Nanoscale therapeutics for erectile dysfunction: a meta-analysis of stem cell-derived extracellular vesicles as natural nanoparticles in diabetic rat models.

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

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. 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. Twenty studies involving 324 rats were included. EVs significantly improved erectile function (SMD = 4.19, 95% CI: 3.31-5.08, P < 0.00001). Subgroup analyses revealed no significant differences between EV sources (e.g., mesenchymal stem cells [MSCs] vs. adipose-derived stem cells [ADSCs], P > 0.05) or disease models (diabetes mellitus [DM] vs. cavernous nerve injury [CNI], P > 0.05). EVs upregulated the expre

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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