| Summary: | 碩士 === 國立成功大學 === 臨床醫學研究所 === 98 === Ejaculatory dysfunction (EjD) is a common problem among men with age more than 50 years old. Reported prevalence rates of EjD in men age 50 and older are 3% to 35% in Caucasian and 68% in Asian population, respectively. However, to date, the prevalence rate of EjD in Taiwanese men has not been reported. Clinically, although several risk factors have been linked to the development of EjD, the causes of EjD at the molecular level remain largely unknown. In this study, Male Sexual Health Questionnaire-Ejaculatory domain was delivered to 500 men with age ranged between 20 to 80 years old. The questionnaire retrieval rate was 75.6%. The results showed that the prevalence of EjD was 18% versus 50% in Taiwanese men with age less versus more than 50 years old, respectively. Men with EjD in the elderly tend to have presentations of anejaculation, delay ejaculation, decreased ejaculatory strength, volume, orgasm pleasure and increased frequency of painful ejaculation. Then cDNA microarray analysis was used to identify the seminal vesicle (SV) genes that are differentially expressed in elderly men with and without EjD. Those genes were uploaded into Ingenuity Pathway Analysis software analysis, and a number of significantly associated networks were generated. Of those associated networks, inflammation responses related network reveals the top one significant network. To validate the mRNA expressions, eight genes were randomly selected from this network for further transcript level quantification. The results of qRT-PCR were generally consistent with the results of microarray, showing the significant up-regulation of KLK3, MMP14, MMP3, TIMP4, UBE2B, and significant down-regulation of MMP-7. Increasing activity of inflammation related genes in EjD implies that inflammation is one of the predisposing factors related to EjD in the elderly. In addition, aging related EjD were further studied in an in vivo rat model. By measuring the SV response to electrostimulation in 24-, 40-, 80-wk-old rat groups, the declining tendency in ejaculation strength, ejaculation duration, and ejaculation volume were noted in aging rats. Collagen fiber content, the end product of inflammation reaction, was further evaluated in the SV tissues in rats of different age. Significant higher percentages of collagen fiber content was noted in 80-wk-old rats compared to those in 24-wk-old rats, suggesting that alternation of SV histological components may lead to SV dysfunction. To the best of our knowledge, this is the first study provides an overview of the prevalence and presentations of EjD in men age between 20 to 80 years old in Taiwan. In addition, our data provide the potential causative roles of inflammatory processes in EjD. A better understanding of these networks will bring us closer to an understanding of the molecular mechanisms underlying the causes of EjD.
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