Erectile Dysfunction (ED) is a common health problem in roughly 50% of males of advanced age (40-70 years old). Recent attention related gene therapy to ED cases; this received much interest to further progress gene therapy ideals to ED treatment. This review is an attempt to analyze key challenges and to emphasize primary areas, including mostly preclinical and few clinical trials, cellular target(s), and different viral vectors/nanoparticles for gene delivery in ED. While overexpression of target genes can be silenced by RNA interference (RNAi), down-regulation of these mechanisms has been implicated in ED. Although many patients with ED show high efficacy with phosphodiesterase type 5 inhibitors, this therapy is insufficient in approximately 30-40% of patients. Although several preclinical studies for ED treatment provided promising results, gene therapy has not shown promise in clinical practice, due to technical limitations of gene therapy to clinical translation and the ED pathogenesis. Developments in small RNA, such as siRNA, approaches for ED may lead to significant management for ED. Also, siRNA delivery into the corpus cavernosum seems a challenging issue and awaits further development. Several safety concerns of gene therapy, gene acquisition, preparation, and delivery are necessary to continue investigation before any widespread application is used in ED.
Current gene therapy. 2018 Jul 29 [Epub ahead of print]
Serap Gur, Asim B Abdel-Mageed, Suresh C Sikka, Alma R Bartolome, Wayne J G Hellstrom
Department of Urology, Tulane University Health Sciences Center, New Orleans, LA. United States.