PD31-11 THE ORIGINS OF CALCIFIED PEYRONIE'S PLAQUE (2017)

You have accessJournal of UrologySexual Function/Dysfunction: Peyronie’s Disease I1 Apr 2017PD31-11 THE ORIGINS OF CALCIFIED PEYRONIE'S PLAQUE Matthew Hennefarth, Ling Chen, Misun Kang, Ryan Hsi, Amanda Reed-Maldonado, Guiting Lin, Marshall Stoller, Tom Lue, and Sunita Ho Matthew HennefarthMatthew Hennefarth More articles by this author , Ling ChenLing Chen More articles by this author , Misun KangMisun Kang More articles by this author , Ryan HsiRyan Hsi More articles by this author , Amanda Reed-MaldonadoAmanda Reed-Maldonado More articles by this author , Guiting LinGuiting Lin More articles by this author , Marshall StollerMarshall Stoller More articles by this author , Tom LueTom Lue More articles by this author , and Sunita HoSunita Ho More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1389AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Calcified Peyronie's plaque (CPP) is thought to be mineralized type I collagen of the tunica albuginea (TA) and within the corpus cavernosum (CC). The mechanistic link transforming a fibrous and vascularized to a mineralized tissue and subsequently impairing function at an organ-level is poorly understood. It is hypothesized that origins of CPP lay at the interface between the circumferential TA and CC, in that the residing pericytes around small diameter vessels produce osteogenic markers, prompting calcification at the CC-TA interface. METHODS Twelve human CPPs were surgically excised, fixed, dehydrated and scanned using a high resolution X-ray computed tomography (micro-CT) at 4X and 10X magnifications (4.5µm and 1.8µm voxel size respectively) and further analyzed with AVIZO for mineral density, porosity and structure. Tissues were processed and stained histologically, and imaged using an Olympus BX51 microscope. RESULTS CPP contained pores (A) with a diameter range of 10-18µm (A, C), see figure. Micro-CT data demonstrated an interface with a lower mineral density of 765 ±172mg/cc between layers 1 and 2 (A in figure) compared to the average mineral density of 1049 ±142mg/cc. Interfacial zone between TA and CC contained tubules of diameter 18±3.5µm with mineralized lumen walls (A). Histological analyses of seemingly non-calcified regions adjacent to CPP, contained similar diameter tubules patent with erythrocytes (region 1 in B in figure), and were within a disorganized extracellular matrix (ECM) positive for increased expression of elastin (bottom row, elastin) within regions positive for alizarin red (bottom row, AR: mineral). These patterns were consistently observed at the interface between TA and CC regions. CONCLUSIONS The branch-like structure of 10-18µm pores is similar to that of the venous structure at the interface between the TA and CC, suggesting that cells within and around the small diameter vessel could play a role in biomineralization, likely following an insult on the outer layers of the TA. Increased expression of elastin alters ECM stiffness within the outer TA prompting a change in smooth muscle stiffness of the CC, and collectively over time can receive signals from the interface to accelerate biomineralization along the length of the penis. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e587 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Matthew Hennefarth More articles by this author Ling Chen More articles by this author Misun Kang More articles by this author Ryan Hsi More articles by this author Amanda Reed-Maldonado More articles by this author Guiting Lin More articles by this author Marshall Stoller More articles by this author Tom Lue More articles by this author Sunita Ho More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...