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Wang C, Zhang H, Wang F, Guo J, Yuan J, Hou G, Gao M, Li Z, Zhang Y. Efficacy and safety of PDE5 inhibitors in middle-aged and old patients with and without hypogonadism. Aging Male 2024; 27:2288347. [PMID: 38146937 DOI: 10.1080/13685538.2023.2288347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/19/2023] [Indexed: 12/27/2023] Open
Abstract
PURPOSE Although several reviews have evaluated the use of PDE5 inhibitors (PDE5i) for treating erectile dysfunction (ED), their specific use in middle-aged and old patients has not been fully evaluated. Given that elderly patients with ED often have a complex combination of systemic and sexual health risk factors, the safety and efficacy of PDE5i in such a context are hereby reviewed. MATERIALS AND METHODS A thorough examination of existing literature has been conducted on PubMed. RESULTS PDE5i has good safety and efficacy, but the situation is more complex for patients with hypogonadism than those with normal testosterone levels, with reduced responsiveness to PDE5i. In this case, combination therapy with testosterone is recommended, safe and effective. CONCLUSIONS Eliminating or reducing reversible risk factors and controlling or slowing the development of irreversible factors is an important foundation for using PDE5i to treat ED in all patients, especially middle-aged and elderly ones.
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Affiliation(s)
- Chunlin Wang
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Hui Zhang
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fu Wang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun Guo
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Guangdong Hou
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ming Gao
- Department of Andrology, Xi'an Daxing Hospital affiliated to Yan'an University, Xi'an, China
| | - Zheng Li
- Shanghai Key Laboratory of Reproductive Medicine, Department of Andrology, Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, 3rd Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Adebayo AA, Ademosun AO, Oboh G. Date ( Phoenix dactylifera L. Mill) fruit enhances sexual performance via modulation of oxido-inflammatory mediators and purinergic signaling in hypertensive male rats. Biomarkers 2024; 29:143-153. [PMID: 38483941 DOI: 10.1080/1354750x.2024.2331502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION The present study aimed at investigating the effect of dietary supplementation of Phoenix dactylifera, an important component of aphrodisiac supplements, on sexual performance, oxido-inflammatory mediators and purinergic signaling system in hypertensive rats. MATERIAL AND METHODS Hypertension was induced via oral administration of 40 mg/kg L-NAME. Thereafter, the sexual performance of the experimental animals was determined and the hypertensive rats with impaired sexual activities were placed on P. dactylifera-supplemented diet for 21 days, and the effects of the treatment on the overall sexual behavior, antioxidant status, oxido-inflammatory biomarkers, and enzyme activity of the purinergic system were assessed. RESULTS Hypertensive rats showed a significant (p < 0.05) decrease in sexual performance, elevated level of oxido-inflammatory mediators, and altered purinergic enzymes activity when compared with the control. However, sub-chronic feeding with P. dactylifera-supplemented diet improved sexual performance, significantly lowered oxido-inflammatory biomarkers, and enhanced the activity of purinergic enzymes in hypertensive rats. CONCLUSION Findings presented in this study suggest that dietary inclusion of P. dactylifera could be useful in managing erectile dysfunction (ED) commonly observed in subjects with hypertension. Findings highlighted in this study thus provide the scientific basis supporting the folkloric use of P. dactylifera as a key ingredient in aphrodisiac supplements.
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Affiliation(s)
- Adeniyi A Adebayo
- Department of Biochemistry, Joseph Ayo Babalola University, Ikeji Arakeji, Nigeria
- Functional Foods and Nutraceutical Unit, Department of Biochemistry, Federal University of Technology, Akure, Nigeria
| | - Ayokunle O Ademosun
- Functional Foods and Nutraceutical Unit, Department of Biochemistry, Federal University of Technology, Akure, Nigeria
| | - Ganiyu Oboh
- Functional Foods and Nutraceutical Unit, Department of Biochemistry, Federal University of Technology, Akure, Nigeria
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Huang Y, Wang Y, Su H, Wang H, Xu H, Xu C, Zhou F, Zhang Y. Association between polyunsaturated fatty acid intake and the prevalence of erectile dysfunction: A cross-sectional analysis of the NHANES 2001-2004. Lipids Health Dis 2023; 22:182. [PMID: 37880723 PMCID: PMC10601238 DOI: 10.1186/s12944-023-01950-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/18/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Polyunsaturated fatty acids (PUFAs) have demonstrated significant therapeutic potential across a wide range of disease. The aim of this study was to investigate the potential impact of PUFA intake on the prevalence of erectile dysfunction (ED). METHODS The study included a total of 3730 participants from the National Health and Nutrition Examination Survey (NHANES) 2001-2004. Univariate analysis, multivariate regression analysis, subgroup analysis and machine learning were utilized to explore the relationship of variables to ED. Dose response curves were constructed to observe the linear or nonlinear relationship between PUFA intake and the prevalence of ED. Propensity score matching (PSM) was used for sensitivity analysis. Finally, the potential mechanistic link between PUFA intake and ED was explored. RESULTS Through univariate and multivariate regression analysis results before and after PSM and XGBoost algorithm model results, arachidonic acid (AA) was chosen as the main research object. The consumption of AA was found to be associated with a decreased prevalence of ED under the fully adjusted model [OR = 0.33 (0.20, 0.56), P < 0.001]. The interaction between AA and education was found in the subgroup analysis. Dose-response curves indicated a linear negative correlation between AA intake and the prevalence of ED. The above results were confirmed in the data analysis after 1:1 PSM. In addition, AA intake was associated with a decrease in inflammatory biomarkers and homocysteine. CONCLUSIONS The results suggest that AA intake is negatively correlated with the prevalence of ED. Further, anti-inflammatory and anti-endothelial damage may play a role in this.
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Affiliation(s)
- Yong Huang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yingying Wang
- Department of Oncology, People Hospital of Jiulongpo District, Chongqing, 400050, China
| | - Huiyi Su
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Hexi Wang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Haoyu Xu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Chengwei Xu
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Fulin Zhou
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yao Zhang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Shao K, Chen W, Li Y, Zheng H, Hu R, Zhang J, Sun T. Effects of heart failure and coronary artery disease on erectile dysfunction: a two-sample mendelian randomization study. BMC Urol 2023; 23:163. [PMID: 37833702 PMCID: PMC10576338 DOI: 10.1186/s12894-023-01335-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND AND AIMS There are no clear conclusions as to whether heart failure (HF) and coronary heart disease (CAD) increase the risk of erectile dysfunction (ED).In our study, we used Mendelian randomization (MR) analysis to discover a causal relationship between HF, CAD and ED. METHODS Single nucleotide polymorphisms (SNPs) associated with HF, CAD and ED were obtained from the MRC IEU Open Genome-Wide Association Study (GWAS) database.After a series of screenings, the remaining SNPs were selected as instrumental variables (IVs) for HF and CAD for MR analysis to assess the relationship between genetically predicted HF or CAD and the pathogenesis of ED.Among them, we used the random-effects inverse variance weighted (IVW) method as the primary analysis method.Finally, Cochran's q-test, funnel plots, MR-Egger regression, Leave-one-out method and MR-PRESSO were used for sensitivity analysis. RESULTS In the IVW method, there was no significant causal relationship between genetically predicted HF and CAD and the incidence of ED.(HF: OR = 1.17, 95% CI 0.99-1.39; p = 0.074;CAD: OR = 1.08, 95% CI 0.99-1.17, p = 0.068)。The results of sensitivity analyses supported our conclusion that no horizontal pleiotropism was found. CONCLUSION This study did not find a causal relationship between HF or CAD and ED in European populations, which requires further in-depth research.
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Affiliation(s)
- Kaiyang Shao
- The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road,Shangcheng District Hangzhou, 310009, Hangzhou, Zhejiang, China
| | - Weikang Chen
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yaling Li
- The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road,Shangcheng District Hangzhou, 310009, Hangzhou, Zhejiang, China
| | - Huiyan Zheng
- The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road,Shangcheng District Hangzhou, 310009, Hangzhou, Zhejiang, China
| | - Ruying Hu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road,Shangcheng District Hangzhou, 310009, Hangzhou, Zhejiang, China
| | - Jianqiao Zhang
- The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road,Shangcheng District Hangzhou, 310009, Hangzhou, Zhejiang, China
| | - Ting Sun
- The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road,Shangcheng District Hangzhou, 310009, Hangzhou, Zhejiang, China.
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Effect of angiotensin receptor-neprilysin inhibitor treatment on erectile dysfunction in heart failure with a reduced ejection fraction. MARMARA MEDICAL JOURNAL 2023. [DOI: 10.5472/marumj.1244456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective: Erectile dysfunction (ED) is a common condition in patients with heart failure (HF), which impairs quality of life. Our
study aimed to compare those patients, who received traditional treatment with a diagnosis of HF and those who received angiotensin
receptor-neprilysin inhibitor (ARNI) treatment in addition to the current treatment, in terms of ED at the end of 6 months.
Patients and Methods: The study was planned as a single-center, prospective study. The study included 200 patients with heart
failure. The patients’ demographic, clinical, and echocardiographic characteristics were recorded, and an international ED scoring
questionnaire was applied. The participants in the study were divided into two groups: those who received ARNI treatment and those
who did not. After 6 months, the ED questionnaire was applied to the patients again and the groups were compared.
Results: The median age of the patients was 53 (years). The median ejection fraction (EF) value was calculated to be 30% and no
significant difference was found between the groups (p: 0.122). It was found that N-terminal pro-brain natriuretic peptide (NT-pro-
BNP) levels measured at the end of the 6th month were significantly lower in patients who had received ARNI treatment than in those
who had not (respectively, 245 pg/ml, 200 pg/ml; p: 0.003). In the analysis performed to detect the presence of ED, it was discovered
that the ED score change was significantly higher in the group that had received 6 months of ARNI treatment (p: 0.031) compared to
that in the group that had not (p: 0.031). When the ED sub-parameters were compared in terms of the 6-month change rate, it was
found that the ARNI group had a significant increase in terms of ED and sexual satisfaction scores, but no significant difference was
found in the other parameters (p: 0.001, p: 0.029).
Conclusion: Erectile dysfunction is more common in patients with heart failure compared to the rest of society and impairs quality of
life. In our study, it was determined that ED complaints decreased significantly in HF patients, who had received ARNI treatment for
6 months than in patients who had not.
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Tang Z, Song J, Yu Z, Cui K, Ruan Y, Liu Y, Wang T, Wang S, Liu J, Yang J. Inhibition of MicroRNA-92a Improved Erectile Dysfunction in Streptozotocin-Induced Diabetic Rats via Suppressing Oxidative Stress and Endothelial Dysfunction. World J Mens Health 2023; 41:142-154. [PMID: 35274504 PMCID: PMC9826907 DOI: 10.5534/wjmh.210177] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/17/2021] [Accepted: 12/08/2021] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To determine whether microRNA could be a therapy target of erectile dysfunction (ED) and the underlying mechanisms. MATERIALS AND METHODS Eight-week-old fasting male SD rats were intraperitoneally injected with streptozotocin to construct diabetic rat models. Diabetic ED rats were treated with miRNA-92a inhibitor. The cavernous nerves were electrically stimulated to measure the intracavernous pressure and mean arterial pressure of rats in each group. After the detection, the penile cavernous tissues are properly stored for subsequent experiments. Rat aortic endothelial cells were used in in vitro studies. RESULTS The expression of miR-92a was significantly increased in the corpus cavernosum of Streptozocin (STZ)-induced diabetic rats and injection of miR-92a antagomir into the corpus cavernosum of diabetic rats significantly increased eNOS/NO/cGMP signaling pathway activities, cavernous endothelial cell proliferation, endothelial cell-cell junction protein expression and decreased the levels of oxidative stress. These changes restored erectile function in STZ-induced diabetic rats. Moreover, in vitro study demonstrated that the miR-92a expression increased significantly in endothelial cells treated with high glucose, inhibiting AMPK/eNOS and AMPK/Nrf2/HO-1 signaling pathways in rat aortic endothelial cells via targeting Prkaa2, causing endothelial dysfunction and overactive oxidative stress, miR-92a inhibitor can improve the above parameters. CONCLUSIONS miRNA-92a inhibitor could exert an inhibition role on oxidative stress and endothelial dysfunction to improve diabetic ED effectively.
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Affiliation(s)
- Zhe Tang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jingyu Song
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhe Yu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kai Cui
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yajun Ruan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yang Liu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jun Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Wiemer L, Bartelheimer T, Raschke R, Miller K. [First data from a digital health app for erectile dysfunction]. UROLOGIE (HEIDELBERG, GERMANY) 2022; 61:971-981. [PMID: 35925101 PMCID: PMC9424143 DOI: 10.1007/s00120-022-01872-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 06/29/2023]
Abstract
PURPOSE In a systematic data analysis, we evaluated the influence of a digital health app on erection scores as well as life quality and patient activation in a group of patients with erectile dysfunction. METHODS In all, 44 participants took part in an evidence-based program for patients with erectile dysfunction. The in app 12-week program included pelvic floor exercises and physiotherapeutic and cardiovascular training. In addition, there where sessions on mindfulness and sexual therapy as well as useful information about erectile dysfunction and its causes, nutrition, and risk factors. The median age was 46 years (19-75 years). All patients answered IIEF‑5, PAM-13 and QoL-Med questionnaires at the beginning and the end of the program. A total of 27 questionnaires could be evaluated at both times. RESULTS The average improvement in IIEF‑5 score was 4.5 points (p < 0.0001). 96% of patients showed overall improvement of erection scores. Improvement in life quality was shown in 93% of participants. Moreover, there was a significant increase in patient activation scores. CONCLUSION We were able to show that a multimodal digital app for self-management of erectile dysfunction improved not only erection scores but also life quality and patient activation. We concluded that it is possible to reproduce results of analog studies in a digital setting. Digital solutions can help to include patients in their treatment and to put guideline suggestions into practice.
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Affiliation(s)
- L Wiemer
- Pro Uro, Berlin, Deutschland
- Charité, Universitätsmedizin Berlin, Berlin, Deutschland
- Kranus Health GmbH, München, Deutschland
| | | | - R Raschke
- Urologische Facharztpraxis Ralph Raschke, Teltow, Deutschland
| | - K Miller
- Charité, Universitätsmedizin Berlin, Berlin, Deutschland.
- Urologische Klinik, Charité - Universitätsmedizin Berlin, Charitépl. 1, 10117, Berlin, Deutschland.
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Endothelial Dysfunction, Erectile Deficit and Cardiovascular Disease: An Overview of the Pathogenetic Links. Biomedicines 2022; 10:biomedicines10081848. [PMID: 36009395 PMCID: PMC9405076 DOI: 10.3390/biomedicines10081848] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/22/2022] Open
Abstract
Erectile dysfunction (ED) is a condition with multifactorial pathogenesis, quite common among men, especially those above 60 years old. A vascular etiology is the most common cause. The interaction between chronic inflammation, androgens, and cardiovascular risk factors determines macroscopically invisible alterations such as endothelial dysfunction and subsequent atherosclerosis and flow-limiting stenosis that affects both penile and coronary arteries. Thus, ED and cardiovascular disease (CVD) should be considered two different manifestations of the same systemic disorder, with a shared aetiological factor being endothelial dysfunction. Moreover, the penile arteries have a smaller size compared with coronary arteries; thus, for the same level of arteriopathy, a more significant blood flow reduction will occur in erectile tissue compared with coronary circulation. As a result, ED often precedes CVD by 2–5 years, and its diagnosis offers a time window for cardiovascular risk mitigation. Growing evidence suggests, in fact, that patients presenting with ED should be investigated for CVD even if they have no symptoms. Early detection could facilitate prompt intervention and a reduction in long-term complications. In this review, we provide an overview of the pathogenetic mechanisms behind arteriogenic ED and CVD, focusing on the role of endothelial dysfunction as the common denominator of the two disorders. Developed algorithms that may help identify those patients complaining of ED who should undergo detailed cardiologic assessment and receive intensive treatment for risk factors are also analyzed.
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Cignarelli A, Genchi VA, D’Oria R, Giordano F, Caruso I, Perrini S, Natalicchio A, Laviola L, Giorgino F. Role of Glucose-Lowering Medications in Erectile Dysfunction. J Clin Med 2021; 10:jcm10112501. [PMID: 34198786 PMCID: PMC8201035 DOI: 10.3390/jcm10112501] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 01/11/2023] Open
Abstract
Erectile dysfunction (ED) is a long-term complication of type 2 diabetes (T2D) widely known to affect the quality of life. Several aspects of altered metabolism in individuals with T2D may help to compromise the penile vasculature structure and functions, thus exacerbating the imbalance between smooth muscle contractility and relaxation. Among these, advanced glycation end-products and reactive oxygen species derived from a hyperglycaemic state are known to accelerate endothelial dysfunction by lowering nitric oxide bioavailability, the essential stimulus of relaxation. Although several studies have explained the pathogenetic mechanisms involved in the generation of erectile failure, few studies to date have described the efficacy of glucose-lowering medications in the restoration of normal sexual activity. Herein, we will present current knowledge about the main starters of the pathophysiology of diabetic ED and explore the role of different anti-diabetes therapies in the potential remission of ED, highlighting specific pathways whose activation or inhibition could be fundamental for sexual care in a diabetes setting.
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Environmental Factors-Induced Oxidative Stress: Hormonal and Molecular Pathway Disruptions in Hypogonadism and Erectile Dysfunction. Antioxidants (Basel) 2021; 10:antiox10060837. [PMID: 34073826 PMCID: PMC8225220 DOI: 10.3390/antiox10060837] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 01/09/2023] Open
Abstract
Hypogonadism is an endocrine disorder characterized by inadequate serum testosterone production by the Leydig cells of the testis. It is triggered by alterations in the hypothalamic–pituitary–gonadal axis. Erectile dysfunction (ED) is another common disorder in men that involves an alteration in erectile response–organic, relational, or psychological. The incidence of hypogonadism and ED is common in men aged over 40 years. Hypogonadism (including late-onset hypogonadism) and ED may be linked to several environmental factors-induced oxidative stresses. The factors mainly include exposure to pesticides, radiation, air pollution, heavy metals and other endocrine-disrupting chemicals. These environmental risk factors may induce oxidative stress and lead to hormonal dysfunctions. To better understand the subject, the study used many keywords, including “hypogonadism”, “late-onset hypogonadism”, “testosterone”, “erectile dysfunction”, “reactive oxygen species”, “oxidative stress”, and “environmental pollution” in major online databases, such as SCOPUS and PUBMED to extract relevant scientific information. Based on these parameters, this review summarizes a comprehensive insight into the important environmental issues that may have a direct or indirect association with hypogonadism and ED in men. The study concludes that environmental factors-induced oxidative stress may cause infertility in men. The hypothesis and outcomes were reviewed critically, and the mechanistic approaches are applied through oxidant-sensitive pathways. This study also provides reccomendations on future therapeutic interventions and protective measures against such adverse environmental factors-induced hypogonadism and ED.
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Tiraboschi RB, Neto FSL, da Cunha Tirapelli DP, de Bessa J, Miranda EP, de Assis Cirino ML, Tirapelli LF, Tucci S, Molina CAF. Expression of MicroRNAs (miR-15b, miR-16, miR-138, miR-221, and miR-222) as Biomarkers of Endothelial Corpus Cavernosum Dysfunction in a Diabetic Alcoholic Murine Model. Sex Med 2021; 9:100326. [PMID: 33676226 PMCID: PMC8072178 DOI: 10.1016/j.esxm.2021.100326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION MicroRNAs (miRNAs) are short noncoding RNA molecules that regulate gene expression and are related to endothelial dysfunction (EnD). Recently, miRNAs have also been explored as potential biomarkers and target molecular therapy of erectile dysfunction (ED). Could the miRNAs be the tip of the iceberg of chronic arterial disease foreshadowed by the ED? AIM To investigate the expression of miR-15b, miR-16, miR-138, miR-221, and miR-222 in corpus cavernosum (CC) and peripheral blood in a rat model of endothelium dysfunction secondary to diabetes (DM) and alcohol consumption to assess potential endothelial lesion biomarkers. METHODS Twenty males Wistar rats were divided into 4 groups: control group (C), alcohol consumption group (A), diabetic group (D), diabetic-alcohol consumption group (D + A). DM was alloxan-induced and alcohol consumption was through progressive increase of ethanol concentration in drinkable water. After 7 weeks, miRNAs expressions from CC and blood sample were evaluated by real-time PCR. Functional assessment of CC was performed in an acetylcholine endothelium-dependent relaxation pharmacological study. MAIN OUTCOME MEASURE miRNA expression in CC and blood were evaluated; pharmacological study in CC strips was conducted to validate EnD. RESULTS We found that 3 miRNAs (miR-16, miR-221, and miR-222) were downregulated in the CC in the D+A group, while all 5 miRNAs were downregulated in the blood of D and D + A groups. The endothelium-dependent relaxation induced by acetylcholine was significantly decreased in groups A, D, and D + A. Diagnostic accuracy estimated by AUC, to discriminating groups A, D, and D + A from controls, was superior to >0.9 in all plasmatic miRNAs. CONCLUSION miRNAs downregulation was identified in both CC and blood notably in DM associated with alcohol consumption animals (D + A), the greatest endothelial injury potential group. Serum miRNAs have also demonstrated high diagnostic accuracy properties in predicting CC relaxation dysfunction labeling EnD. RB Tiraboschi, FSL Neto, DP da Cunha Tirapelli, et al. Expression of MicroRNAs (miR-15b, miR-16, miR-138, miR-221, and miR-222) as Biomarkers of Endothelial Corpus Cavernosum Dysfunction in a Diabetic Alcoholic Murine Model. Sex Med 2021;9:100326.
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Affiliation(s)
- Ricardo Brianezi Tiraboschi
- Department of Surgery, Division of Urology, Universidade Estadual de Feira de Santana, Medical School, State University of Feira de Santana, Feira de Santana, Brazil; Division of Urology, University of São Paulo, Ribeirão Preto Medical School, Surgery and Anatomy, Ribeirao Preto, São Paulo, Brazil
| | | | | | - Jose de Bessa
- Department of Surgery, Division of Urology, Universidade Estadual de Feira de Santana, Medical School, State University of Feira de Santana, Feira de Santana, Brazil
| | | | - Mucio Luiz de Assis Cirino
- University of São Paulo, Ribeirão Preto Medical School, Surgery and Anatomy, Ribeirao Preto, São Paulo, Brazil
| | - Luis Fernando Tirapelli
- University of São Paulo, Ribeirão Preto Medical School, Surgery and Anatomy, Ribeirao Preto, São Paulo, Brazil
| | - Silvio Tucci
- Division of Urology, University of São Paulo, Ribeirão Preto Medical School, Surgery and Anatomy, Ribeirao Preto, São Paulo, Brazil
| | - Carlos Augusto Fernandes Molina
- Division of Urology, University of São Paulo, Ribeirão Preto Medical School, Surgery and Anatomy, Ribeirao Preto, São Paulo, Brazil
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12
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Gupta A, Priyadarshi S, Vyas N, Sharma G, Swain PK. Novel predictive risk factor for Erectile Dysfunction: Serum folic acid. Andrologia 2020; 53:e13890. [PMID: 33141950 DOI: 10.1111/and.13890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/04/2020] [Indexed: 12/26/2022] Open
Abstract
The purpose of this study was to compare the serum Folic Acid (FA) levels in patients with Erectile Dysfunction (ED) and healthy controls and whether levels vary with its severity. The study was carried out on 77 sexually active individuals, out of which 41 complained of ED and 36 were apparently normal. Patients were excluded if they had any diseases known to cause ED. The severity was further categorised based on IIEF-5 scores. Blood serum levels of testosterone, lipid profile, random blood sugar, liver function test, renal function test and FA levels were obtained in each patient. Independent-samples t test of significance was used when comparing between two means. Pearson's correlation coefficient (r) test was used for correlating data. All clinical and biochemical parameters except FA were comparable in both the groups. FA levels were significantly decreased in ED group (5.29 vs. 10.8; p value = .004). Smoking habits were comparable between the groups, and FA levels did not vary among smokers and nonsmokers (p value = .46). Serum FA levels significantly declined with increasing severity of ED (8.28 vs. 5.56 vs. 4.37 vs. 3.5; p value < .001). Thus, decreased FA might possibly be one of the novel risk factors for ED.
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Affiliation(s)
- Abhimanyu Gupta
- Department of Urology and Renal Transplant, SMS Medical College and Hospital, Jaipur, India
| | - Shivam Priyadarshi
- Department of Urology and Renal Transplant, SMS Medical College and Hospital, Jaipur, India
| | - Nachiket Vyas
- Department of Urology and Renal Transplant, SMS Medical College and Hospital, Jaipur, India
| | - Govind Sharma
- Department of Urology and Renal Transplant, SMS Medical College and Hospital, Jaipur, India
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13
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Bahar A, Elyasi F, Moosazadeh M, Afradi G, Kashi Z. Sexual dysfunction in men with type II diabetes. CASPIAN JOURNAL OF INTERNAL MEDICINE 2020; 11:295-303. [PMID: 32874437 PMCID: PMC7442469 DOI: 10.22088/cjim.11.3.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: Diabetes mellitus (DM) is a chronic disease inducing short-term and long-term complications including sexual dysfunction (SD) which can consequently reduce patients’ quality of life. Given the limited literature on frequency of SD in men experiencing diabetes in northern Iran, the present study was conducted in the city of Sari in Mazandaran Province, with the aim of investigating SD in men with type II diabetes. Methods: Using a descriptive cross-sectional research design, a total number of 350 male patients suffering from type II diabetes referring to endocrinology clinics in the city of Sari in. The patients were requested to fill out the demographic questionnaire, depression, anxiety and stress scale-21 items (DASS-21) and the 15-question International Index of Erectile Function (IIEF). The data were analyzed using the IBM SPSS statistics software Results: The average period of time in which the patients were facing diabetes was 3.65±5.75 years. The IIEF mean score was equal to 16.98±43.79. Erectile dysfunction (ED) was also evident in 152 patients (62.2%). Moreover, increase in age had significantly decreased the IIEF scores (p<0.001). The chance of being affected with ED among diabetic patients above 50 was 11.21 times as much as those below 50 years of age (odds ratio (OR): 11.21, 95% confidence interval (CI): 6.40-19.62). Conclusion: Concerning the high prevalence rate of ED in men suffering from type II diabetes, doctors are required to directly ask them about sexual disorders in follow-up visits. Furthermore, using screening questionnaires can be helpful in identifying this problem.
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Affiliation(s)
- Adele Bahar
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Sexual and Reproductive Health Research Center, Addiction Institute, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ghasem Afradi
- Department of Internal Medicine, School Of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Kashi
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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14
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Sussman H, Labastie MN, Hauet P, Allaire E, Lombion S, Virag R. Ultrasonography after pharmacological stimulation of erection for the diagnosis and therapeutic follow-up of erectile dysfunction due to cavernovenous leakage. JOURNAL DE MÉDECINE VASCULAIRE 2020; 45:3-12. [PMID: 32057324 DOI: 10.1016/j.jdmv.2019.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/02/2019] [Indexed: 11/26/2022]
Abstract
The goal of this work was to demonstrate that Doppler ultrasound (DUS) after pharmacological stimulation of erection (PSE) can be used to evaluate the presence and intensity of a cavernovenous leak (CVL) suspected in erectile dysfunction (ED) patients. The study was built around 50 DUS-PSE exams of penile arteries and veins, which were carried out 3, 5, 10 and 20minutes after pharmacological stimulation. Measured parameters were end diastolic velocity of the cavernous arteries and mean velocity of the deep penile vein and/or penile superficial veins. A score from 0 to 3 was attributed to each according to the recorded velocities. A final score from 0 to 9 was established by adding the three values: patients quoting 0 and 1 were classified as "no leak" (n=8); from 2 to 9 (n=42) as "leaking". Penile computed tomography (CT-scan) under identical pharmacological stimulation identified the cavernovenous leak to be compared with the DUS-PSE results, which were valid in 47 cases (94%), with 97.6% sensitivity and 77.7% specificity. The kappa correlation coefficient for CT-scan diagnosis of suspected CVL was 0.7875 (P<0.001). In addition, we found that end diastolic velocity in the cavernous artery, considered up until now as the gold standard in cases of suspected CVL was insufficient (negative predictive value=47%). In addition to its well-known diagnostic value regarding ED of arterial origin, DUS-PSE is an excellent screening test for CVL, especially in young patients without vascular risk factors who are resistant to medical treatments. For those with well-established CVL, confirmation by CT-scan to discuss possible surgery should be the next step. Moreover, DUS-PSE is useful in postoperative monitoring.
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Affiliation(s)
- H Sussman
- Centre CETI, 8, rue de Duras, 75008 Paris, France
| | - M N Labastie
- Centre CETI, 8, rue de Duras, 75008 Paris, France; Service des explorations fonctionnelles cardiovasculaires, hôpital Henri-Mondor, 94000 Créteil, France
| | - P Hauet
- Cabinet de radiologie, 13, avenue de l'Opéra, 75001 Paris, France
| | - E Allaire
- Clinique Geoffroy-Saint-Hilaire, 59, rue Geoffroy-Saint-Hilaire, 75005 Paris, France
| | - S Lombion
- SLc conseil et expertise, 6, rue de l'Église, 25380 Chamesey, France
| | - R Virag
- Service des explorations fonctionnelles cardiovasculaires, hôpital Henri-Mondor, 94000 Créteil, France.
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15
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ALTUNÖREN O, ERKEN E, GÜNGÖR Ö, YAVUZ YC. Hipertansiyon ve Erektil Disfonksiyon. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2019. [DOI: 10.17517/ksutfd.477511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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16
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Effects of light-emitting diodes irradiation on human vascular endothelial cells. Int J Impot Res 2018; 30:312-317. [PMID: 30046164 DOI: 10.1038/s41443-018-0051-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 05/21/2018] [Accepted: 05/27/2018] [Indexed: 12/28/2022]
Abstract
Endothelial cell proliferation is a hallmark of angiogenesis and plays a key role in the process of tissue repair. Low-intensity (670 nm) laser irradiation influences endothelial cell proliferation in vitro. Light in the near infrared spectrum may have clinical applications in erectile dysfunction. The purpose of this study was to investigate the effects of irradiation with light-emitting diodes (LEDs) at different wavelengths on human vascular endothelial cells in vitro. Human umbilical vein endothelial cells (HUVECs) were irradiated with LEDs at 410, 480, 595, and 630 nm in doses of 1, 2.5, 5, and 10 J/cm2. After 24 h of LED irradiation, effects on cell viability, nitric oxide (NO) secretion, and eNOS expression were assessed by using cell viability assays, Western blot, and real time-polymerase chain reaction, respectively. The cell viability assay demonstrated that irradiation with LEDs at 630 nm significantly increased the proliferation of HUVECs. In addition, irradiation with LEDs at 630 nm was more effective in stimulating NO secretion and eNOS expression from HUVECs than irradiation with LEDs at 410, 480, and 595 nm. Irradiation with LEDs at 630 nm was effective for inducing cell proliferation, NO secretion, and eNOS expression in HUVECs. These results suggest that irradiation with LEDs at 630 nm may be a therapeutic strategy for vasculogenic erectile dysfunction.
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17
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Kałka D, Gebala J, Rusiecki L, Smoliński R, Dulanowski J, Rusiecka M, Biełous-Wilk A, Pilecki W, Womperski K, Zdrojowy R. Relation of Postexercise Reduction of Arterial Blood Pressure and Erectile Dysfunction in Patients with Coronary Heart Disease. Am J Cardiol 2018; 122:229-234. [PMID: 29751956 DOI: 10.1016/j.amjcard.2018.03.368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 12/23/2022]
Abstract
Penile erection is a hemodynamic process consisting of 2 synchronized components in which the first (active) requires proper vascular endothelium functioning, whereas the second one (passive) is based on a veno-occlusive mechanism. Antihypertensive treatment reduces the passive component, often leading to the development of erectile dysfunction (ED), but lifestyle modifications can improve the sexual functioning. The study aimed to evaluate the association between blood pressure (BP) reduction caused by cardiovascular training and the intensity of ED in men with coronary heart disease. A total of 101 men (mean age 59.50 ± 7.93) with ED treated invasively for coronary heart disease and subjected to cardiac rehabilitation were enrolled. Patient characteristics, the International Index of Erectile Function 5 (IIEF-5) questionnaire (IIEF-5), and BP values were collected at baseline and after 6 months of cardiac rehabilitation and were analyzed. Cardiac rehabilitation led to a significant reduction of 5.08 mm Hg in systolic BP (p <0.001) and of 1.60 mm Hg in diastolic BP (p <0.001). The IIEF-5 score (EQ) significantly increased (median 15, interquartile range 11 to 19 vs median 18, interquartile range 12 to 21, p <0.001). Greater improvement in sexual performance was significantly negatively correlated with age, concentration of triglycerides, and high-density lipoprotein, whereas it was positively correlated with the presence of diabetes and baseline IIEF-5 score. After excluding patients with diabetes, a greater decrease in systolic BP was found to be significantly associated with greater improvement in erectile performance. In conclusion, a reduction of arterial BP caused by cardiac training is accompanied by improvement in erectile performance. This effect is the strongest in patients with hypertension and those with dyslipidemia.
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18
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Lee SR, Kim KH, You HS, Fu J, Hsieh TCM, Bhargava V, Raj Rajasekaran M. Characterization of age-related penile microvascular hemodynamic impairment using laser speckle contrast imaging: possible role of increased fibrogenesis. Physiol Rep 2018; 5:5/21/e13481. [PMID: 29122956 PMCID: PMC5688777 DOI: 10.14814/phy2.13481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 09/17/2017] [Indexed: 02/07/2023] Open
Abstract
Current technology for penile hemodynamic evaluations in small animals is invasive and has limitations. We evaluated a novel laser speckle contrast imaging (LSCI) technique to determine age‐related changes in penile microvascular perfusion (PMP) and tested the role of cavernosal muscle (CC) fibrosis mediated by Wnt‐TGF β1 signaling pathways in a mouse model. Ten young (2–3 months) and old (24–28 months) wild‐type C57BL6 male mice were subjected to PMP measured using a LSCI system. Penile blood flow (PBF, peak systolic velocity, PSV) was also measured using a color Doppler ultrasound for comparison. Measurements were made before and after injection of vasoactive drugs: prostaglandin E1 (PGE1) and acetylcholine (ACh). CC was processed for immunohistochemical studies for markers of endothelium and fibrosis. Protein levels were quantified by Western blot.PMP and PBF increased significantly from baseline after injection of vasoactive drugs. Peak PMP after PGE1 and ACh was higher in young mice (225.0 ± 12.0 and 211.3 ± 12.1 AU) compared to old (155.9 ± 7.1 and 162.6 ± 5.1 AU, respectively). PSV after PGE1 was higher in young than old mice (112.7 ± 8.5 vs. 78.2 ± 4.6 mm/sec). PSV after ACh was also higher in young (112.7 ± 5.6 mm/sec) than older mice (69.2 ± 7.1 mm/sec). PMP positively correlated with PSV (r = 0.867, P = 0.001). Immunostaining and Western blot showed increased protein expression of all fibrosis markers with aging. LSCI is a viable technique for evaluating penile hemodynamics. Increased cavernosal fibrosis may cause impaired penile hemodynamics and increased incidence of erectile dysfunction in older men.
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Affiliation(s)
- Seung-Ryeol Lee
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California.,Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Ki-Ho Kim
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California.,Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
| | - Ho-Song You
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California.,Department of Urology, Chonnam National University Hospital, Gwangju, Korea
| | - Johnny Fu
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California
| | - Tung-Chin Mike Hsieh
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California
| | - Valmik Bhargava
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California
| | - M Raj Rajasekaran
- Departments of Urology and Medicine, VA San Diego Health Care System University of California, San Diego, California
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19
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Hyperbaric oxygen can induce angiogenesis and recover erectile function. Int J Impot Res 2018; 30:292-299. [DOI: 10.1038/s41443-018-0023-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/29/2018] [Accepted: 04/07/2018] [Indexed: 01/28/2023]
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20
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Silva AB, Sousa N, Azevedo LF, Martins C. Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis. Br J Sports Med 2016; 51:1419-1424. [DOI: 10.1136/bjsports-2016-096418] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 12/31/2022]
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21
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Castela A, Gomes P, Silvestre R, Guardão L, Leite L, Chilro R, Rodrigues I, Vendeira P, Virag R, Costa C. Vasculogenesis and Diabetic Erectile Dysfunction: How Relevant Is Glycemic Control? J Cell Biochem 2016; 118:82-91. [PMID: 27237706 DOI: 10.1002/jcb.25613] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 05/26/2016] [Indexed: 12/16/2022]
Abstract
Erectile dysfunction (ED) is a complication of diabetes, condition responsible for causing endothelial dysfunction (EDys) and hampering repair mechanisms. However, scarce information is available linking vasculogenesis mediated by Endothelial Progenitor Cells (EPCs) and diabetes-associated ED. Furthermore, it remains to be elucidated if glycemic control plays a role on EPCs functions, EPCs modulators, and penile vascular health. We evaluated the effects of diabetes and insulin therapy on bone marrow (BM) and circulating EPCs, testosterone, and systemic/penile Stromal Derived Factor-1 alpha (SDF-1α) expression. Male Wistar rats were divided into groups: age-matched controls, 8-weeks streptozotocin-induced type 1 diabetics, and insulin-treated 8-weeks diabetics. EPCs were identified by flow cytometry for CD34/CD133/VEGFR2/CXCR4 antigens. Systemic SDF-1α and testosterone levels were evaluated by ELISA. Penile SDF-1α protein expression was assessed, in experimental and human diabetic cavernosal samples, by immunohistochemical techniques. Diabetic animals presented a reduction of BM-derived EPCs and an increase in putative circulating endothelial cells (CECs) sloughed from vessels wall. These alterations were rescued by insulin therapy. In addition, glycemic control promoted an increase in systemic testosterone and SDF-1α levels, which were significantly decreased in animals with diabetes. SDF-1α protein expression was reduced in experimental and human cavernosal diabetic samples, an effect prevented by insulin in treated animals. Insulin administration rescued the effects of diabetes on BM function, CECs levels, testosterone, and plasmatic/penile SDF-1α protein expression. This emphasizes the importance of glycemic control in the prevention of diabetes-induced systemic and penile EDys, by the amelioration of endothelial damage, and increase in protective pathways. J. Cell. Biochem. 118: 82-91, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Angela Castela
- Faculty of Medicine, Department of Biochemistry, University of Porto, Porto, Portugal.,Institute for Molecular and Cell Biology of the University of Porto (IBMC-UP), Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Pedro Gomes
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
| | - Ricardo Silvestre
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Luísa Guardão
- Animal Facility, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Liliana Leite
- Animal Facility, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Rui Chilro
- Digital University, University of Porto, Porto, Portugal
| | - Ilda Rodrigues
- Faculty of Medicine, Department of Biochemistry, University of Porto, Porto, Portugal
| | - Pedro Vendeira
- Clínica Saúde Atlântica, Clínica Urológica Vendeira, Porto, Portugal
| | - Ronald Virag
- Centre d'Explorations et Traitements de l'Impuissance, Paris, France
| | - Carla Costa
- Faculty of Medicine, Department of Biochemistry, University of Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Association Between Inflammatory Bowel Disease and Erectile Dysfunction: A Nationwide Population-Based Study. Inflamm Bowel Dis 2016; 22:1065-70. [PMID: 26863266 DOI: 10.1097/mib.0000000000000695] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND To determine whether inflammatory bowel disease (IBD) is associated with an increased risk of subsequent erectile dysfunction (ED). METHODS We identified 1845 patients who received a diagnosis with IBD between 2000 and 2011 from Taiwan's National Health Insurance Research Database. For the comparison cohort, we randomly extracted the data of 7380 patients matched by sex, age, and baseline year. Follow-up continued until the development of ED, withdrawal from the National Health Insurance program, or the end of 2011. The cumulative incidences and hazard ratios (HRs) for ED development were determined. RESULTS After 12 years of follow-up, subsequent ED incidence rates in the IBD and comparison cohorts were 2.23 and 1.29 per 10,000 person-years, respectively (adjusted hazard ratio = 1.64; 95% confidence interval [CI], 1.07-2.52; P < 0.05). Compared with the non-IBD cohort without comorbidity, the risk of ED was higher in the IBD cohort with comorbidity (adjusted hazard ratio = 2.46, 95% CI, 1.32-4.58). Patients with ulcerative colitis were 2.27-fold more likely to develop ED than were patients without IBD (95% CI, 1.22-4.20). Compared with patients without IBD who were aged ≤49 years, patients with IBD aged ≥65 years were 3.36-fold more likely to develop ED (95% CI, 1.42-7.96). CONCLUSIONS We found that the patients with IBD had a 1.64-fold higher risk of developing ED than did the comparison group. Physicians should be aware of the link to ED when assessing patients with IBD.
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Hwang I, Lee HS, Yu HS, Kim ME, Lee JS, Park K. Testosterone modulates endothelial progenitor cells in rat corpus cavernosum. BJU Int 2016; 117:976-81. [DOI: 10.1111/bju.13438] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Insang Hwang
- Department of Urology; Chonnam National University Medical School; Sexual Medicine Research Center; Chonnam National University; Gwangju Korea
| | - Hyun-Suk Lee
- Department of Urology; Chonnam National University Medical School; Sexual Medicine Research Center; Chonnam National University; Gwangju Korea
| | - Ho Song Yu
- Department of Urology; Chonnam National University Medical School; Sexual Medicine Research Center; Chonnam National University; Gwangju Korea
| | - Mi Eun Kim
- Department of Biology; BK21-plus Research Team for Bioactive Control Technology; College of Natural Sciences; Chosun University; Gwangju Korea
| | - Jun Sik Lee
- Department of Biology; BK21-plus Research Team for Bioactive Control Technology; College of Natural Sciences; Chosun University; Gwangju Korea
| | - Kwangsung Park
- Department of Urology; Chonnam National University Medical School; Sexual Medicine Research Center; Chonnam National University; Gwangju Korea
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24
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Abstract
Erectile dysfunction (ED) is a common complication of diabetes, affecting up to 75% of all diabetic men. Although the aetiology of diabetic ED is multifactorial, endothelial dysfunction is recognized as a mainstay in the pathophysiology of the disease. Endothelial dysfunction is induced by the detrimental actions of high glucose levels and increased oxidative stress on endothelial cells that make up the vascular lining. Besides directly injuring the endothelium, diabetes might also hamper vascular repair mechanisms of angiogenesis and vasculogenesis. These states exacerbate and maintain endothelial dysfunction, impairing vasorelaxation events and cavernosal blood perfusion, which are crucial for normal erectile function.
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25
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Freitas M, Rodrigues AR, Tomada N, Fonseca J, Magalhães A, Gouveia AM, Neves D. Effects of Aging and Cardiovascular Disease Risk Factors on the Expression of Sirtuins in the Human Corpus Cavernosum. J Sex Med 2015; 12:2141-52. [PMID: 26556180 DOI: 10.1111/jsm.13035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Sirtuin (SIRT)1 was recently identified in human corpus cavernosum (CC). We hypothesized that other sirtuins could also be expressed in the CC. Expression of these enzymes in tissues is affected by aging, the main independent risk factor for erectile dysfunction besides other cardiovascular disease risk factors (CVDRF), such as diabetes or obesity. AIM The aim of this study was to characterize the expression of SIRT1-3 and SIRT5-7 in human CC relatively to age and CVDRF. METHODS Samples of CC collected from patients submitted to programmed surgeries or organ donors were divided in three groups according to age and presence of CVDRF. Expression of SIRT1-3 and SIRT5-7 mRNAs was assessed by real-time polymerase chain reaction. Cellular localization and semi-quantification of sirtuins proteins were performed by immunofluorescence and Western blotting (WB), respectively. Nuclear factor kappa B (NFkB)-p65, inducible (iNOS) and endothelial nitric oxide synthase (eNOS) levels were also assayed by WB. MAIN OUTCOME MEASURES The main outcome measure was to characterize the expression of SIRT1-3 and SIRT5-7 in human CC. RESULTS SIRT1-3 and SIRT5-7 mRNAs were detected in all individuals, without statistical differences among groups, excepting SIRT7 that decreased four times in aged groups relatively to young (P = 0.013). WB analysis demonstrated that aged individuals with CVDRF presented higher levels of SIRT7 protein relatively to young (P = 0.0495) and lower levels of SIRT3 protein relatively to healthy aged (P = 0.0077). Expression of NFkB-p65 and iNOS were higher in aged than in young individuals (P = 0.0185; P = 0.004, respectively). No differences in other sirtuins or total eNOS were seen among groups although phospho eNOS Ser(1177) levels decreased in groups of aged men relatively to young (P = 0.0043; P = 0.0099). CONCLUSIONS Our results demonstrate for the first time expression of SIRT2-3 and SIRT5-7 in the human CC. Aged individuals with CVDRF presented an increase in SIRT7 protein levels and a decrease in mitochondrial SIRT3. This finding suggests that CVDRF induces the loss of antioxidant defense mechanisms leading to endothelial injury.
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Affiliation(s)
- Margarida Freitas
- Department of Experimental Biology, Faculty of Medicine of Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Institute for Molecular and Cell Biology (IBMC) of Universidade do Porto, Porto, Portugal
| | - Adriana R Rodrigues
- Department of Experimental Biology, Faculty of Medicine of Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Institute for Molecular and Cell Biology (IBMC) of Universidade do Porto, Porto, Portugal
| | - Nuno Tomada
- Department of Urology, Central Hospital of S. João, Porto, Portugal
| | - João Fonseca
- Department of Experimental Biology, Faculty of Medicine of Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Institute for Molecular and Cell Biology (IBMC) of Universidade do Porto, Porto, Portugal
| | - Alexandre Magalhães
- REQUIMTE/Department of Chemistry & Biochemistry, Faculty of Sciences of Universidade do Porto, Porto, Portugal
| | - Alexandra M Gouveia
- Department of Experimental Biology, Faculty of Medicine of Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Institute for Molecular and Cell Biology (IBMC) of Universidade do Porto, Porto, Portugal.,Faculty of Nutrition and Food Sciences, Universidade do Porto, Porto, Portugal
| | - Delminda Neves
- Department of Experimental Biology, Faculty of Medicine of Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde, Institute for Molecular and Cell Biology (IBMC) of Universidade do Porto, Porto, Portugal
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26
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Belba A, Cortelazzo A, Andrea G, Durante J, Nigi L, Dotta F, Timperio AM, Zolla L, Leoncini R, Guerranti R, Ponchietti R. Erectile dysfunction and diabetes: Association with the impairment of lipid metabolism and oxidative stress. Clin Biochem 2015; 49:70-8. [PMID: 26500005 DOI: 10.1016/j.clinbiochem.2015.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 10/02/2015] [Accepted: 10/19/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To test the hypothesis that exists an association of non-diabetic and diabetic patients suffering from erectile dysfunction (ED) with lipid metabolism and oxidative stress. DESIGN AND METHODS Clinical and laboratory characteristics in non-diabetic (n = 30, middle age range: 41–55.5 years; n = 25, old age range: 55.5–73), diabetic ED patients (n = 30, age range: 55.5–75 years) and diabetic patients (n = 25, age range: 56–73.25), were investigated. Proteomic analysis was performed to identify differentially expressed plasma proteins and to evaluate their oxidative posttranslational modifications. RESULTS A decreased level of high-density lipoproteins in all ED patients (P < 0.001, C.I. 0.046–0.10), was detected by routine laboratory tests. Proteomic analysis showed a significant decreased expression (P < 0.05) of 5 apolipoproteins (i.e. apolipoprotein H, apolipoprotein A4, apolipoprotein J, apolipoprotein E and apolipoprotein A1) and zinc-alpha-2-glycoprotein, 50% of which are more oxidized proteins. Exclusively for diabetic ED patients, oxidative posttranslational modifications for prealbumin, serum albumin, serum transferrin and haptoglobin markedly increased. CONCLUSIONS Showing evidence for decreased expression of apolipoproteins in ED and the remarkable enhancement of oxidative posttranslational modifications in diabetes-associated ED, considering type 2 diabetes mellitus and age as independent risk factors involved in the ED pathogenesis, lipid metabolism and oxidative stress appear to exert a complex interplay in the disease.
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Affiliation(s)
- Arben Belba
- Urological and Andrological Unit, Department of Medicine, Surgery and Neuroscience, University Hospital, Siena, Italy
| | - Alessio Cortelazzo
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.
| | - Giansanti Andrea
- Urological and Andrological Unit, Department of Medicine, Surgery and Neuroscience, University Hospital, Siena, Italy
| | - Jacopo Durante
- Urological and Andrological Unit, Department of Medicine, Surgery and Neuroscience, University Hospital, Siena, Italy
| | - Laura Nigi
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Francesco Dotta
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Anna Maria Timperio
- Department of Ecological and Biological Sciences, University of Tuscia, Viterbo, Italy
| | - Lello Zolla
- Department of Ecological and Biological Sciences, University of Tuscia, Viterbo, Italy
| | - Roberto Leoncini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Roberto Guerranti
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Roberto Ponchietti
- Urological and Andrological Unit, Department of Medicine, Surgery and Neuroscience, University Hospital, Siena, Italy
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Giovannone R, Busetto GM, Antonini G, De Cobelli O, Ferro M, Tricarico S, Del Giudice F, Ragonesi G, Conti SL, Lucarelli G, Gentile V, De Berardinis E. Hyperhomocysteinemia as an Early Predictor of Erectile Dysfunction: International Index of Erectile Function (IIEF) and Penile Doppler Ultrasound Correlation With Plasma Levels of Homocysteine. Medicine (Baltimore) 2015; 94:e1556. [PMID: 26426624 PMCID: PMC4616856 DOI: 10.1097/md.0000000000001556] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Erectile dysfunction (ED) is inability to achieve and maintain an erection to permit satisfactory sexual activity. Homocysteine (Hcys) is a sulfur-containing amino acid synthesized from the essential amino acid methionine. Experimental models have elucidated the role of hyperhomocysteinemia (HHcys) as a strong and independent predictor for atherosclerosis progression and impaired cavernosal perfusion. The aim of this study is to investigate the serum levels of Hcys in our cohort of patients with ED, to compare these values with these of control population and to examine Hcys as a predictive marker for those patients who are beginning to complain mild-moderate ED. A total of 431 patients were enrolled in the study. The whole cohort was asked to complete the International Index of Erectile Function (IIEF) questionnaire. The study population was divided in 3 main groups: Group A: 145 patients with no ED serving as a control group; Group B: 145 patients with mild or mild-moderate ED; Group C: 141 patients with moderate or severe ED. Each participant underwent blood analysis. All patients underwent baseline and dynamic penile Doppler ultrasonography. We found in our cohort mean Hcys plasma concentrations significantly higher than the cut-off point in both groups B and C (18.6 ± 4.7 and 28.38 ± 7.8, respectively). Mean IIEF score was 27.9 ± 1.39, 19.5 ± 2.6, and 11.1 ± 2.5 for groups A, B, and C, respectively (P < 0.0001). In the penile Doppler ultrasonography studies, a high significant inverse correlation was detected between the mean values of the 10th minute's peak-systolic velocity (PSV) and Hcys levels for the groups B and C. This establishes a dose-dependent association between Hcys and ED. Furthermore, we showed that Hcys was an earlier predictor of ED than Doppler studies, as the Hcys increase was present in patients with mild ED even before abnormal Doppler values.
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Affiliation(s)
- Riccardo Giovannone
- From the Department of Urology, Policlinico Umberto I Sapienza Rome University, Rome, Italy (RG, GMB, GA, ST, FDG, GR, VG, EDB); Department of Urology, European Oncology Institute (IEO), Milan, Italy (ODC, MF); Department of Urology, Stanford University of School of Medicine, Stanford, California, USA (SLC); and Department of Emergency and Organ Transplantation, Urology Unit, University of Bari, Bari, Italy (GL)
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Karabakan M, Erkmen AE, Guzel O, Aktas BK, Bozkurt A, Akdemir S. Association between serum folic acid level and erectile dysfunction. Andrologia 2015; 48:532-5. [DOI: 10.1111/and.12474] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2015] [Indexed: 01/08/2023] Open
Affiliation(s)
- M. Karabakan
- Urology Department; Erzincan University; Mengucek Gazi Training and Research Hospital; Erzincan Turkey
| | - A. E. Erkmen
- Urology Department; Oltu State Hospital; Erzurum Turkey
| | - O. Guzel
- Urology Department; Ankara Numune Training and Research Hospital; Ankara Turkey
| | - B. K. Aktas
- Urology Department; Ankara Numune Training and Research Hospital; Ankara Turkey
| | - A. Bozkurt
- Urology Department; Erzincan University; Mengucek Gazi Training and Research Hospital; Erzincan Turkey
| | - S. Akdemir
- Urology Department; İzmir University; Medical Park Hospital; İzmir Turkey
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Yan WJ, Yu N, Yin TL, Zou YJ, Yang J. A new potential risk factor in patients with erectile dysfunction and premature ejaculation: folate deficiency. Asian J Androl 2015; 16:902-6. [PMID: 25080932 PMCID: PMC4236337 DOI: 10.4103/1008-682x.135981] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We investigated serum folic acid (FA) levels in patients with erectile dysfunction (ED) and/or premature ejaculation (PE). Fasting serum samples were obtained from 42 patients with ED, 36 with PE, 25 ED patients with PE, and 30 healthy men; the mean intravaginal ejaculation latency time (IELT) was measured during a 4 weeks baseline period. Levels of sex hormones (follicle-stimulating hormone, luteinizing hormone, total testosterone), homocysteine (Hcys), and FA were measured using chemiluminescent immunoassays. The sexual functions of PE patients and normal control men were evaluated using the Chinese Index of Premature Ejaculation (CIPE). The abridged International Index of Erectile Function-5 (IIEF-5) questionnaire was used to gauge erectile quality for ED patients and for normal controls. Serum FA concentrations were lower in ED (7.61 ± 3.97 ng ml−1), PE (9.37 ± 3.40 ng ml−1), and ED/PE (8.84 ± 4.28 ng ml−1) patients than in healthy men (12.23 ± 5.76 ng ml−1, P < 0.05). No significant differences in sex hormone levels were found between patients with sexual dysfunction and healthy controls (P > 0.05). There were positive correlations between serum FA concentrations and CIPE scores (r = 0.530, P < 0.01), IIEF-5 scores (r = 0.589, P < 0.01), and IELT (r = 0.445, P < 0.01); negative correlations with Hcys concentrations (r = −0.487, P < 0.01) were found in all participants. These findings showed a strong relationship between serum FA levels and sexual dysfunction, possibly due to an effect of FA on the metabolism of nitric oxide, Hcys, and 5-hydroxytryptamine.
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Affiliation(s)
| | | | | | | | - Jing Yang
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China
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HU CHAO, DONG YINYING, DONG YEHAO, CUI JIEFENG, DAI JICAN. Identification of oxidative stress-induced gene expression profiles in cavernosal endothelial cells. Mol Med Rep 2015; 11:2781-8. [DOI: 10.3892/mmr.2014.3112] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 11/05/2014] [Indexed: 11/06/2022] Open
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Aldemir M, Keleş İ, Karalar M, Tecer E, Adalı F, Pektaş MB, Parlar Aİ, Darçın OT. Nebivolol compared with metoprolol for erectile function in males undergoing coronary artery bypass graft. Anatol J Cardiol 2015; 16:131-6. [PMID: 26467373 PMCID: PMC5336728 DOI: 10.5152/akd.2015.5936] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate erectile function in males undergoing coronary artery bypass graft (CABG) while on two different adrenoceptor beta-blocker regimens, namely nebivolol and metoprolol. We hypothesize that the negative effects of cardiopulmonary bypass on erectile function may be possibly attenuated by preferring a vasodilating selective β1-blocker, nebivolol, to metoprolol as an anti-ischemic and antiarrhythmic agent in males undergoing CABG. METHODS This randomized, double-blind, prospective clinical study was conducted in patients scheduled for CABG surgery between February 2012 and June 2014. A total of 60 consecutive patients who met inclusion criteria were randomized and divided into the following two groups: N group, which received 5 mg of nebivolol orally for 2 weeks before surgery plus 12 weeks after surgery or M group, which received 50 mg of metoprolol orally for the same period. All patients were evaluated by the erectile function domain of the International Index of Erectile Function-5 (IIEF-5) at the time of admission (before starting the beta-blocker) and 3 months after surgery. RESULTS In the metoprolol group, the mean IIEF-5 score decreased significantly from a baseline of 15.2±5.8 to 12.9±5.8 (p<0.001), but in the nebivolol group, this difference was not significant (from a baseline 12.9±5.5 to 12.4±5.5, p=0.053). In all patients, the mean IIEF-5 score decreased significantly from a baseline of 14.0±5.7 to 12.6±5.6 (p<0.001). CONCLUSION Although erectile function in males undergoing CABG surgery decreases when metoprolol is used, nebivolol exerts protective effects on erectile function against the disruptive effects of cardiopulmonary bypass in patients undergoing CABG.
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Affiliation(s)
- Mustafa Aldemir
- Department of Cardiovascular Surgery, Faculty of Medicine, Afyon Kocatepe University; Afyonkarahisar-Turkey.
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Fonseca J, Tomada N, Magalhães A, Rodrigues AR, Gouveia AM, Neves D. Effect of aging and cardiovascular risk factors on receptor Tie1 expression in human erectile tissue. J Sex Med 2014; 12:876-86. [PMID: 25487286 DOI: 10.1111/jsm.12794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Erectile dysfunction is highly prevalent in patients with advanced age or cardiovascular disease risk factors (CVDRFs). These conditions interfere on expression of vascular growth factors and respective receptors causing disturbance in endothelial function. AIM This study aims to assess the effect of aging and CVDRF on the expression of tyrosine kinase with immunoglobulin-like and EGF-like domains (Tie) 1 in human corpus cavernosum (CC). METHODS CC fragments obtained from programmed surgeries or organ donors were divided into three groups: young, healthy aged, and aged with CVDRF. Angiopoietin (Ang) 1, Ang2, Tie1, and Tie2 mRNA and protein levels were assessed by real-time polymerase chain reaction and Western blotting, respectively. Dual-immunolabeling of Tie1 with specific markers of endothelium and smooth muscle and Ang1 and Ang2 was performed. MAIN OUTCOME MEASURES To characterize the expression of Tie1 in human CC and elucidate its potential inhibitory effect in Ang-Tie2 system. RESULTS Analysis of mRNAs demonstrated a decrease in Tie1 expression in CVDRF individuals compared with aged or young healthy individuals. No variation for Tie2, Ang1, or Ang2 expression was observed among the studied groups. In all analyzed CC fragments, a 125 kDa band, Tie1, was detected. This protein presented a significant age-related decrease, specially in individuals with CVDRF. Immunofluorescence study revealed Tie1 expression in the endothelium of samples of all experimental groups. CONCLUSIONS Employing different methodological approaches, we show for the first time that Tie1 is expressed in human CC endothelium, and its level of expression diminishes in aged individuals, particularly those with CVDRF. This finding reinforces the view that delivery of Ang1 to the CC of erectile dysfunction affected CVDRF patients is able to activate a beneficial Tie2 response.
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Affiliation(s)
- João Fonseca
- Department of Experimental Biology, Faculty of Medicine, Universidade do Porto, Porto, Portugal; Institute for Molecular and Cell Biology (IBMC), Universidade do Porto, Porto, Portugal
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Initial evidence demonstrating the association between the vascular status in surgically resected renal parenchymal pathology and sexual function. Int J Impot Res 2014; 27:90-4. [PMID: 25471317 DOI: 10.1038/ijir.2014.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 08/17/2014] [Accepted: 10/18/2014] [Indexed: 11/08/2022]
Abstract
Our goal is to evaluate the association between histopathology of glomerulosclerosis (GS) and atherosclerosis (AS) in the nephrectomized normal parenchyma together with patients' background, and erectile dysfunction (ED) of patients treated with radical nephrectomy (RN) for renal cell carcinoma (RCC). ED was assessed with the International Index of Erectile Function in 65 patients who were less than age 70 years at the time of questionnaire. Glomeruli status was assessed by the extent of global GS. AS was graded based on lumen occlusion and frequency of involvement. Patients' backgrounds included any comorbidities, post-RN renal insufficiency, tumor pathology, demographics and social status. The presence of diabetes mellitus and lack of a spouse were independent predictors for severe ED, whereas G0/1 AS was an independent predictor for mild/no ED. The extent of global GS was significantly lower in patients with mild/no ED than in other patients. Our study represents the first report identifying healthy arterial status in the renal parenchyma as a significant indicator of favorable erectile function and that the evaluation of AS severity is not a superior indicator of severe ED in the presence of comorbidities or social status among patients treated with RN.
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Identification of endothelial progenitor cells in the corpus cavernosum in rats. BIOMED RESEARCH INTERNATIONAL 2014; 2014:910564. [PMID: 25401106 PMCID: PMC4221983 DOI: 10.1155/2014/910564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/17/2014] [Accepted: 09/22/2014] [Indexed: 01/15/2023]
Abstract
The vascular wall resident progenitor cells seem to serve as a local reservoir of cells for vascular repair. It was hypothesized that the corpus cavernosum may contain vascular wall endothelial progenitor cells (EPCs). In this study, we investigated the identification and localization of EPCs in the corpus cavernosum in a rat model. Adult male Sprague-Dawley rats were used to isolate EPCs from corpora cavernosum. To verify the existence and localization of EPCs, EPC-specific markers (CD34, Flk-1, and VE-cadherin) were evaluated by flow cytometric analysis and confocal microscopy. The EPC markers were mainly expressed in the cavernosal sinusoidal endothelial space. EPC-marker-positive cells made up about 3.31% of the corpus cavernosum of normal rat by FACS analysis. As shown by confocal microscopy, CD34+/Flk-1+ and CD34+/VE-cadherin+ positive cells existed in the corpus cavernosum. Our findings imply that regulation of corpus cavernosal EPCs may be a new therapeutic strategy in the treatment of erectile dysfunction.
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Sejima T, Honda M, Takenaka A. Renal parenchymal histopathology predicts life-threatening chronic kidney disease as a result of radical nephrectomy. Int J Urol 2014; 22:14-21. [PMID: 25195572 DOI: 10.1111/iju.12612] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 08/03/2014] [Indexed: 01/20/2023]
Abstract
The preoperative prediction of post-radical nephrectomy renal insufficiency plays an important role in the decision-making process regarding renal surgery options. Furthermore, the prediction of both postoperative renal insufficiency and postoperative cardiovascular disease occurrence, which is suggested to be an adverse consequence caused by renal insufficiency, contributes to the preoperative policy decision as well as the precise informed consent for a renal cell carcinoma patient. Preoperative nomograms for the prediction of post-radical nephrectomy renal insufficiency, calculated using patient backgrounds, are advocated. The use of these nomograms together with other types of nomograms predicting oncological outcome is beneficial. Post-radical nephrectomy attending physicians can predict renal insufficiency based on the normal renal parenchymal pathology in addition to preoperative patient characteristics. It is suggested that a high level of global glomerulosclerosis in nephrectomized normal renal parenchyma is closely associated with severe renal insufficiency. Some studies showed that post-radical nephrectomy severe renal insufficiency might have an association with increased mortality as a result of cardiovascular disease. Therefore, such pathophysiology should be recognized as life-threatening, surgically-related chronic kidney disease. On the contrary, the investigation of the prediction of mild post-radical nephrectomy renal insufficiency, which is not related to adverse consequences in the postoperative long-term period, is also promising because the prediction of mild renal insufficiency might be the basis for the substitution of radical nephrectomy for nephron-sparing surgery in technically difficult or compromised cases. The deterioration of quality of life caused by post-radical nephrectomy renal insufficiency should be investigated in conjunction with life-threatening matters.
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Affiliation(s)
- Takehiro Sejima
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
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Ückert S, Bannowsky A, Albrecht K, Kuczyk MA. Melanocortin receptor agonists in the treatment of male and female sexual dysfunctions: results from basic research and clinical studies. Expert Opin Investig Drugs 2014; 23:1477-83. [DOI: 10.1517/13543784.2014.934805] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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The connection between type 2 diabetes and erectile dysfunction in Taiwanese aboriginal males. Int J Impot Res 2014; 26:235-40. [DOI: 10.1038/ijir.2014.26] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 06/03/2014] [Accepted: 06/13/2014] [Indexed: 12/15/2022]
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Chao JK, Ma MC, Lin YC, Chiang HS, Hwang TIS. Study on Alcohol Dependence and Factors Related to Erectile Dysfunction Among Aborigines in Taiwan. Am J Mens Health 2014; 9:247-56. [DOI: 10.1177/1557988314543657] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Relatively few studies have addressed the risk factors of erectile dysfunction (ED) in Taiwanese— most have described ED and medical problems in the general population. In this study, the cardiovascular risk factors of ED among aborigines in Taiwan were investigated. However, alcohol dependence (AD) was prevalent in Taiwan’s aborigine population. So this study also focused on the relationship among AD, the cardiovascular risk factors and ED. A cross-sectional study was conducted, and data was obtained from a baseline survey of 192 aboriginal adults (35-75 years of age). The participants’ demographic data, AD, markers of endothelial function, serum testosterone, and ED status were assessed. Ninety-four (49%) of the 192 participants had a history of alcoholism and 79 (84%) of those with alcoholism had ED. The study reported that AD and hyperlipidemia, metabolic syndrome (MetS), ED, abnormality of testosterone, and high-sensitivity C-reactive protein are highly prevalent among the aborigines. Factors that may affect ED included age, AD, central obesity, diabetes mellitus, hyperlipidemia, hypertension, MetS, and testosterone. ED is highly prevalent among aborigines with the risk factors of AD, MetS, old age, and abnormal testosterone serum level. MetS, atherosclerosis, and ED are risk factors for cardiovascular diseases. Hence, an increased focus on Taiwanese aborigines with ED is necessary.
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Affiliation(s)
- Jian-Kang Chao
- Department of Psychiatry, Yuli branch, Taipei Veterans General Hospital, Hualien, Taiwan
- Department of Health Administration, Tzu Chi College of Technology, Hualien County, Taiwan
| | - Mi-Chia Ma
- Department of Statistics, National Cheng Kung University, Tainan, Taiwan
| | - Yen-Chin Lin
- Graduate School of Human Sexuality, Shu-Te University, Kaohsiung City, Taiwan
| | - Han-Sun Chiang
- Fu Jen Catholic University, New Taipei, Taiwan
- Department of Urology, Medical University Hospital, Taipei, Taiwan
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Huang Y, Chen B, Yao F, Chen S, Ouyang B, Deng C, Huang Y. Weaker Masturbatory Erection May Be a Sign of Early Cardiovascular Risk Associated with Erectile Dysfunction in Young Men Without Sexual Intercourse. J Sex Med 2014; 11:1519-26. [DOI: 10.1111/jsm.12460] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Kostis JB, Dobrzynski JM. The effect of statins on erectile dysfunction: a meta-analysis of randomized trials. J Sex Med 2014; 11:1626-35. [PMID: 24684744 DOI: 10.1111/jsm.12521] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Erectile dysfunction (ED) is common in older men, especially those with comorbidities such as diabetes and atherosclerotic disease, conditions where statins are frequently prescribed. AIM To examine the effect of statin therapy on ED using the five-item version of the International Inventory of Erectile Function (IIEF). METHODS We performed a random-effects meta-analysis of studies identified by a systematic search of MEDLINE, Web of Knowledge, the Cochrane Database, and ClinicalTrials.gov. Examination of the 186 retrieved citations resulted in the selection of 11 randomized trials for inclusion in the meta-analysis. MAIN OUTCOME MEASURES Change in the IIEF score. RESULTS IIEF increased by 3.4 points (95% CI 1.7-5.0, P = 0.0001) with statins compared to control. This effect remained statistically significant after multiple sensitivity analyses, including analysis for publication bias, a cumulative meta-analysis, and 11 repeated analyses with each study omitted sequentially. The increase in IIEF with statins was approximately one-third to one-half of that previously reported with phosphodiesterase-5 inhibitors and larger than the effect of lifestyle modification. Metaregression showed an increase in benefit with decreasing lipophilicity. The average age of participants and the degree of LDL cholesterol lowering did not alter the effect on IIEF. CONCLUSION Statins cause a clinically relevant improvement of erectile function as measured by the five-item version of the IIEF.
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Affiliation(s)
- John B Kostis
- Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Yano S, Moseley K, Wong L, Castelnovi C, Azen C, Pavlova Z. Glycosaminoglycan metabolism defects and atherosclerosis: frequent association of endothelial dysfunction in patients with Mucopolysaccharidosis. J Inherit Metab Dis 2014; 37:255-61. [PMID: 23893050 PMCID: PMC8889886 DOI: 10.1007/s10545-013-9642-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/03/2013] [Accepted: 07/15/2013] [Indexed: 12/15/2022]
Abstract
Cardiovascular lesions, including coronary artery stenosis, are frequently associated and can cause sudden death in patients with genetic defects of glycosaminoglycan (GAG) metabolism. Early diagnosis of coronary artery lesions is difficult, although potentially lifesaving. Histopathological similarities between atherosclerotic changes in adults and in patients with genetic GAG metabolism defects have been known. Atherosclerosis is the result of a complex process involving metabolism of GAGs and proteoglycans preceded by endothelial dysfunction as a key event. Decreased nitric oxide (NO) bioavailability is considered the hallmark of endothelial dysfunction. Reduced NO synthase (NOS) has been reported in atherosclerotic arteries. Impairment in reactive hyperemia-digital peripheral arterial tonometry (RH-PAT) with EndoPAT has been validated to correlate coronary microvascular function in patients with atherosclerosis. RH-PAT is thought to reflect endothelial NO production. Immunohistological staining of endothelial NOS was performed in the stenotic lesions in the coronary artery of a 3-year-old patient with Mucopolysaccharidosis-I, showing decreased activities. This prompted a study to measure endothelial function in patients with GAG metabolism defects for early diagnosis of endothelial dysfunction in the coronary arteries as an early sign of coronary artery changes. Evaluation by RH-PAT in 30 patients with variable genetic defects in GAG metabolism revealed significantly decreased Reactive Hyperemia Indexes compared with 12 controls. Evaluation of endothelial function with RH-PAT in patients with GAG metabolism defects may detect coronary artery lesions that can be underdiagnosed by the other measures such as coronary angiography. Use of this method may prove vital in the management of patients with GAG metabolism defects.
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Affiliation(s)
- Shoji Yano
- Genetics Division, Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, 1801 Marengo Street General Laboratory Building, Room 1G-24, Los Angeles, CA, 90033, USA,
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The Relationship between Neovascular Age-Related Macular Degeneration and Erectile Dysfunction. J Ophthalmol 2013; 2013:589274. [PMID: 24191192 PMCID: PMC3804368 DOI: 10.1155/2013/589274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 08/26/2013] [Indexed: 11/17/2022] Open
Abstract
Purpose. To evaluate association between erectile dysfunction (ED) and neovascular age-related macular degeneration (AMD). Methods. 195 men enrolled in this cross-sectional study. 90 of them had neovascular AMD and 105 of them were healthy volunteers. The International Index of Erectile Function (IIEF) questionnaire's erectile function (EF) domain was used to assess ED. The patients in the study and control groups were statistically compared according to visual acuity, EF score, and body mass index. Results. The mean ages were 62 (54.5–73) and 60 (54–68), in the neovascular AMD and control groups, respectively. The total EF scores were 9 (6–16) in neovascular AMD and 18 (9.5–27) in control group. The results of IIEF questionnaire on neovascular AMD patients revealed that 85 men (94.4%) had some degree of ED, whereas 68 men (64.8%) had some degree of ED on control group. Patients with neovascular AMD had a significantly higher incidence of ED than control patients (P < 0.01). There was a significant association between ED and neovascular AMD (P < 0.01). Conclusions. Our results suggested that neovascular AMD has a high association with ED.
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Treatment with CB2 agonist JWH-133 reduces histological features associated with erectile dysfunction in hypercholesterolemic mice. Clin Dev Immunol 2013; 2013:263846. [PMID: 24302957 PMCID: PMC3835849 DOI: 10.1155/2013/263846] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 09/08/2013] [Accepted: 09/09/2013] [Indexed: 12/20/2022]
Abstract
Hypercholesterolemia is one of the most important risk factors for erectile dysfunction, mostly due to the impairment of oxidative stress and endothelial function in the penis. The cannabinoid system might regulate peripheral mechanisms of sexual function; however, its role is still poorly understood. We investigated the effects of CB2 activation on oxidative stress and fibrosis within the corpus cavernosum of hypercholesterolemic mice. Apolipoprotein-E-knockout mice were fed with a western-type diet for 11 weeks and treated with JWH-133 (selective CB2 agonist) or vehicle during the last 3 weeks. CB2 receptor expression, total collagen content, and reactive oxygen species (ROS) production within the penis were assessed. In vitro corpus cavernosum strips preparation was performed to evaluate the nitric oxide (NO) bioavailability. CB2 protein expression was shown in cavernosal endothelial and smooth muscle cells of wild type and hypercholesterolemic mice. Treatment with JWH-133 reduced ROS production and NADPH-oxidase expression in hypercholesterolemic mice penis. Furthermore, JWH-133 increased endothelial NO synthase expression in the corpus cavernosum and augmented NO bioavailability. The decrease in oxidative stress levels was accompanied with a reduction in corpus cavernosum collagen content. In summary, CB2 activation decreased histological features, which were associated with erectile dysfunction in hypercholesterolemic mice.
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Tsai DC, Huang CC, Chen SJ, Chou P, Chung CM, Chan WL, Huang PH, Lin SJ, Chen JW, Leu HB. Increased risk of erectile dysfunction among males with central serous chorioretinopathy -- a retrospective cohort study. Acta Ophthalmol 2013; 91:666-71. [PMID: 22998678 DOI: 10.1111/j.1755-3768.2012.02528.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Central serous chorioretinopathy (CSCR) mostly affects middle-aged men and has been associated with stress and hypercortisolism. We hypothesized that some factors prone to inducing CSCR could also have a harmful effect on erectile function. This study aimed to investigate the risk of subsequent erectile dysfunction after CSCR using Taiwan National Health Insurance Research Database. METHODS The study cohort (n = 1220) consisted of newly diagnosed CSCR men aged 19-64 years between 1999 and 2007, and men matched for age, monthly income and time of enrolment were randomly selected as the control group (n = 10870). Cox proportional hazard regressions were performed to calculate the hazard ratios (HR) of clinically diagnosed erectile dysfunction (including organic origin and/or psychogenic origin) for the two groups. Erectile dysfunction-free survival analysis was assessed using a Kaplan-Meier method. RESULTS Twenty-five patients (2.0%) from the CSCR cohort and 103 (0.9%) from the control group were diagnosed erectile dysfunction clinically during a mean observation period of 4.3 years. Patients with CSCR had a significantly higher incidence of erectile dysfunction diagnosis than those without CSCR (p < 0.001). After adjusting for age, geographic location, chronic comorbidities and medication habits, patients with CSCR were found to have a 2.22-fold [95% confidence interval (CI), 1.42-3.46] higher hazard ratio of a subsequent erectile dysfunction diagnosis than the matched controls. The adjusted HR for organic and psychogenic erectile dysfunction were 2.14 (95% CI: 1.34-3.44) and 3.83 (95% CI: 1.47-10.01), respectively. CONCLUSIONS Central serous chorioretinopathy was independently associated with an increased risk of being diagnosed with erectile dysfunction.
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Affiliation(s)
- Der-Chong Tsai
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, TaiwanDepartment of Ophthalmology, National Yang-Ming University Hospital, Taipei, TaiwanInstitute of Pharmacology, National Yang-Ming University, Taipei, TaiwanCardiovascular Research Center, School of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Medical Research and Education, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Ophthalmology, Taipei Veterans General Hospital, Taipei, TaiwanInstitute of Biomedical Sciences, Academia Sinica, Taipei, TaiwanHealthcare and Management Center, Taipei Veterans General Hospital, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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Condorelli RA, Calogero AE, La Vignera S. Different profile of endothelial cell apoptosis in patients with Klinefelter's syndrome. J Endocrinol Invest 2013; 36:84-91. [PMID: 22399099 DOI: 10.3275/8287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the effects of testosterone (T) therapy on the sexual function of middle-aged patients with acquired pre-pubertal hypergonadotropic hypogonadism (HrHy) and patients with Klinefelter syndrome (KS). PATIENTS AND METHODS A selected series of 35 middle-aged hypogonadal patients, including those who had recently been observed during andrological counseling (extracted from our database) and had not yet begun hormonal treatment, was recruited for this evaluation. This series of patients included 20 patients with acquired prepubertal HrHy and 15 KS patients who were matched by age and body mass index. All patients underwent an andrological evaluation, which included the administration of the International Index of Erectile Function 5 (IIEF-5) questionnaire and the evaluation of penile echo color Doppler. In addition, by flow cytometry we evaluated the serum levels of apoptotic endothelial microparticles (EMPa) and the vitronectin receptor (VR) at baseline and 6 months after the onset of T therapy. RESULTS After 6 months of T therapy, patients with HrHy demonstrated mean IIEF-5 scores and a peak systolic velocity that were significantly greater and a mean acceleration time that was significantly lower (p<0.05) than those of patients with KS (p<0.05). In addition, patients with HrHy showed mean EMPa values and VR serum concentrations that were significantly lower than those of patients with KS (p<0.05). KS patients showed significantly improved IIEF-5 scores and Doppler parameters (p<0.05) but not EMPa or VR serum concentrations following treatment. DISCUSSION These results indicate that erectile dysfunction in KS can improve with T therapy, although this improvement is more profound in HrHy patients, and these results also suggest that T therapy does not improve the severity of endothelial cell apoptosis in KS patients.
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Affiliation(s)
- R A Condorelli
- Section of Endocrinology, Andrology and Internal Medicine and Master in Andrological, Human Reproduction and Biotechnology Sciences, Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy
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Alberti L, Torlasco C, Lauretta L, Loffi M, Maranta F, Salonia A, Margonato A, Montorsi F, Fragasso G. Erectile dysfunction in heart failure patients: a critical reappraisal. Andrology 2013; 1:177-91. [PMID: 23339018 DOI: 10.1111/j.2047-2927.2012.00048.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 11/15/2012] [Accepted: 11/19/2012] [Indexed: 12/31/2022]
Abstract
Heart failure (HF) is a complex clinical syndrome with a constantly increasing incidence and prevalence in western countries. Total absence of sexual activity is registered in 30% of HF patients. Moreover, HF-induced reduction in exercise tolerance, side effects of HF medications and the coexistence of shared risk factors between HF and sexual dysfunction may further aggravate the sexual health of HF patients. The purpose of this review is to examine the pathophysiological mechanisms behind the association of erectile dysfunction (ED) and HF, the potential therapeutic approaches and the eventual indications for sexual activity in HF patients. Medline and Cochrane Library search was performed from January 1970 through October 2012 to retrieve relevant papers outlining the association between ED and HF. Many evidences have outlined a tight association between ED and HF pathophysiological standpoint. Shared risk factors, common pathogenic traits and epidemiologic association represent some of the links between these conditions. Erectile dysfunction has been recognized as an earlier predictor of cardiovascular events; moreover, HF itself may cause and/or worsen ED because of its particular feature and co-morbidities. Furthermore, some cardiovascular drugs may contribute to impaired erectile function. In stable patients with stable HF, sexual activity is generally not contraindicated but it should be encouraged, as a form of moderate-intensity physical exertion. An effective treatment of ED in HF patients should be founded on the correction of reversible risk factors, on the choice of cardiovascular drugs with the lowest effect upon patient's erectile function, and on the use of phosphodiesterase-5-inhibitors. Physicians should be aware of the close relation between HF and ED and of the related clinical and therapeutic implications, in order to improve patients quality of life and clinical outcome.
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Affiliation(s)
- L Alberti
- Heart Failure Clinic, Ospedale San Raffaele, Milano, Italy
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Aschenbach R, Steiner T, Kerl MJ, Zangos S, Basche S, Vogl TJ. Endovascular embolisation therapy in men with erectile impotence due to veno-occlusive dysfunction. Eur J Radiol 2012; 82:504-7. [PMID: 23219214 DOI: 10.1016/j.ejrad.2012.10.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 10/12/2012] [Accepted: 10/26/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the impact of endovascular embolisation therapy in men with erectile impotence due to veno-occlusive dysfunction. METHODS We retrospectively evaluated 29 patients with a history of erectile impotence due to veno-oclusive dysfunction confirmed by pharmacocavernosometry and cavernosography. All underwent endovascular embolisation therapy over transfemoral approach. After positioning the catheter system at the target level heights, embolisation with N-butyl-2-cyanoacrylate (Histoacryl(®)) was performed. Technical and clinical success as well as major and minor complications were evaluated. RESULTS All procedures were performed without any major or minor events. Complication rate was 0%. Technical success was achieved in 27/29 (93.1%). Two patients failed for anatomical reasons. Overall clinical success was achieved in 24/27 (88.8%) patients with recovering from E1 (poor tumescense/no rigidity) to E4 (good tumescence/intermediate rigidity) in 11/27 (40.7%), E1 to E5 in 8/27 (tumescence/normal rigidity) (29.6%) and E1 to E3 (good tumescence/poor rigidity) in 5/27 (18.5%) respectively. 3/27 (11.1%) received no change in ED severity score. CONCLUSION Endovascular embolisation therapy for veno-occlusive dysfunction in erectile impotence is a safe and effective therapeutic option with low complication rate and highly technical and clinical success rates.
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Affiliation(s)
- R Aschenbach
- HELIOS Hospital Erfurt, Department of diagnostic and interventional Radiology and Neuroradiology, Nordhaeuser Str. 74, 99089 Erfurt, Germany.
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Salonia A, Ferrari M, Saccà A, Pellucchi F, Castagna G, Clementi MC, Matloob R, Briganti A, Rigatti P, Montorsi F. Delay in Seeking Medical Help in Patients with New‐Onset Erectile Dysfunction Remained High Over and Despite the PDE5 Era—An Ecological Study. J Sex Med 2012; 9:3239-46. [DOI: 10.1111/j.1743-6109.2012.02953.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hotaling JM, Walsh TJ, Macleod LC, Heckbert S, Pocobelli G, Wessells H, White E. Erectile Dysfunction Is Not Independently Associated with Cardiovascular Death: Data from the Vitamins and Lifestyle (VITAL) Study. J Sex Med 2012; 9:2104-10. [DOI: 10.1111/j.1743-6109.2012.02826.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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