Regele, Eric J.

Abstract Introduction Peyronie’s disease (PD) is a fibrosing condition of the tunica albuginea characterized by a palpable plaque with varying impacts on the patient’s erection: curvature, shortening, indentations, hinging, and concentric narrowing. Stepwise intralesional injection of collagenase clostridium histolyticum (Xiaflex) is the only FDA approved medical treatment for PD. We retrospectively reviewed Xiaflex treated patients for satisfaction with therapy or pursuit of subsequent surgery. Objective To assess satisfaction of Xiaflex treatment without subsequent surgical intervention. Methods This is a retrospective review of patients presenting with PD to a single center and managed by a single provider with six-month follow-up after treatment. Patient presentations were recorded in an Institutional Review Board approved database. Data storage and analytics were conducted using REDCap. Results The cohort for this study was 81 men treated with intralesional Xiaflex. 71.6% of patients (58/81) were satisfied with Xiaflex outcomes and sought no further therapy. 27.2% of patients (22/81) were not satisfied with their outcomes and 12 (14.8%) elected subsequent surgical interventions: 6 penile plications, 2 incision and graftings and 4 inflatable penile prostheses. 63.3% of patients had full (8) Xiaflex treatment. Among the 50 who had full Xiaflex treatment, 12% had surgery after Xiaflex. Among the patients who had partial Xiaflex treatment 20.7% had surgery following Xiaflex. The degrees of curvature in patients receiving Xiaflex was: < 60 (n = 42), ≥ 60 (34) and hourglass deformity (n = 4). Among the 12 patients who had surgery following Xiaflex, 6 men received 8 Xiaflex treatments, and 1 patient each received 2, 4, 5, 6, and 7 Xiaflex treatments. Conclusions If successful medical management of Peyronie’s disease is defined by men who do not seek subsequent surgical intervention following therapy, Xiaflex was highly successful. In our series of 81 patients, only 14.8% sought surgical interventions following intralesional collagenase histolyticum. Disclosure No.

Facial motoneuron (FMN) survival is mediated by CD4+ T cells in an interleukin-10 (IL-10)-dependent manner after facial nerve axotomy (FNA), but CD4+ T cells themselves are not the source of this neuroprotective IL-10. The aims of this study were to (1) identify the temporal and cell-specific induction of IL-10 expression in the facial motor nucleus and (2) elucidate the neuroprotective capacity of this expression after axotomy. Immunohistochemistry revealed that FMN constitutively produced IL-10, whereas astrocytes were induced to make IL-10 after FNA. Il10 mRNA co-localized with microglia before and after axotomy, but microglial production of IL-10 protein was not detected. To determine whether any single source of IL-10 was critical for FMN survival, Cre/Lox mouse strains were utilized to selectively knock out IL-10 in neurons, astrocytes, and microglia. In agreement with the localization data reflecting concerted IL-10 production by multiple cell types, no single cellular source of IL-10 alone could provide neuroprotection after FNA. These findings suggest that coordinated neuronal and astrocytic IL-10 production is necessary for FMN survival and has roles in neuronal homeostasis, as well as neuroprotective trophism after axotomy.