Nanoscale therapeutics for erectile dysfunction: a meta-analysis of stem cell-derived extracellular vesicles as natural nanoparticles in diabetic rat models
Abstract
Background: Erectile dysfunction (ED), a prevalent male sexual disorder, severely impacts quality of life. Extracellular vesicles (EVs), natural nanoparticles (30-200 nm) secreted by stem cells, represent a novel nanomedicine platform for ED treatment due to their ability to encapsulate bioactive cargo (e.g., miRNAs, proteins) and target damaged tissues. Stem cell-derived extracellular vesicles (SC-EVs) have emerged as a promising therapeutic strategy for multiple diseases. This meta-analysis evaluates the therapeutic efficacy of SC-EVs in rat ED models and explores their translational potential.
Methods: We systematically searched PubMed, Embase, Cochrane Library, and Web of Science for studies published up to December 2024. Randomized controlled trials (RCTs) assessing EVs in ED treatment were included. A random-effects model was applied to account for between-study heterogeneity, with standardized mean differences (SMDs) and 95% confidence intervals (CIs) calculated for continuous outcomes.
Results: Twenty studies involving 324 rats were included. EVs significantly improved erectile function (SMD = 4.19, 95% CI: 3.31-5.08, P 0.05) or disease models (diabetes mellitus [DM] vs. cavernous nerve injury [CNI], P > 0.05). EVs upregulated the expression of nitric oxide synthase isoforms (nNOS and eNOS), increased smooth muscle content (α-SMA), and improved smooth muscle-to-collagen ratios (P < 0.00001 for all). Funnel plot asymmetry and Egger's test (P < 0.05) indicated…
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Evidence Hub reads this as a meta-analysis, done in animal, not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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