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Testosterone, Endothelial Health, and Erectile Function

By Angela Castela, Pedro Vendeira and Carla Costa

Abstract

Experimental and clinical studies have reported that testosterone has a critical role in the maintenance of homeostatic and morphologic corpus cavernosum components, essential for normal erectile physiology. Although the exact mechanisms mediated by testosterone in erectile function are still under investigation, recent research has suggested an important role in the regulation of endothelial cell (EC) biological functions. Besides stimulating the production of EC mediators, testosterone is also thought to promote the vasculogenic reendothelialization process, mediated by bone marrow-derived endothelial progenitor cells. Additionally, testosterone seems to modulate other erectile tissue components, including trabecular smooth muscle cells, nerve fibers, and tunica albuginea structure, all essential for the erectile process. This paper summarizes current data regarding testosterone-induced cellular and molecular mechanisms that regulate penile tissue components, focusing particularly on the role of testosterone in endothelial health and erectile function

Topics: Review Article
Publisher: International Scholarly Research Network
OAI identifier: oai:pubmedcentral.nih.gov:3262643
Provided by: PubMed Central
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    Citations

    1. (2003). A .A v e r s a ,A .M .I s i d o r i ,G .S p e r a ,A .L e n z i ,a n dA .F a b b r i , “Androgens improve cavernous vasodilation and response to sildenafil in patients with erectile dysfunction,”
    2. (2010). A .A v e r s a ,R .B r u z z i c h e s ,D .F r a n c o m a n o ,M .N a t a l i ,P .G a r e r i
    3. (1999). A .M .T r a i s h ,K .P a r k ,V .D h i r
    4. (2005). A .M .T r a i s h ,P .T o s e l l i ,S .J .J e o n g ,a n dN .N .K i m ,“ A d i p o c y t e accumulation in penile corpus cavernosum of the orchiectomized rabbit: a potential mechanism for veno-occlusive dysfunction in androgen deficiency,”
    5. (1997). A b u ,A .H o r n e r ,V .K u s e c ,J .T .T r i ffitt, and
    6. (2008). A doseresponse study of testosterone on sexual dysfunction and features of the metabolic syndrome using testosterone gel and parenteral testosterone undecanoate,”
    7. (2006). a l d ,R .B .M e a c h a m ,L .S .R o s s ,a n dC .S .N i e d e r b e r g e r , “Testosterone replacement therapy for older men,”
    8. (2007). a s s i n k ,J .K .O l i j h o e k ,a n dF .L .J .V i s s e r e n , “The metabolic syndrome: metabolic changes with vascular consequences,”
    9. (2006). A.A.Yassin,F.Saad,andA.Traish,“Testosteroneundecanoate restores erectile function in a subset of patients with venous leakage: a series of case reports,”
    10. Age-related changes in testosterone and the role of replacement therapy
    11. (2002). Akt-dependent phosphorylation of endothelial nitric-oxide synthase mediates penile erection,”
    12. (2006). Anatomy and physiology of erection,”inStandardPracticeinSexualMedicine,H.P
    13. (2003). Androgen and estrogen receptors in the human corpus cavernosum penis: immunohistochemical and cell culture results,”
    14. (1997). Androgenic regulation of NO availability in rat penile erection,”
    15. (2009). Androgens play a pivotal role in maintaining penile tissue architecture and erection: a review,”
    16. (2004). Androgens regulate phosphodiesterase type 5 expression and functional activity in corpora cavernosa,”
    17. (2008). Androgens stimulate endothelial progenitor cells through an androgen receptor-mediated pathway,”
    18. Androgensmodulatenitricoxidesynthasemessengerribonucleic acid expression in neurons of the major pelvic ganglion intherat,”Endocrinology,vol.138,no.8,pp.3093–3102,1997.
    19. (2006). Are androgens critical for penile erections in humans? Examining the clinical and preclinical evidence,”
    20. Bone marrow origin of endothelial progenitor cells responsible for postnatal vasculogenesis in physiological and pathological neovascularization,”CirculationResearch,vol.85,no.3,pp.221–228,1999.
    21. (2002). C.A.HeinleinandC.Chang,“Therolesofandrogenreceptors and androgen-binding proteins in nongenomic androgen actions,” Molecular Endocrinology,
    22. (2009). C.Costa,“Roleofendothelialprogenitorcellsinthemetabolic syndrome,” in Oxidative Stress, Inflammation and Angiogenesis in the Metabolic Syndrome,
    23. (2005). Cellek et al., “Pathophysiology of erectile dysfunction,”
    24. (2007). Changes in aortic endothelium ultrastructure in male rats following castration, replacement with testosterone and administration of 5α-reductase inhibitor,”
    25. (2008). Characteristic of the endogenous peptides–endothelins and their role in the connectivetissuefibrosis,”Wiadomo´
    26. (2005). Circulating endothelial (progenitor) cells reflect the state of the endothelium: vascular injury, repair and neovascularization,” Vox Sanguinis,
    27. (2005). Circulating endothelial progenitor cells in subjects with erectile dysfunction,”
    28. (2006). Circulatingendothelialprogenitorcellscorrelatewitherectile function in patients with coronary heart disease,”
    29. (2002). D.BehrendtandP.Ganz,“Endothelialfunction:fromvascular biology to clinical applications,”
    30. (2000). Delayed testosterone replacement restores nitric oxide synthase-containing nerve fibres and the erectile response in rat penis,”
    31. (2006). Dihydrotestosterone decreases tumor necrosis factor-α and lipopolysaccharide-induced inflammatory response in human endothelial cells,”
    32. (1995). Dihydrotestosterone is the active androgen in the maintenance of nitric oxide-mediated penile erection in the rat,”
    33. (2000). Effe c to ft e s t o s t e r o n e on the number of NADPH diaphorase-stained nerve fibers in the rat corpus cavernosum and dorsal nerve,”
    34. (2003). Effect of androgen deprivation on penile ultrastructure,”
    35. (2003). Effects of medicalorsurgicalcastrationonerectilefunctioninananimal model,”
    36. (2008). Effects of testost e r o n eg e lf o l l o w e db yp a r e n t e r a lt e s t o s t e r o n eu n d e c a n o a t e on sexual dysfunction and on features of the metabolic syndrome,”
    37. (1997). Endocrine screening in 1,022 men with erectile dysfunction: clinical significance and cost-effective strategy,”
    38. (2006). Endothelial dysfunction and its role in diabetic vascular disease,”
    39. (2007). Endothelial dysfunction in diabetic erectile dysfunction,”
    40. (2003). Endothelial dysfunction in erectile dysfunction: role of the endothelium in erectile physiology and disease,”
    41. (2005). Endothelial dysfunction links erectile dysfunction to heart disease,”
    42. (2005). Endothelial nitric oxide synthase gene therapy for erectile dysfunction,”
    43. (1993). Endothelin in vascular and endocrine systems: biological activities and its mechanisms of action,”
    44. (2000). Erectile dysfunction in cyclic GMP-dependent kinase I-deficient mice,”
    45. (2004). Expression of cavernous transforming growth factor-β1 and its Type II Receptor in patients with erectile dysfunction,”
    46. (1996). Gonz´ alezCadavid, “Androgen and pituitary control of penile nitric oxide synthase and erectile function in the rat,”
    47. (2005). Hypogonadism and metabolic syndrome: implications for testosterone therapy,”
    48. (2009). i r o n e ,C .I m b i m b o ,F .F u s c o ,P .V e r z e ,M .C r e t a ,a n dG . Tajana, “Androgens and morphologic remodeling at penile and cardiovascular levels: a common piece in complicated puzzles?”
    49. (2007). Inflammation, metabolic syndrome, erectile dysfunction, and coronary artery disease: common links,”
    50. (2003). Intracavernosal vascular endothelial growth factor (VEGF) injection and adeno-associated virus-mediated VEGF gene therapy prevent and reverse venogenic erectile dysfunction in rats,”
    51. (2007). Jagodzi´ nski, “Endothelial progenitor cells as a new agent contributing to vascular repair,”
    52. (2001). Localization of androgen receptor expression in human bone marrow,”
    53. (2007). Low testosterone level is an independent determinant of endothelial dysfunction
    54. (1992). Nitric oxide: a physiologic mediator of penile erection,”
    55. (1985). o l d s t e i n
    56. (2006). of Andrology, “Testosterone replacement therapy for male aging: SAS position statement,”
    57. (2003). Oral testosterone undecanoate reverses erectile dysfunction associated with diabetes mellitus in patients failing on sildenafil citrate therapy alone,”
    58. (1992). orntorp, “Androgen treatment of middle-aged, obese men: effects on metabolism, muscleandadiposetissues,”TheEuropeanJournalofMedicine,
    59. (2000). Pathophysiology of erectile dysfunction: the contributions of trabecular structure to function and the role of functional antagonism,”
    60. (2001). Pharmacology of penile erection,”
    61. (2004). Randomizedstudyoftestosteronegelasadjunctivetherapyto sildenafil in hypogonadal men with erectile dysfunction who
    62. (2006). Reduced number of circulating endothelial progenitor cells in hypogonadal men,”
    63. (2006). Relationship between androgenic hormones and arterial stiffness, based on longitudinal hormone measurements,”
    64. (2000). S t e l l a t o ,H .A .F e l d m a n ,O .H a m d y ,E .S .H o r t o n ,a n d
    65. (2007). S.M.Haag,E.W.Hauck,C.Szardening-Kirchneretal.,“Alterations in the transforming growth factor (TGF)-β pathway as a potential factor in the pathogenesis of peyronie’s disease,”
    66. (2004). Tatsura et al., “Penile apoptosis in association with p53 under lack of testosterone,”
    67. (2008). Testosterone and erectile dysfunction,”
    68. (2007). Testosterone and erectile function: from basic research to a new clinical paradigmformanagingmenwithandrogeninsufficiencyanderectile dysfunction,”
    69. (2002). Testosterone and estradiol modulate TNF-α-induced expression of adhesion molecules inendothelialcells,”MethodsandFindingsinExperimentaland Clinical Pharmacology,
    70. (2007). Testosterone associations with erectile dysfunction, diabetes, and the metabolic syndrome,”
    71. (2008). Testosterone improves erectile function in hypogonadal patients with venous leakage,”
    72. (2005). Testosterone regulates PDE5 expression and in vivo responsiveness to tadalafil in rat corpus cavernosum,”
    73. (2006). Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes,”
    74. (2007). Testosterone replacement therapy in male hypogonadism is not associated with increase of endothelin-1 levels,”
    75. Testosterone supplementation for erectile dysfunction: results of a metaanalysis,”JournalofUrology,vol.164,no.2,pp.371–375,2000.
    76. (1997). Testosterone supplementation for hypogonadal impotence: assessment of biochemical measures and therapeutic outcomes,”
    77. (2003). Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency,”
    78. (2009). The dark side of testosterone deficiency: II. type 2 diabetes and insulin resistance,”
    79. (2008). The effects of testosterone deficiency on the structural integrity of the penile dorsal nerve in the rat,”
    80. (1992). The effects of testosterone treatment on body composition and metabolism in middle-aged obese men,”
    81. (2009). The endothelial-erectile dysfunction connection: an essential update,”
    82. (2009). The PDE5 inhibitor sildenafil increases circulating endothelial progenitor cells and CXCR4 expression,”
    83. (2005). The physiological role of androgens in penile erection: regulation of corpus cavernosum structure and function,”
    84. (1998). Transforming growth factor-β1( T G F - β1) in penile and prostate growth in the rat during sexual maturation,”
    85. (2004). Vascular repair by circulating endothelial progenitor cells: the missing link in atherosclerosis?”
    86. (2003). Vasculogenic erectile dysfunction: newer therapeutic strategies,”
    87. (2007). Vasodilating mechanisms of testosterone,”

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