Oxidative Stress and Erectile Dysfunction: Pathophysiology, Impacts, and Potential Treatments.
Aris KaltsasAthanasios ZikopoulosFotios DimitriadisDanja SheshiMagdalena PolitisEfthalia MoustakliEvangelos N SymeonidisMichael ChrisofosNikolaos SofikitisAthanasios ZachariouPublished in: Current issues in molecular biology (2024)
Erectile dysfunction (ED) is a prevalent condition affecting men's sexual health, with oxidative stress (OS) having recently been identified as a significant contributing causative factor. This narrative review aims to elucidate the role of OS in the pathophysiology of ED, focusing on impact, mechanisms, and potential therapeutic interventions. Key findings indicate that OS disrupts endothelial function and nitric oxide (NO) signaling, crucial for erectile function. Various sources of reactive oxygen species (ROS) and their detrimental effects on penile tissue are discussed, including aging, diabetes mellitus, hypertension, hyperlipidemia, smoking, obesity, alcohol consumption, psychological stress, hyperhomocysteinemia, chronic kidney disease, and sickle cell disease. Major sources of ROS, such as NADPH oxidase, xanthine oxidase, uncoupled endothelial NO synthase (eNOS), and mitochondrial electron transport, are identified. NO is scavenged by these ROS, leading to endothelial dysfunction characterized by reduced NO availability, impaired vasodilation, increased vascular tone, and inflammation. This ultimately results in ED due to decreased blood flow to penile tissue and the inability to achieve or maintain an erection. Furthermore, ROS impact the transmission of nitrergic neurotransmitters by causing the death of nitrergic neurons and reducing the signaling of neuronal NO synthase (nNOS), exacerbating ED. Therapeutic approaches targeting OS, including antioxidants and lifestyle modifications, show promise in ameliorating ED symptoms. The review underscores the need for further research to develop effective treatments, emphasizing the interplay between OS and vascular health in ED. Integrating pharmacological and non-pharmacological strategies could enhance clinical outcomes for ED patients, advocating for OS management in ED treatment protocols to improve patient quality of life.
Keyphrases
- emergency department
- oxidative stress
- reactive oxygen species
- dna damage
- chronic kidney disease
- end stage renal disease
- nitric oxide
- blood flow
- sickle cell disease
- alcohol consumption
- metabolic syndrome
- cell death
- blood pressure
- weight loss
- prostate cancer
- healthcare
- public health
- cardiovascular disease
- nitric oxide synthase
- type diabetes
- newly diagnosed
- endothelial cells
- drinking water
- induced apoptosis
- ejection fraction
- spinal cord injury
- big data
- diabetic rats
- ischemia reperfusion injury
- high fat diet
- stress induced
- depressive symptoms
- combination therapy
- cell proliferation
- sleep quality
- smoking cessation
- uric acid
- subarachnoid hemorrhage
- skeletal muscle
- heat stress
- risk assessment
- middle aged