—Dr. Trost Commentary and Key Take-home Points—
This is a great proof of concept study and goes directly after one of the mechanisms that is thought to contribute to Peyronie’s Disease. The challenge with a therapy such as this, though, is that often, men are not even aware of the condition until the fibrotic tissue has already formed. In that case, even if this therapy were effective at preventing scarring, it would be too late in nearly every case. So, the key to make a therapy such as this effective is finding a way to detect the onset of Peyronie’s Disease as quickly as possible. Additionally, one other challenge with treatments like this is that it’s possible that Peyronie’s Disease actually occurs because of the body’s response to the development of a benign (not cancerous) tumor in the penis that then leads to the scar tissue. This is not well known among Peyronie’s experts. If that is indeed the case, then treatments such as this are going after the wrong mechanisms altogether. Rather than trying to stop the body from fighting the tumor, therapies should be aimed at preventing development of the tumor or more effectively / quickly treating the tumor before it can lead to rapid changes in the penis. This may be one reason that intralesional interferon has shown better promise as a treatment compared to things such as verapamil (since it helps the body fight off processes such as tumors).
Verteporfin is a drug used mainly to treat macular degeneration by weakening fibrotic tissue. This objective of this study is to see if verteporfin would work in a similar fashion for fibrotic plaques in patients with Peyronie’s disease.
Five patients who underwent incision and grafting consented to plaque tissue samples being collected to test the myofibroblasts with verteporfin. The myofibroblasts were isolated and starved for 16 hours, then exposed to verteporfin. The samples were split into 3 groups: control, 24-hour and 48-hour exposure to verteporfin.
All groups of myofibroblasts responded to the verteporfin treatment, proving its long-lasting anti-fibrotic effects. It is known that the Peyronie’s disease plaques contain myofibroblasts and this study shows that verteporfin inhibits growth by down-regulation of fibrosis-associated genes. Further investigation should be made, as verteporfin could benefit patients with both acute and chronic phase Peyronie’s disease.
Reference for Article
“Verteporfin as a Medical Treatment in Peyronie’s Disease” Mohede, Daan C.J. et al.Sexual Medicine, Volume 6, Issue 4, 302 – 308 Article Link: https://www.smoa.jsexmed.org/article/S2050-1161(18)30082-5/fulltext