The pathophysiology of erectile dysfunction related to endothelial dysfunction and mediators of vascular function.
The incidence of erectile dysfunction increases with diabetes, hypertension, hypercholesterolaemia, cardiovascular disease and renal failure. All these conditions are associated with endothelial dysfunction. This review addresses the pathophysiology of erectile dysfunction with a special focus on new insights into nitric oxide (NO)-mediated pathways, oxidative stress and parallels to endothelial dysfunction. NO appears to be the key mediator promoting endothelium-derived vasodilation and penile erection. The possibility is discussed that elevated plasma concentrations of asymmetrical dimethylarginine (ADMA), an endogenous NO synthase inhibitor, may provide an additional pathomechanism for various forms of erectile dysfunction associated with cardiovascular risk factors and disease. Likewise, the role of endothelium-derived factors mediating NO-independent pathways is evaluated.
Maas
Renke
R
Institut für Experimentelle und Klinische Pharmakologie und Toxikologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany. maas@uke.uni-hamburg.de
Schwedhelm
Edzard
E
Albsmeier
Jennifer
J
Böger
Rainer H
RH
D004730:Endothelium, Vascular / Q000503:physiopathology*; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000503:physiopathology*; D019317:Evidence-Based Medicine; D006801:Humans; D015994:Incidence; D008297:Male; D009126:Muscle Relaxation / Q000502:physiology; D009131:Muscle, Smooth, Vascular / Q000503:physiopathology*; D009569:Nitric Oxide / Q000502:physiology; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
D009569:Nitric Oxide