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BioMed Research International
Volume 2014, Article ID 616149, 10 pages
Research Article

The Role of Intrinsic Pathway in Apoptosis Activation and Progression in Peyronie’s Disease

1Department of Bio-Medical Sciences, Anatomy and Histology Section, University of Catania, Via S. Sofia 87, 95123 Catania, Italy
2Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90100 Palermo, Italy
3Department G.F. Ingrassia Section of Anatomic Pathology University of Catania, 95123 Catania, Italy
4Department of Urology, School of Medicine Tor Vergata University of Rome, 00133 Rome, Italy
5University College London Hospital, London WC1E 6BT, UK
6Cranfield Health Cranfield University, MK43 0AL, UK
7Sava Perovic Foundation, Center for Genito-Urinary Reconstructive Surgery, 11000 Belgrade, Serbia
8Clinic of Urology, Clinical Center Nis, 18000 Nis, Serbia

Received 26 February 2014; Accepted 31 May 2014; Published 13 August 2014

Academic Editor: Ralf Herwig

Copyright © 2014 Carla Loreto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Peyronie’s disease (PD) is characterized with formation of fibrous plaques which result in penile deformity, pain, and erectile dysfunction. The aim of this study was to investigate the activation of the intrinsic apoptotic pathway in plaques from PD patients. Tunica albuginea from either PD or control patients was assessed for the expression of bax, bcl-2 and caspases 9 and 3 using immunohistochemistry and by measurement of apoptotic cells using TUNEL assay. Bax overexpression was observed in metaplastic bone tissue, in fibroblasts, and in myofibroblast of plaques from PD patients. Little or no bcl-2 immunostaining was detected in samples from either patients or controls. Caspase 3 immunostaining was very strong in fibrous tissue, in metaplasic bone osteocytes, and in primary ossification center osteoblasts. Moderate caspase 9 immunostaining was seen in fibrous cells plaques and in osteocytes and osteoblasts of primary ossification centers from PD patients. Control samples were negative for caspase 9 immunostaining. In PD patients the TUNEL immunoassay showed intense immunostaining of fibroblasts and myofibroblasts, the absence of apoptotic cells in metaplasic bone tissue and on the border between fibrous and metaplastic bone tissue. Apoptosis occurs in stabilized PD plaques and is partly induced by the intrinsic pathway.