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    Expressão de fatores indutores de fibrose no tecido cavernoso de pacientes com disfunção erétil pós prostatectomia radical
    (Universidade Federal de São Paulo (UNIFESP), 2015-12-15) Cabrini, Marcelo Rodrigues [UNIFESP]; Ribeiro, Cassio Andreoni Ribeiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To characterize transforming growth factor beta 1 (TGF?1) and related signaling pathway proteins in a large cohort of human penile tissue (HPT) samples from men with post-radical prostatectomy (RP) erectile dysfunction (ED). Method: HPT was collected from patients undergoing penile prosthesis implantation for postradical prostatectomy erectile dysfunction (RP-ED; n = 57). Two groups of tissue were used for comparison: organic ED (O-ED; n = 30), also collected during penile prosthesis implantation, and control (CON; n = 6), collected from patients undergoing partial penectomy, without ED. Western blot analysis was performed to investigate the protein expressions of TGF?1, thrombospondin 1 (TSP1; an activator of TGF?1), a family of transcriptional factors activated by TGF?1 (Smad2, phospho-Smad2- serine-465/467 [pSmad2], Smad3, phospho-Smad3-serine-423/425 [pSmad3]), and fibronectin (FN; an extracellular matrix glycoprotein induced by TGF?1). Results: Expressions of TGF?1 and TSP1 were significantly higher in RP-ED (p <0.05) and OED (p <0.05) groups compared with that of the CON group and were not different between either ED groups. Expressions of Smad2, pSmad2, Smad3, pSmad3, and FN were similar among all groups. Within the RP-ED group, a subgroup analysis showed that body mass index (BMI)>25Kg/m2 was related to increased expression of TGF?1 and TSP1, previous history of intracavernosal injection was related to increased expression of TGF?1 (p<0.05), and time from RP to penile prosthesis implantation (moment of tissue collection) was related to increased expression of pSmad2 (p<0.05). Conclusions: Our results demonstrate that TSP1- and TGF?1- dependent fibrotic changes occur in penile tissue in patients with ED regardless of etiology. The unchanged expression of the Smad transcriptional factors may be reconciled by a Smad-independent downstream signaling pathway transmitting TGF?1 signals. Among RP-ED men, BMI, previous use of intracavernosal injection and time sice RP affect fibrotic protein expression.