Hirudin-Based Treatment of Diabetes-Induced Erectile Dysfunction Through Inhibition of the HIF-1α to Regulate RhoA/ROCK Signaling Pathway: An In Vivo Animal Experiment.

Diabetes-induced erectile dysfunction (DIED) is a type of refractory erectile dysfunction which can be clinically treated using the traditional Chinese medicine leech whose main ingredient is hirudin. Oxidative stress can damage vascular endothelial cells, affect blood circulation, and induce fibrosis of smooth muscle cells. This study assessed the efficacy of hirudin in treating DIED before exploring its potential mechanism of action. DIED was induced in rats using streptozotocin, while experimental apomorphine was used to screen for erectile dysfunction models. The rats were then divided into four groups: a blank control group (NC group), a model group (M group), a hirudin group (H group), and an inhibitor group (YC group). After 2 weeks, the serum levels of malondialdehyde (MDA), superoxide dismutase (SOD), and nitric oxide (NO) were determined. The histological features and HIF-1α/RhoA/ROCK signaling pathway-related proteins of the penile corpus cavernosum were detected. Erectile function improved in the H and YC groups without significantly affecting body weight and blood glucose levels, with histopathological analysis also showing improvement in penile structure in these groups. In addition, the expression of HIF-1α/RhoA/ROCK signaling pathway-related proteins was lower in the penile cavernous tissue of rats in the H and YC groups (p < .05), with the serum levels of NO and SOD also being higher in these groups (p < .05). The serum level of MDA decreased in the YC and H groups (p < .05). In this study, only animal experiments were conducted to investigate the regulation of Rho/ROCK pathway by HIF-1α. Cellular studies of the underlying mechanisms are lacking.