Key result
Losartan reduces collagen deposition ~21% and improves fibrosis in a rat model of priapism.
Why the study?
Fibrosis of corpora cavernosa in priapism is related to the Renin-Angiotensin II System, and the effect of losartan on reducing this fibrosis was evaluated.
Does losartan reduce corpora cavernosa fibrosis in a priapism model of Wistar rats?
Does losartan reduce corpora cavernosa fibrosis in a priapism model of Wistar rats?
Mean Difference: 1.78 (95% CI 0.6–2.95)
Absolute Event Rate: 5.57% vs 7.06%
p-value: p=0.01
In a rat model of priapism, losartan reduced collagen-type-1 deposition and histopathological fibrosis, suggesting a potential role in preventing erectile dysfunction post-priapism.
Losartan merits human trials for post-priapism fibrosis prevention; animal data leave open translation to clinical erectile dysfunction outcomes.
Background: Priapism induces regulation of Transforming Growth Factor-β1 (TGF-β1) expression and collagen-type-1 deposition. This will replace the normal corpora cavernosa with fibrotic tissue which eventually resulted in erectile dysfunction. It is also known that the fibrosis process of corpora cavernosa is related to Renin-Angiotensin II System (RAS). Angiotensin II receptor blockers (ARB), especially losartan, inhibit the inflammation process and fibrotic tissue formation. This study evaluated the effect of losartan in reducing fibrosis in priapism by evaluating TGF-β1 and collagen-type-1 in cavernous tissue and determined the effect of losartan in preventing fibrosis in priapism model of Wistar rats assessed by the metavir score. Methods : A total of eighteen male Wistar rats mean were divided into five groups. For the priapism models, we applied negative pressure on the penis to make an artificial erection to mimic the priapism process. The control groups were observed and the treatment groups were orally given losartan 15 mg/kg/day. Corpora cavernosa was harvested for TGF-β1 and collagen-type-1 measurement using an enzyme-linked immunosorbent assay (ELISA). The fibrotic tissue of each rat was then collected and assessed histopathologically with the metavir scoring system. Results : Penile TGF-β1 concentration in the losartan-treated group was not significantly different on day 10 and day 28 of observation (p10=0,30; p28=0,17). Meanwhile, collagen-type-1 concentration was significantly lower compared to control group (p10=0,002; p28=0,01). There was a significant difference in metavir scores in rats that received losartan and those who did not (p<0,05). Conclusion : Losartan could suppress the fibrosis process in the priapism model. It could decrease the collagen type 1 deposition during corpora cavernosa tissue regeneration. Based on the metavir score, the group receiving losartan therapy was better than the control group.
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Siregar et al. (2023) studied Priapism (n=18). Losartan vs. No therapy (priapism model control) was evaluated on Type 1 collagen concentration at day 28 (ng/mL) (MD 1.78, 95% CI 0.60-2.95, p=0.01). Losartan significantly decreased collagen type 1 deposition (5.57 vs 7.06 ng/mL, p=0.01) and improved metavir fibrosis scores at 28 days in a rat model of priapism.
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