FIBRIN DEPOSITION IN PEYRONIES-DISEASE PLAQUE

Purpose: Peyronie's disease is a pathological fibrosis characterized b y excessive deposition of collagen in the plaque. Although the etiolog y of Peyronie's disease is unknown, trauma has been hypothesized as th e inciting event. In an effort to obtain more insight into the pathoge nesis of Peyronie's disease plaque tissue was examined for collagen, e lastic fiber, and fibrin content and distribution. Materials and Metho ds: Plaque tissue specimens from 33 patients with Peyronie's disease, control penile tissue and nodular tissue from 8 patients with Dupuytre n's contracture were analyzed histochemically for collagen staining an d elastic fiber structure and distribution. Plaque tissue from 19 Peyr onie's disease patients, control tissue and nodular tissue from Dupuyt ren's disease were also analyzed for the presence of fibrin by histoch emical staining and immunoblotting. Results: Aberrantly stained collag en was detected in 32 of 33 plaque specimens (97%) and disrupted elast ic fibers in 31 of the same specimens (94%). Fibrin deposition was det ected histochemically in plaque tissue from 18 of 19 patients (95%) bu t it was not detectable in normal or scarred tunica from control patie nts. The presence of authentic fibrin accumulation in plaque tissue wa s confirmed by immunoblot analysis but fibrin was not detected in derm al tissue extracts from the same patient. Aberrant collagen staining a nd fibrin deposition were detected in nodular tissue from 7 of 8 Dupuy tren's contracture patients (88%) and altered elastic fibers in 5 of t he same patients (63%). Conclusions: Deposition of fibrin in plaque ti ssue is consistent with the hypothesis that repetitive microvascular i njury results in fibrin deposition in the tissue space and has served to provide insights into the pathophysiology of Peyronie's disease. We propose a model that accounts for the clinical and biological feature s of Peyronie's disease.