Peyranie hastalığı tedavisinde pirfenidon'un etkisi
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Dosyalar
Tarih
2021
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Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Peyronie hastalığı, akut ve kronik olmak üzere iki dönemden oluşmaktadır. Akut dönemde peniste ağrı, fibrotik plakların oluşması, ereksiyon problemlerinin başlaması/artması şeklinde ilerlerken, kronik dönemde ağrı ortadan kalkmakta, akut dönemde oluşan fibrotik plaklar ve erektil disfonksiyon gibi patolojiler kalıcı hal almaktadırlar. Günümüzde peyronie hastalığını akut döneminde medikal tedavi uygulanmaktadır. Hastalığın kronik döneminde medikal tedavilerin faydası bulunmamaktadır. Güncel medikal tedavi seçenekleri içinde çok sayıda ajan bulunmakla birlikte bunlardan yüzde yüz fayda sağladığı gösterilen bir molekül bulunmamaktadır. Pirfenidon günümüzde sıklıkla göğüs hastalıkları tarafından İdiyopatik Pulmoner Fibrozis(İPF) hastalığında kullanılmaktadır. Peyronie hastalığı patofizyolojisi ile benzer olan İPF tedavisinde kullanılan pirfenidon, peyronie hastalığı için daha önce hiçbir çalışmada denenmemiştir. Bu çalışmada sıçanlarda oluşturulan deneysel peyronie hastalığında pirfenidonun etkisinin incelemesi amaçlandı. Bu çalışmada, peyronie hayvan modeli oluşturulacak 3 aylık, ağırlıkları 280 gram ile 320 gram arasında değişen 27 adet erkek Sprague Dawley cinsi sıçan kullanıldı. Sıçanlar randomize olarak 3 farklı gruba ayrıldı. Grup 1 e konulan sıçanlar kontrol grubu olarak belirlendi. Grup 2’ye ve grup 3’e konulan sıçanlara peyronie modeli oluşturuldu. Grup 3’e konulan sıçanlara, deneyin başlangıcından 3 hafta sonra, 28 gün boyunca her gün oral gavaj ile pirfenidon verildi. 28. Gün sonunda tüm sıçanlar sakrifiye edilmeden önce erektil fonksiyon değerlendirmesi amacıyla kavernosal sinir stimulasyonu yöntemi ile hemodinamik çalışma yapıldı. Ardından sakrifiye edilerek sıçanların penisleri immunohistokimyasal olarak değerlendirildi. İmmunohistokimyasal olarak elde edilen sonuçlarda pirfenidonun peyronie hastalığında penisteki fibroziste bir miktar düzelme sağladığı ancak istatistiksel olarak anlamlı bir iyileşme olmadığı görüldü. Ayrıca yapılan hemodinamik erektil fonksiyon değerlendirmesinde, pirfenidonun erektil fonksiyonda bir miktar düzelme sağladığı ancak istatistiksel olarak anlamlı bir düzelme olmadığı görüldü.
Peyronie's disease consists of two periods, acute and chronic. In the acute period, pain in the penis progresses as fibrotic plaques formation, erection problems start / increase, pain disappears in the chronic period, and pathologies such as fibrotic plaques and erectile dysfunction in the acute period become permanent. Today, medical treatment is applied in the acute phase of Peyronie's disease. Medical treatments do not help in the chronic phase of the disease. Although there are many agents in current medical treatment options, there is no molecule that has been shown to benefit 100% from them. Pirfenidone is now frequently used by pulmonary diseases in Idiopathic Pulmonary Fibrosis (IPF) disease. Pirfenidone, which is used in IPF treatment, which is similar to Peyronie's disease pathophysiology, has not been tried in any study before for Peyronie's disease. In this study, it was aimed to investigate the effect of pirfenidone on experimental Peyronie's disease in rats. In this study, 27 male Sprague Dawley rats, 3 months old and weighing between 280 grams and 320 grams, were used to create a Peyronie animal model. The rats were randomly divided into 3 different groups. The rats placed in group 1 were determined as the control group. The peyronie model was created for the rats that were placed in group 2 and group 3. The rats in Group 3 were given pirfenidone by oral gavage every day for 28 days, 3 weeks after the start of the experiment. At the end of the 28th day, before all rats were sacrificed, hemodynamic study was performed by cavernosal nerve stimulation method in order to evaluate erectile function. Then, they were sacrificed and the penises of the rats were evaluated immunohistochemically. Immunohistochemically, it was seen that pirfenidone provided some improvement in penile fibrosis in Peyronie's disease, but there was no statistically significant improvement. In addition, in the hemodynamic evaluation of erectile function, it was observed that pirfenidone provided some improvement in erectile function, but there was no statistically significant improvement.
Peyronie's disease consists of two periods, acute and chronic. In the acute period, pain in the penis progresses as fibrotic plaques formation, erection problems start / increase, pain disappears in the chronic period, and pathologies such as fibrotic plaques and erectile dysfunction in the acute period become permanent. Today, medical treatment is applied in the acute phase of Peyronie's disease. Medical treatments do not help in the chronic phase of the disease. Although there are many agents in current medical treatment options, there is no molecule that has been shown to benefit 100% from them. Pirfenidone is now frequently used by pulmonary diseases in Idiopathic Pulmonary Fibrosis (IPF) disease. Pirfenidone, which is used in IPF treatment, which is similar to Peyronie's disease pathophysiology, has not been tried in any study before for Peyronie's disease. In this study, it was aimed to investigate the effect of pirfenidone on experimental Peyronie's disease in rats. In this study, 27 male Sprague Dawley rats, 3 months old and weighing between 280 grams and 320 grams, were used to create a Peyronie animal model. The rats were randomly divided into 3 different groups. The rats placed in group 1 were determined as the control group. The peyronie model was created for the rats that were placed in group 2 and group 3. The rats in Group 3 were given pirfenidone by oral gavage every day for 28 days, 3 weeks after the start of the experiment. At the end of the 28th day, before all rats were sacrificed, hemodynamic study was performed by cavernosal nerve stimulation method in order to evaluate erectile function. Then, they were sacrificed and the penises of the rats were evaluated immunohistochemically. Immunohistochemically, it was seen that pirfenidone provided some improvement in penile fibrosis in Peyronie's disease, but there was no statistically significant improvement. In addition, in the hemodynamic evaluation of erectile function, it was observed that pirfenidone provided some improvement in erectile function, but there was no statistically significant improvement.
Açıklama
Anahtar Kelimeler
Pirfenidon, Peyronie hastalığı, Kavernosal sinir stimulasyonu, Pirfenidone, Peyronie's disease, Cavernosal nerve stimulation
