella, A; Gan, BS; Brock, G

Introduction: The true pathogenesis and natural history of Peyronie's Disease (PD) remains unclear more than 250 years since its initial description. Clinicians faced with patients affected by PD, have little scientific basis on which to provide risk of disease progression information. The formation of PD fibrotic plaques appears to be an example of abnormal wound-healing.

Objectives: In this study our objectives were to determine if an altered protein expression exists in PD affected tunica albuginea (TA) samples compared to normal controls, consistent with abnormal wound healing and correlated these results to the extent of disease, attempting to provide prognostic information about progression.

Methods: Western blot and immunocytochemistry were performed on tissue and primary cell cultures obtained from 10 men undergoing penile implants (controls) and from 10 PD affected TA samples obtained during reconstructive surgery. Among our panel of proteins, we measured tissue levels of b-catenin and TGF-b, cell level of TGFb1/3 receptors, smooth muscle a-actin, transglutaminase II (tTG), fibronectin and HSP47 (heat shock protein) expression.

Results: Increased tissue levels of b-catenin and TGFb 1 were meas ured in diseased tissue compared with controls. A 10 fold increase of smooth muscle a-actin, two fold increase ofTGFb1/3 receptors, transglutaminase II (tTG), fibronectin and HSP47 were shown in cultured fibroblasts derived from plaque tissue PD cells compared with controls. These findings were conformed by western blot.

Conclusions: PD represents a condition of altered wound healing. Changes in protein expression may serve as a biological markers predicting for disease progression.

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