Erectile dysfunction (ED) is a major health problem as the population ages. Basic science
research for the last two decades has expanded the knowledge on ED and identified several key molecular
changes associated with the pathogenesis of ED, including nitric oxide (NO) / cyclic guanosine
monophosphate (cGMP) / protein kinase G (PKG) pathway, RhoA/Rho-associated protein kinase
(ROCK) signaling pathway, reactive oxygen species (ROS), renin-angiotensin system (RAS) and tumor
necrosis factor-alpha (TNF-α). The causes of ED are classified into aging, vasculogenic, neurogenic,
endocrinological, drug-induced and psychogenic. ED is often associated with systemic diseases,
such as diabetes and cardiovascular diseases. In this review, we will review the molecular mechanisms of ED and known
mechanisms behind ED associated with systemic diseases.
Keywords: Angiotensin, erectile dysfunction, nitric oxide, pathophysiology, reactive oxygen species, RhoA/Rho-associated
protein kinase, tumor necrosis factor-alpha.
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