title: Arterial erectile dysfunction: reliability of penile Doppler evaluation integrated with serum concentrations of late endothelial progenitor cells and endothelial microparticles.
abstract: We recently showed the diagnostic value of a new immunophenotype of blood  endothelial progenitor cells (EPC)  (CD45(-)/CD34(+)/CD144(+)) and endothelial  microparticles (EMP) (CD45(-)/CD144(+)/annexin  V(+)) in patients with arterial erectile dysfunction (AED),  particularly in patients with associated late-onset hypogonadism and/or  metabolic syndrome. In addition, we evaluated the effects of androgen  replacement therapy, aerobic physical activity, and tadalafil administration  on these markers. The aim of this study was to evaluate the serum  concentrations of EPCs and EMPs in a large cohort of patients with AED  according to severity of cavernous arterial insufficiency evaluated by penile  Doppler. A total of 120 patients (aged 58.0 ± 6.0 years) with AED were  enrolled in this study. Patients were classified into 3 groups based on value  of peak systolic velocity (PSV). Group A: 37 patients with PSV <25 cm/s  (severe arterial insufficiency); group B: 40 patients with PSV between 25 and  29 cm/s (moderate arterial insufficiency); group C: 43 patients with PSV  between 30 and 34 cm/s (mild arterial insufficiency). Twenty patients (aged  60.0 ± 3.0 years) with psychogenic erectile dysfunction (PED)  represented the control group. EPC and EMP blood concentrations were evaluated  by flow cytometry. Patients with AED had significantly higher blood pressure,  triglyceride levels, homeostasis model assessment index of insulin resistance,  cavernous artery acceleration time, and intima-media thickness than those with  PED, whereas International Index of Erectile Function score, high-density  lipoprotein cholesterol level, and cavernous artery PSV were lower than those  in PED. Both EPC and EMP levels were significantly higher in patients with AED  compared with patients with PED. Among 3 groups of patients with AED, there  were no significant differences in metabolic parameters examined, but group A  showed significantly higher values of cavernous artery acceleration time and  intima-media thickness than group B and group C. Finally, group A showed serum  concentrations of EPCs and EMPs significantly higher compared with other  groups with AED. Patients with AED showed worse metabolic parameters,  cavernous artery parameters, and EPC and EMP levels compared with patients  with PED. Among patients with AED, those with PSV <25 cm/s showed worse  findings of endothelial dysfunction. This suggests that AED is an expression  of endothelial damage and that this original immunophenotype of EPCs and EMPs  may be considered a predictor of endothelial dysfunction in patients with AED.  Finally, this study confirmed the reliability of penile Doppler evaluation  integrated with these serum markers of endothelial dysfunction.
authors.affiliation: 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. sandrolavignera@email.it
authors.forename: Sandro
authors.initials: S
authors.lastname: La Vignera
authors.forename: Enzo
authors.initials: E
authors.lastname: Vicari
authors.forename: Rosita A
authors.initials: RA
authors.lastname: Condorelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Pino
authors.forename: Aldo E
authors.initials: AE
authors.lastname: Calogero
mesh_terms: D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging; D001794:Blood Pressure; D055252:Cell-Derived Microparticles; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D042783:Endothelial Cells; D007172:Erectile Dysfunction / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005434:Flow Cytometry; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000098:blood supply*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013234:Stem Cells; D014280:Triglycerides / Q000097:blood; D018608:Ultrasonography, Doppler / Q000379:methods*
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides