The Inflammation Network in the Pathogenesis of Erectile Dysfunction: Attractive Potential Therapeutic Targets

Author(s): Ecem Kaya-Sezginer, Serap Gur*

Journal Name: Current Pharmaceutical Design

Volume 26 , Issue 32 , 2020

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Background: Erectile dysfunction (ED) is an evolving health problem in the aging male population. Chronic low-grade inflammation is a critical component of ED pathogenesis and a probable intermediate stage of endothelial dysfunction, especially in metabolic diseases, with the inclusion of obesity, metabolic syndrome, and diabetes.

Objective: This review will present an overview of preclinical and clinical data regarding common inflammatory mechanisms involved in the pathogenesis of ED associated with metabolic diseases and the effect of antiinflammatory drugs on ED.

Methods: A literature search of existing pre-clinical and clinical studies was performed on databases [Pubmed (MEDLINE), Scopus, and Embase] from January 2000 to October 2019.

Results: Low-grade inflammation is a possible pathological role in endothelial dysfunction as a consequence of ED and other related metabolic diseases. Increased inflammation and endothelial/prothrombotic markers can be associated with the presence and degree of ED. Pharmacological therapy and modification of lifestyle and risk factors may have a significant role in the recovery of erectile response through reduction of inflammatory marker levels.

Conclusion: Inflammation is the least common denominator in the pathology of ED and metabolic disorders. The inflammatory process of ED includes a shift in the complex interactions of cytokines, chemokines, and adhesion molecules. These data have established that anti-inflammatory agents could be used as a therapeutic opportunity in the prevention and treatment of ED. Further research on inflammation-related mechanisms underlying ED and the effect of therapeutic strategies aimed at reducing inflammation is required for a better understanding of the pathogenesis and successful management of ED.

Keywords: Erectile dysfunction, endothelial dysfunction, metabolic disease, inflammation, cytokines, anti-inflammatory drugs.

Giugliano F, Esposito K, Di Palo C, et al. Erectile dysfunction associates with endothelial dysfunction and raised proinflammatory cytokine levels in obese men. J Endocrinol Invest 2004; 27(7): 665-9.
[] [PMID: 15505991]
Carneiro FS, Webb RC, Tostes RC. Emerging role for TNF-α in erectile dysfunction. J Sex Med 2010; 7(12): 3823-34.
[] [PMID: 20345734]
Vlachopoulos C, Rokkas K, Ioakeimidis N, Stefanadis C. Inflammation, metabolic syndrome, erectile dysfunction, and coronary artery disease: common links. Eur Urol 2007; 52(6): 1590-600.
[] [PMID: 17707576]
Vlachopoulos C, Aznaouridis K, Ioakeimidis N, et al. Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease. Eur Heart J 2006; 27(22): 2640-8.
[] [PMID: 17056702]
Chiurlia E, D’Amico R, Ratti C, Granata AR, Romagnoli R, Modena MG. Subclinical coronary artery atherosclerosis in patients with erectile dysfunction. J Am Coll Cardiol 2005; 46(8): 1503-6.
[] [PMID: 16226175]
Araña Rosaínz Mde J, Ojeda MO, Acosta JR, et al. Imbalanced low-grade inflammation and endothelial activation in patients with type 2 diabetes mellitus and erectile dysfunction. J Sex Med 2011; 8(7): 2017-30.
[] [PMID: 21554550]
Bocchio M, Desideri G, Scarpelli P, et al. Endothelial cell activation in men with erectile dysfunction without cardiovascular risk factors and overt vascular damage. J Urol 2004; 171(4): 1601-4.
[] [PMID: 15017230]
Zuo Z, Jiang J, Jiang R, et al. Effect of periodontitis on erectile function and its possible mechanism. J Sex Med 2011; 8(9): 2598-605.
[] [PMID: 21699666]
Nishimatsu H, Suzuki E, Saito Y, et al. Senescent cells impair erectile function through induction of endothelial dysfunction and nerve injury in mice. PLoS One 2015; 10(4)e0124129
[] [PMID: 25894557]
Maiorino MI, Bellastella G, Esposito K. Lifestyle modifications and erectile dysfunction: what can be expected? Asian J Androl 2015; 17(1): 5-10.
[] [PMID: 25248655]
Esposito K, Giugliano D. Obesity, the metabolic syndrome, and sexual dysfunction in men. Clin Pharmacol Ther 2011; 90(1): 169-73.
[] [PMID: 21613988]
Meldrum DR, Gambone JC, Morris MA, Esposito K, Giugliano D, Ignarro LJ. Lifestyle and metabolic approaches to maximizing erectile and vascular health. Int J Impot Res 2012; 24(2): 61-8.
[] [PMID: 22072232]
Billups KL, Kaiser DR, Kelly AS, et al. Relation of C-reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction. Int J Impot Res 2003; 15(4): 231-6.
[] [PMID: 12934049]
Eaton CB, Liu YL, Mittleman MA, Miner M, Glasser DB, Rimm EB. A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men. Int J Impot Res 2007; 19(2): 218-25.
[] [PMID: 16915303]
Esposito K, Giugliano F, Martedì E, et al. High proportions of erectile dysfunction in men with the metabolic syndrome. Diabetes Care 2005; 28(5): 1201-3.
[] [PMID: 15855589]
Sambel M, Kilic M, Demirbas M, et al. Relationship between erectile dysfunction and the neutrophil to lymphocyte and platelet to lymphocyte ratios. Int J Impot Res 2018; 30(1): 27-35.
[] [PMID: 29196693]
Glina S, Sharlip ID, Hellstrom WJ. Modifying risk factors to prevent and treat erectile dysfunction. J Sex Med 2013; 10(1): 115-9.
[] [PMID: 22971247]
Esper RJ, Nordaby RA, Vilariño JO, Paragano A, Cacharrón JL, Machado RA. Endothelial dysfunction: a comprehensive appraisal. Cardiovasc Diabetol 2006; 5: 4.
[] [PMID: 16504104]
Pober JS, Sessa WC. Evolving functions of endothelial cells in inflammation. Nat Rev Immunol 2007; 7(10): 803-15.
[] [PMID: 17893694]
Endemann DH, Schiffrin EL. Endothelial dysfunction. J Am Soc Nephrol 2004; 15(8): 1983-92.
[] [PMID: 15284284]
Behrendt D, Ganz P. Endothelial function. From vascular biology to clinical applications. Am J Cardiol 2002; 90(10C): 40L-8L.
[] [PMID: 12459427]
Deanfield JE, Halcox JP, Rabelink TJ. Endothelial function and dysfunction: testing and clinical relevance. Circulation 2007; 115(10): 1285-95.
[] [PMID: 17353456]
Trepels T, Zeiher AM, Fichtlscherer S. The endothelium and inflammation. Endothelium 2006; 13(6): 423-9.
[] [PMID: 17169774]
Matos G, Hirotsu C, Alvarenga TA, et al. The association between TNF-α and erectile dysfunction complaints. Andrology 2013; 1(6): 872-8.
[] [PMID: 24123864]
Anderson HD, Rahmutula D, Gardner DG. Tumor necrosis factor-alpha inhibits endothelial nitric-oxide synthase gene promoter activity in bovine aortic endothelial cells. J Biol Chem 2004; 279(2): 963-9.
[] [PMID: 14581470]
Neumann P, Gertzberg N, Johnson A. TNF-alpha induces a decrease in eNOS promoter activity. Am J Physiol Lung Cell Mol Physiol 2004; 286(2): L452-9.
[] [PMID: 14555463]
Yoshizumi M, Perrella MA, Burnett JC Jr, Lee ME. Tumor necrosis factor downregulates an endothelial nitric oxide synthase mRNA by shortening its half-life. Circ Res 1993; 73(1): 205-9.
[] [PMID: 7685252]
Chia S, Qadan M, Newton R, Ludlam CA, Fox KA, Newby DE. Intra-arterial tumor necrosis factor-alpha impairs endothelium-dependent vasodilatation and stimulates local tissue plasminogen activator release in humans. Arterioscler Thromb Vasc Biol 2003; 23(4): 695-701.
[] [PMID: 12692009]
Bouloukaki I, Papadimitriou V, Sofras F, et al. Abnormal cytokine profile in patients with obstructive sleep apnea-hypopnea syndrome and erectile dysfunction. Mediators Inflamm 2014; 2014568951
[] [PMID: 24966468]
Balta I, Balta S, Demirkol S, et al. Elevated serum levels of endocan in patients with psoriasis vulgaris: correlations with cardiovascular risk and activity of disease. Br J Dermatol 2013; 169(5): 1066-70.
[] [PMID: 23889284]
Balta I, Balta S, Koryurek OM, et al. Serum endocan levels as a marker of disease activity in patients with Behçet disease. J Am Acad Dermatol 2014; 70(2): 291-6.
[] [PMID: 24176522]
Yang J, Yang Q, Yu S, Zhang X. Endocan: A new marker for cancer and a target for cancer therapy. Biomed Rep 2015; 3(3): 279-83.
[] [PMID: 26137222]
Balta S, Mikhailidis DP, Demirkol S, Ozturk C, Celik T, Iyisoy A. Endocan: A novel inflammatory indicator in cardiovascular disease? Atherosclerosis 2015; 243(1): 339-43.
[] [PMID: 26448266]
Celık T, Balta S, Karaman M, et al. Endocan, a novel marker of endothelial dysfunction in patients with essential hypertension: comparative effects of amlodipine and valsartan. Blood Press 2015; 24(1): 55-60.
[] [PMID: 25390761]
De Freitas Caires N, Gaudet A, Portier L, Tsicopoulos A, Mathieu D, Lassalle P. Endocan, sepsis, pneumonia, and acute respiratory distress syndrome. Crit Care 2018; 22(1): 280.
[] [PMID: 30367649]
Huang X, Chen C, Wang X, et al. Prognostic value of endocan expression in cancers: Evidence from meta-analysis. OncoTargets Ther 2016; 9: 6297-304.
[] [PMID: 27785077]
Zonda GI, Zonda R, Cernomaz AT, Paduraru L, Avasiloaiei AL, Grigoriu BD. Endocan - a potential diagnostic marker for early onset sepsis in neonates. J Infect Dev Ctries 2019; 13(4): 311-7.
[] [PMID: 32045375]
Karabakan M, Bozkurt A, Akdemir S, Gunay M, Keskin E. Significance of serum endothelial cell specific molecule-1 (Endocan) level in patients with erectile dysfunction: a pilot study. Int J Impot Res 2017; 29(4): 175-8.
[] [PMID: 28424502]
Onuk Ö, Arslan B, Gezmis TC, et al. Is the plasma endocan level a reliable predictor for the severity of erectile dysfunction? Int Urol Nephrol 2018; 50(9): 1577-82.
[] [PMID: 30054863]
Elkamshoushi AAM, Hassan EM, El Abd AM, Hassan SZ, Maher AA. Serum endocan as a predictive biomarker of cardiovascular risk in erectile dysfunction patients. Andrologia 2018; 50(10)e13113
[] [PMID: 30039584]
Akarsu M, Atalay HA, Canat L, et al. Endocan is markedly overexpressed in severe erectile dysfunction. Andrologia 2018; 50(3): 50.
[] [PMID: 29057489]
Oktar SF, Guney I, Eren SA, et al. Serum endocan levels, carotid intima-media thickness and microalbuminuria in patients with newly diagnosed hypertension. Clin Exp Hypertens 2019; 1-8.
[] [PMID: 31390906]
Dozio E, Barassi A, Marazzi MG, et al. Plasma myeloperoxidase in patients with erectile dysfunction of arteriogenic- and non-arteriogenic origin: association with markers of endothelial dysfunction. J Biol Regul Homeost Agents 2013; 27(3): 749-55.
[PMID: 24152842]
Vita JA, Brennan ML, Gokce N, et al. Serum myeloperoxidase levels independently predict endothelial dysfunction in humans. Circulation 2004; 110(9): 1134-9.
[] [PMID: 15326065]
Golubinskaya V, Brandt-Eliasson U, Gan LM, Kjerrulf M, Nilsson H. Endothelial function in a mouse model of myeloperoxidase deficiency. BioMed Res Int 2014; 2014128046
[] [PMID: 24707472]
Boudjeltia KZ, Legssyer I, Van Antwerpen P, et al. Triggering of inflammatory response by myeloperoxidase-oxidized LDL. Biochem Cell Biol 2006; 84(5): 805-12.
[] [PMID: 17167545]
Zouaoui Boudjeltia K, Roumeguere T, Delree P, et al. Presence of LDL modified by myeloperoxidase in the penis in patients with vascular erectile dysfunction: a preliminary study. Eur Urol 2007; 51(1): 262-8.
[] [PMID: 17007997]
Zhang H, Zhang S, Jia L, Li H. MyD88 overexpression deteriorates Ang-II-induced ED via upregulating MPO and COX2 and downregulating eNOS in the corpus cavernosum of rats J Cell Biochem 2018.Online ahead of print..
[PMID: 30484894]
Demirtaş Şahin T, Yazir Y, Utkan T, Gacar G, Furat Rençber S, Gocmez SS. TNF-α antagonism with etanercept enhances penile NOS expression, cavernosal reactivity, and testosterone levels in aged rats. Can J Physiol Pharmacol 2018; 96(2): 200-7.
[] [PMID: 29260891]
Yamashita S, Kato R, Kobayashi K, Hisasue S, Arai Y, Tsukamoto T. Inhibition of interleukin-6 attenuates erectile dysfunction in a rat model of nerve-sparing radical prostatectomy. J Sex Med 2011; 8(7): 1957-64.
[] [PMID: 21492407]
Antuna-Puente B, Feve B, Fellahi S, Bastard JP. Adipokines: the missing link between insulin resistance and obesity. Diabetes Metab 2008; 34(1): 2-11.
[] [PMID: 18093861]
Micić D, Polovina S. Obesity and coronary heart disease: the mechanism of atherogenic impact. Med Pregl 2009; 62(Suppl. 3): 43-6.
[PMID: 19702115]
Michalakis K, Mintziori G, Kaprara A, Tarlatzis BC, Goulis DG. The complex interaction between obesity, metabolic syndrome and reproductive axis: a narrative review. Metabolism 2013; 62(4): 457-78.
[] [PMID: 22999785]
Kaur J. A comprehensive review on metabolic syndrome. Cardiol Res Pract 2014; 2014943162
[] [PMID: 24711954]
Das UN. Acetylcholinesterase and butyrylcholinesterase as markers of low-grade systemic inflammation. Ann Hepatol 2012; 11(3): 409-11.
[] [PMID: 22481463]
Dandona P, Aljada A, Bandyopadhyay A. Inflammation: The link between insulin resistance, obesity and diabetes. Trends Immunol 2004; 25(1): 4-7.
[] [PMID: 14698276]
Carneiro FS, Zemse S, Giachini FR, et al. TNF-alpha infusion impairs corpora cavernosa reactivity. J Sex Med 2009; 6(Suppl. 3): 311-9.
[] [PMID: 19267854]
Hayward MD, Jones BK, Saparov A, et al. An extensive phenotypic characterization of the hTNFalpha transgenic mice. BMC Physiol 2007; 7: 13.
[] [PMID: 18070349]
Carneiro FS, Sturgis LC, Giachini FR, et al. TNF-alpha knockout mice have increased corpora cavernosa relaxation. J Sex Med 2009; 6(1): 115-25.
[] [PMID: 19170842]
Long T, Liu G, Wang Y, Chen Y, Zhang Y, Qin D. TNF-α, erectile dysfunction, and NADPH oxidase-mediated ROS generation in corpus cavernosum in high-fat diet/streptozotocin-induced diabetic rats. J Sex Med 2012; 9(7): 1801-14.
[] [PMID: 22524530]
Facio FN Jr, Facio MF, Spessoto LF, et al. Anti-inflammatory and anti-fibrotic effects of annexin1 on erectile function after cavernous nerve injury in rats. Int J Impot Res 2016; 28(6): 221-7.
[] [PMID: 27557611]
Karadag F, Ozcan H, Karul AB, Ceylan E, Cildag O. Correlates of erectile dysfunction in moderate-to-severe chronic obstructive pulmonary disease patients. Respirology 2007; 12(2): 248-53.
[] [PMID: 17298458]
Ben Khedher MR, Bouhajja H, Haj Ahmed S, Abid M, Jamoussi K, Hammami M. Role of disturbed fatty acids metabolism in the pathophysiology of diabetic erectile dysfunction. Lipids Health Dis 2017; 16(1): 241.
[] [PMID: 29233142]
Ermertcan AT. Sexual dysfunction in dermatological diseases. J Eur Acad Dermatol Venereol 2009; 23(9): 999-1007.
[] [PMID: 19250323]
Blake DJ, Maisiak R, Koplan A, Alarcón GS, Brown S. Sexual dysfunction among patients with arthritis. Clin Rheumatol 1988; 7(1): 50-60.
[] [PMID: 3409645]
Dincer U, Cakar E, Kiralp MZ, Dursun H. Assessment of sexual dysfunction in male patients with Ankylosing Spondylitis. Rheumatol Int 2007; 27(6): 561-6.
[] [PMID: 17094004]
Oh JS, Heo HM, Kim YG, Lee SG, Lee CK, Yoo B. The effect of anti-tumor necrosis factor agents on sexual dysfunction in male patients with ankylosing spondylitis: a pilot study. Int J Impot Res 2009; 21(6): 372-5.
[] [PMID: 19759542]
Mauduit C, Gasnier F, Rey C, et al. Tumor necrosis factor-alpha inhibits leydig cell steroidogenesis through a decrease in steroidogenic acute regulatory protein expression. Endocrinology 1998; 139(6): 2863-8.
[] [PMID: 9607795]
Huang WJ, Yang LY, Pu HF, Tsai YT, Wang PS. The effects of anti-TNF-α antibody on hyperprolactinemia-related suppression of hCG-induced testosterone release in male rats. J Sex Med 2012; 9(4): 1005-14.
[] [PMID: 20946175]
Li H, Qi T, Huang ZS, et al. Relationship between gut microbiota and type 2 diabetic erectile dysfunction in Sprague-Dawley rats. J Huazhong Univ Sci Technolog Med Sci 2017; 37(4): 523-30.
[] [PMID: 28786059]
Sullivan ME, Miller MA, Bell CR, et al. Fibrinogen, lipoprotein (a) and lipids in patients with erectile dysfunction. A preliminary study. Int Angiol 2001; 20(3): 195-9.
[PMID: 11573052]
Cimen S, Dursun M, Sulukaya M, Besiroglu H. Could the monocyte/HDL cholesterol ratio be an early marker of erectile dysfunction? Aging Male 2019; 1-6.
[] [PMID: 30777468]
Kadihasanoglu M, Karabay E, Yucetas U, Erkan E, Ozbek E. Relation between monocyte to high-density lipoprotein cholesterol ratio and presence and severity of erectile dysfunction. Aktuelle Urol 2018; 49(3): 256-61.
[] [PMID: 29145685]
Kifor I, Williams GH, Vickers MA, Sullivan MP, Jodbert P, Dluhy RG. Tissue angiotensin II as a modulator of erectile function. I. Angiotensin peptide content, secretion and effects in the corpus cavernosum. J Urol 1997; 157(5): 1920-5.
[] [PMID: 9112563]
Schiffrin EL, Touyz RM. From bedside to bench to bedside: role of renin-angiotensin-aldosterone system in remodeling of resistance arteries in hypertension. Am J Physiol Heart Circ Physiol 2004; 287(2): H435-46.
[] [PMID: 15277186]
Marchesi C, Paradis P, Schiffrin EL. Role of the renin-angiotensin system in vascular inflammation. Trends Pharmacol Sci 2008; 29(7): 367-74.
[] [PMID: 18579222]
Jin LM. Angiotensin II signaling and its implication in erectile dysfunction. J Sex Med 2009; 6(Suppl. 3): 302-10.
[] [PMID: 19267853]
Yang R, Yang B, Wen Y, et al. Losartan, an angiotensin type I receptor, restores erectile function by downregulation of cavernous renin-angiotensin system in streptozocin-induced diabetic rats. J Sex Med 2009; 6(3): 696-707.
[] [PMID: 19175863]
Granchi S, Vannelli GB, Vignozzi L, et al. Expression and regulation of endothelin-1 and its receptors in human penile smooth muscle cells. Mol Hum Reprod 2002; 8(12): 1053-64.
[] [PMID: 12468637]
Schiffrin EL. Vascular endothelin in hypertension. Vascul Pharmacol 2005; 43(1): 19-29.
[] [PMID: 15955745]
Tostes RC, Muscará MN. Endothelin receptor antagonists: another potential alternative for cardiovascular diseases. Curr Drug Targets Cardiovasc Haematol Disord 2005; 5(4): 287-301.
[] [PMID: 16101562]
Fellner SK, Arendshorst W. Endothelin-A and -B receptors, superoxide, and Ca2+ signaling in afferent arterioles. Am J Physiol Renal Physiol 2007; 292(1): F175-84.
[] [PMID: 16788136]
Just A, Whitten CL, Arendshorst WJ. Reactive oxygen species participate in acute renal vasoconstrictor responses induced by ETA and ETB receptors. Am J Physiol Renal Physiol 2008; 294(4): F719-28.
[] [PMID: 18256310]
Cerrato R, Cunnington C, Crabtree MJ, et al. Endothelin-1 increases superoxide production in human coronary artery bypass grafts. Life Sci 2012; 91(13-14): 723-8.
[] [PMID: 22483692]
Ritchie R, Sullivan M. Endothelins & erectile dysfunction. Pharmacol Res 2011; 63(6): 496-501.
[] [PMID: 21185376]
Contreras C, Sánchez A, Martínez P, et al. Impaired endothelin calcium signaling coupled to endothelin type B receptors in penile arteries from insulin-resistant obese Zucker rats. J Sex Med 2013; 10(9): 2141-53.
[] [PMID: 23875673]
Böhm F, Ahlborg G, Pernow J. Endothelin-1 inhibits endothelium-dependent vasodilatation in the human forearm: reversal by ETA receptor blockade in patients with atherosclerosis. Clin Sci (Lond) 2002; 102(3): 321-7.
[] [PMID: 11869173]
Böhm F, Settergren M, Pernow J. Vitamin C blocks vascular dysfunction and release of interleukin-6 induced by endothelin-1 in humans in vivo. Atherosclerosis 2007; 190(2): 408-15.
[] [PMID: 16527283]
Mather KJ, Lteif A, Steinberg HO, Baron AD. Interactions between endothelin and nitric oxide in the regulation of vascular tone in obesity and diabetes. Diabetes 2004; 53(8): 2060-6.
[] [PMID: 15277386]
Esposito K, Nicoletti G, Giugliano D. Obesity, cytokines and endothelial dysfunction: A link for the raised cardiovascular risk associated with visceral obesity. J Endocrinol Invest 2002; 25(7): 646-9.
[] [PMID: 12150343]
Solak Y, Afsar B, Vaziri ND, et al. Hypertension as an autoimmune and inflammatory disease. Hypertens Res 2016; 39(8): 567-73.
[] [PMID: 27053010]
Grandl G, Wolfrum C. Hemostasis, endothelial stress, inflammation, and the metabolic syndrome. Semin Immunopathol 2018; 40(2): 215-24.
[] [PMID: 29209827]
Rondinone CM. Adipocyte-derived hormones, cytokines, and mediators. Endocrine 2006; 29(1): 81-90.
[] [PMID: 16622295]
Rahmouni K, Correia ML, Haynes WG, Mark AL. Obesity-associated hypertension: New insights into mechanisms. Hypertension 2005; 45(1): 9-14.
[] [PMID: 15583075]
Fillo J, Breza J, Levčíkova M, et al. Occurrence of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome in patients with abdominal obesity. Where is a sufficient level of testosterone? Int Urol Nephrol 2012; 44(4): 1113-20.
[] [PMID: 22315154]
Ye J, Keller JN. Regulation of energy metabolism by inflammation: a feedback response in obesity and calorie restriction. Aging (Albany NY) 2010; 2(6): 361-8.
[] [PMID: 20606248]
Vignozzi L, Filippi S, Comeglio P, et al. Nonalcoholic steatohepatitis as a novel player in metabolic syndrome-induced erectile dysfunction: an experimental study in the rabbit. Mol Cell Endocrinol 2014; 384(1-2): 143-54.
[] [PMID: 24486698]
Maiorino MI, Bellastella G, Giugliano D, Esposito K. From inflammation to sexual dysfunctions: a journey through diabetes, obesity, and metabolic syndrome. J Endocrinol Invest 2018; 41(11): 1249-58.
[] [PMID: 29549630]
Arrabal-Polo MA, Arias-Santiago S, López-Carmona Pintado F, et al. Metabolic syndrome, hormone levels, and inflammation in patients with erectile dysfunction. ScientificWorldJournal 2012; 2012272769
[] [PMID: 22973171]
Laughlin GA, Barrett-Connor E, Bergstrom J. Low serum testosterone and mortality in older men. J Clin Endocrinol Metab 2008; 93(1): 68-75.
[] [PMID: 17911176]
Vincent HK, Innes KE, Vincent KR. Oxidative stress and potential interventions to reduce oxidative stress in overweight and obesity. Diabetes Obes Metab 2007; 9(6): 813-39.
[] [PMID: 17924865]
Kataoka T, Hotta Y, Maeda Y, Kimura K. Testosterone deficiency causes endothelial dysfunction via elevation of asymmetric dimethylarginine and oxidative stress in castrated rats. J Sex Med 2017; 14(12): 1540-8.
[] [PMID: 29198509]
Sibal L, Agarwal SC, Home PD, Boger RH. The role of Asymmetric Dimethylarginine (ADMA) in endothelial dysfunction and cardiovascular disease. Curr Cardiol Rev 2010; 6(2): 82-90.
[] [PMID: 21532773]
Al-Roujeaie AS, Abuohashish HM, Ahmed MM, Alkhamees OA. Effect of rutin on diabetic-induced erectile dysfunction: Possible involvement of testicular biomarkers in male rats. Andrologia 2017; 49(8): 49.
[] [PMID: 27785836]
Kataoka T, Hotta Y, Maeda Y, Kimura K. Assessment of androgen replacement therapy for erectile function in rats with type 2 diabetes mellitus by examining nitric oxide-related and inflammatory factors. J Sex Med 2014; 11(4): 920-9.
[] [PMID: 24467772]
Dandona P, Dhindsa S, Chandel A, Chaudhuri A. Hypogonadotropic hypogonadism in men with type 2 diabetes. Postgrad Med 2009; 121(3): 45-51.
[] [PMID: 19491539]
Burney BO, Hayes TG, Smiechowska J, et al. Low testosterone levels and increased inflammatory markers in patients with cancer and relationship with cachexia. J Clin Endocrinol Metab 2012; 97(5): E700-9.
[] [PMID: 22419719]
Santi D, Granata AR, Guidi A, et al. Six months of daily treatment with vardenafil improves parameters of endothelial inflammation and of hypogonadism in male patients with type 2 diabetes and erectile dysfunction: a randomized, double-blind, prospective trial. Eur J Endocrinol 2016; 174(4): 513-22.
[] [PMID: 26792933]
Yao F, Huang Y, Zhang Y, et al. Subclinical endothelial dysfunction and low-grade inflammation play roles in the development of erectile dysfunction in young men with low risk of coronary heart disease. Int J Androl 2012; 35(5): 653-9.
[] [PMID: 22519624]
Masouminia M, Gelfand R, Kovanecz I, et al. Dyslipidemia is a major factor in stem cell damage induced by uncontrolled long-term type 2 diabetes and obesity in the rat, as suggested by the effects on stem cell culture. J Sex Med 2018; 15(12): 1678-97.
[] [PMID: 30527052]
Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA. Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005; 294(23): 2996-3002.
[] [PMID: 16414947]
Ponholzer A, Temml C, Obermayr R, Wehrberger C, Madersbacher S. Is erectile dysfunction an indicator for increased risk of coronary heart disease and stroke? Eur Urol 2005; 48(3): 512-8.
[] [PMID: 15998563]
Vlachopoulos C, Rokkas K, Ioakeimidis N, et al. Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study. Eur Urol 2005; 48(6): 996-1002.
[] [PMID: 16174548]
Montorsi P, Montorsi F, Schulman CC. Is erectile dysfunction the “tip of the iceberg” of a systemic vascular disorder? Eur Urol 2003; 44(3): 352-4.
[] [PMID: 12932935]
Montorsi P, Ravagnani PM, Galli S, et al. Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J 2006; 27(22): 2632-9.
[] [PMID: 16854949]
Zhang L, Peppel K, Sivashanmugam P, et al. Expression of tumor necrosis factor receptor-1 in arterial wall cells promotes atherosclerosis. Arterioscler Thromb Vasc Biol 2007; 27(5): 1087-94.
[] [PMID: 17442899]
Burnett AL, Strong TD, Trock BJ, Jin L, Bivalacqua TJ, Musicki B. Serum biomarker measurements of endothelial function and oxidative stress after daily dosing of sildenafil in type 2 diabetic men with erectile dysfunction. J Urol 2009; 181(1): 245-51.
[] [PMID: 19013603]
Mong PY, Petrulio C, Kaufman HL, Wang Q. Activation of Rho kinase by TNF-alpha is required for JNK activation in human pulmonary microvascular endothelial cells. J Immunol 2008; 180(1): 550-8.
[] [PMID: 18097057]
Petrache I, Birukova A, Ramirez SI, Garcia JG, Verin AD. The role of the microtubules in tumor necrosis factor-alpha-induced endothelial cell permeability. Am J Respir Cell Mol Biol 2003; 28(5): 574-81.
[] [PMID: 12707013]
McKenzie JA, Ridley AJ. Roles of Rho/ROCK and MLCK in TNF-alpha-induced changes in endothelial morphology and permeability. J Cell Physiol 2007; 213(1): 221-8.
[] [PMID: 17476691]
Petrache I, Crow MT, Neuss M, Garcia JG. Central involvement of Rho family GTPases in TNF-alpha-mediated bovine pulmonary endothelial cell apoptosis. Biochem Biophys Res Commun 2003; 306(1): 244-9.
[] [PMID: 12788095]
Ferrandis-Cortes C, Martínez-Jabaloyas JM, Díez-Calzadilla NA, Hernández-Medina JA, Chuan-Nuez P. Cardiovascular risk assessment using high-sensitivity C-reactive protein in patients with erectile dysfunction. Urol Int 2013; 91(2): 187-91.
[] [PMID: 23816857]
Wu F, Xiong ZQ, Mao SH, et al. Aldosterone induces inflammatory cytokines in penile corpus cavernosum by activating the NF-κB pathway. Asian J Androl 2018; 20(1): 24-9.
[] [PMID: 28382926]
Vlachopoulos C, Dima I, Aznaouridis K, et al. Acute systemic inflammation increases arterial stiffness and decreases wave reflections in healthy individuals. Circulation 2005; 112(14): 2193-200.
[] [PMID: 16186422]
de Tejada IS. Therapeutic strategies for optimizing PDE-5 inhibitor therapy in patients with erectile dysfunction considered difficult or challenging to treat. Int J Impot Res 2004; 16(Suppl. 1): S40-2.
[] [PMID: 15224136]
Garcia LA, Hlaing SM, Gutierrez RA, et al. Sildenafil attenuates inflammation and oxidative stress in pelvic ganglia neurons after bilateral cavernosal nerve damage. Int J Mol Sci 2014; 15(10): 17204-20.
[] [PMID: 25264738]
Hotston MR, Jeremy JY, Bloor J, Koupparis A, Persad R, Shukla N. Sildenafil inhibits the up-regulation of phosphodiesterase type 5 elicited with nicotine and tumour necrosis factor-alpha in cavernosal vascular smooth muscle cells: mediation by superoxide. BJU Int 2007; 99(3): 612-8.
[] [PMID: 17176295]
Bayat N, Izadpanah R, Ebrahimi-Barough S, et al. Anti-inflammatory effects of atorvastatin in human glioblastoma spheroids cultured in a three-dimensional model: possible relevance to glioblastoma treatment. Mol Neurobiol 2018; 55(3): 2102-10.
[] [PMID: 28283885]
Beheshtian A, Salmasi AH, Payabvash S, et al. Protective effects of sildenafil administration on testicular torsion/detorsion damage in rats. World J Urol 2008; 26(2): 197-202.
[] [PMID: 18265987]
Hemnes AR, Zaiman A, Champion HC. PDE5A inhibition attenuates bleomycin-induced pulmonary fibrosis and pulmonary hypertension through inhibition of ROS generation and RhoA/Rho kinase activation. Am J Physiol Lung Cell Mol Physiol 2008; 294(1): L24-33.
[] [PMID: 17965319]
Lagoda G, Jin L, Lehrfeld TJ, Liu T, Burnett AL. FK506 and sildenafil promote erectile function recovery after cavernous nerve injury through antioxidative mechanisms. J Sex Med 2007; 4(4 Pt 1): 908-16.
[] [PMID: 17627738]
Abdel Aziz MT, El-Asmer MF, Mostafa T, et al. Heme oxygenase vs. nitric oxide synthase in signaling mediating sildenafil citrate action. J Sex Med 2007; 4(4 Pt 2): 1098-107.
[] [PMID: 17627722]
Koka S, Das A, Salloum FN, Kukreja RC. Phosphodiesterase-5 inhibitor tadalafil attenuates oxidative stress and protects against myocardial ischemia/reperfusion injury in type 2 diabetic mice. Free Radic Biol Med 2013; 60: 80-8.
[] [PMID: 23385031]
Chen Y, Li XX, Lin HC, et al. The effects of long-term administration of tadalafil on STZ-induced diabetic rats with erectile dysfunction via a local antioxidative mechanism. Asian J Androl 2012; 14(4): 616-20.
[] [PMID: 22504870]
Mammi C, Pastore D, Lombardo MF, et al. Sildenafil reduces insulin-resistance in human endothelial cells. PLoS One 2011; 6(1)e14542
[] [PMID: 21297971]
Elmarakby AA, Sullivan JC. Relationship between oxidative stress and inflammatory cytokines in diabetic nephropathy. Cardiovasc Ther 2012; 30(1): 49-59.
[] [PMID: 20718759]
Jeong KH, Lee TW, Ihm CG, Lee SH, Moon JY, Lim SJ. Effects of sildenafil on oxidative and inflammatory injuries of the kidney in streptozotocin-induced diabetic rats. Am J Nephrol 2009; 29(3): 274-82.
[] [PMID: 18812693]
Küçük A, Yucel M, Erkasap N, et al. The effects of PDE5 inhibitory drugs on renal ischemia/reperfusion injury in rats. Mol Biol Rep 2012; 39(10): 9775-82.
[] [PMID: 22736111]
Omer E, Atassi H. The microbiome that shapes us: Can it cause obesity? Curr Gastroenterol Rep 2017; 19(12): 59.
[] [PMID: 29080046]
Vlachopoulos C, Ioakeimidis N, Rokkas K, et al. Acute effect of sildenafil on inflammatory markers/mediators in patients with vasculogenic erectile dysfunction. Int J Cardiol 2015; 182: 98-101.
[] [PMID: 25577741]
García-Cardoso J, Vela R, Mahillo E, et al. Increased cyclic guanosine monophosphate production and endothelial nitric oxide synthase level in mononuclear cells from sildenafil citrate-treated patients with erectile dysfunction. Int J Impot Res 2010; 22(1): 68-76.
[] [PMID: 19907424]
Roumeguère T, Zouaoui Boudjeltia K, Babar S, et al. Effects of phosphodiesterase inhibitors on the inflammatory response of endothelial cells stimulated by myeloperoxidase-modified low-density lipoprotein or tumor necrosis factor alpha. Eur Urol 2010; 57(3): 522-8.
[] [PMID: 19185976]
Aversa A, Vitale C, Volterrani M, et al. Chronic administration of Sildenafil improves markers of endothelial function in men with Type 2 diabetes. Diabet Med 2008; 25(1): 37-44.
[] [PMID: 18199130]
Jamaluddin BM, Bansal M, Srivastava GK, Gupta NP. Role of serum high-sensitivity c-reactive protein as a predictor of therapeutic response to tadalafil in patients with erectile dysfunction: a prospective observational study. J Sex Med 2019; 16(12): 1912-21.
[] [PMID: 31668733]
Gleason JM, Slezak JM, Jung H, et al. Regular nonsteroidal anti-inflammatory drug use and erectile dysfunction. J Urol 2011; 185(4): 1388-93.
[] [PMID: 21334642]
Shiri R, Koskimäki J, Häkkinen J, Tammela TL, Auvinen A, Hakama M. Effect of nonsteroidal anti-inflammatory drug use on the incidence of erectile dysfunction. J Urol 2006; 175(5): 1812-5.
[] [PMID: 16600768]
Patel DP, Schenk JM, Darke A, Myers JB, Brant WO, Hotaling JM. Non-steroidal anti-inflammatory drug (NSAID) use is not associated with erectile dysfunction risk: results from the Prostate Cancer Prevention Trial. BJU Int 2016; 117(3): 500-6.
[] [PMID: 26305866]
Chen LW, Yin HL. A literature review of antithrombotic and anticoagulating agents on sexual function. Andrologia 2017; 49(10): 49.
[] [PMID: 28261826]
Bayraktar Z, Albayrak S. Antiplatelet (aspirin) therapy as a new option in the treatment of vasculogenic erectile dysfunction: a prospective randomized double-blind placebo-controlled study. Int Urol Nephrol 2018; 50(3): 411-8.
[] [PMID: 29344879]
Hafez G, Gonulalan U, Kosan M, et al. Acetylsalicylic acid protects erectile function in diabetic rats. Andrologia 2014; 46(9): 997-1003.
[] [PMID: 24428436]
Dhikav V, Gupta S, Anand KS. Erectile dysfunction induced probably by celecoxib. Pharmacoepidemiol Drug Saf 2008; 17(2): 211-2.
[] [PMID: 18236511]
O’Banion MK. Cyclooxygenase-2: molecular biology, pharmacology, and neurobiology. Crit Rev Neurobiol 1999; 13(1): 45-82.
[] [PMID: 10223523]
Bassiouni W, Daabees T, Louedec L, Norel X, Senbel A. Evaluation of some prostaglandins modulators on rat corpus cavernosum in-vitro: Is relaxation negatively affected by COX-inhibitors? Biomed Pharmacother 2019; 111: 1458-66.
[] [PMID: 30841461]
Senbel AM. Functional inhibition of erectile process in rats by indomethacin. World J Urol 2011; 29(4): 523-7.
[] [PMID: 20927528]
Ignarro LJ, Bush PA, Buga GM, Wood KS, Fukuto JM, Rajfer J. Nitric oxide and cyclic GMP formation upon electrical field stimulation cause relaxation of corpus cavernosum smooth muscle. Biochem Biophys Res Commun 1990; 170(2): 843-50.
[] [PMID: 2166511]
Esposito K, Giugliano F, Di Palo C, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA 2004; 291(24): 2978-84.
[] [PMID: 15213209]
Jackson G. The importance of risk factor reduction in erectile dysfunction. Curr Urol Rep 2007; 8(6): 463-6.
[] [PMID: 18042325]
Esposito K, Giugliano D. Lifestyle/dietary recommendations for erectile dysfunction and female sexual dysfunction. Urol Clin North Am 2011; 38(3): 293-301.
[] [PMID: 21798391]
Hannan JL, Maio MT, Komolova M, Adams MA. Beneficial impact of exercise and obesity interventions on erectile function and its risk factors. J Sex Med 2009; 6(Suppl. 3): 254-61.
[] [PMID: 19170860]
Silva AB, Sousa N, Azevedo LF, Martins C. Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis. Br J Sports Med 2017; 51(19): 1419-24.
[] [PMID: 27707739]
Lamina S, Okoye CG, Dagogo TT. Managing erectile dysfunction in hypertension: The effects of a continuous training programme on biomarker of inflammation. BJU Int 2009; 103(9): 1218-21.
[] [PMID: 19076137]
Morelli A, Filippi S, Comeglio P, et al. Physical activity counteracts metabolic syndrome-induced hypogonadotropic hypogonadism and erectile dysfunction in the rabbit. Am J Physiol Endocrinol Metab 2019; 316(3): E519-35.
[] [PMID: 30645174]
Sponton AC, Silva FH, Araujo HN, et al. Circulating concentrations of adipocytokines and their receptors in the isolated corpus cavernosum and femoral artery from trained rats on a high-fat diet. J Vasc Res 2017; 54(1): 33-50.
[] [PMID: 28288470]
La Favor JD, Anderson EJ, Dawkins JT, Hickner RC, Wingard CJ. Exercise prevents Western diet-associated erectile dysfunction and coronary artery endothelial dysfunction: Response to acute apocynin and sepiapterin treatment. Am J Physiol Regul Integr Comp Physiol 2013; 305(4): R423-34.
[] [PMID: 23761637]
Zheng H, Mayhan WG, Patel KP. Exercise training improves the defective centrally mediated erectile responses in rats with type I diabetes. J Sex Med 2011; 8(11): 3086-97.
[] [PMID: 21883945]
Després JP. Obesity and cardiovascular disease: weight loss is not the only target. Can J Cardiol 2015; 31(2): 216-22.
[] [PMID: 25661557]
Rocha B, Rodrigues AR, Tomada I, et al. Energy restriction, exercise and atorvastatin treatment improve endothelial dysfunction and inhibit miRNA-155 in the erectile tissue of the aged rat. Nutr Metab (Lond) 2018; 15: 28.
[] [PMID: 29686722]
Khoo J, Piantadosi C, Duncan R, et al. Comparing effects of a low-energy diet and a high-protein low-fat diet on sexual and endothelial function, urinary tract symptoms, and inflammation in obese diabetic men. J Sex Med 2011; 8(10): 2868-75.
[] [PMID: 21819545]
Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R. Metabolic syndrome: A comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 2005; 111(11): 1448-54.
[] [PMID: 15781756]
Johnson BD, Padilla J, Harris RA, Wallace JP. Vascular consequences of a high-fat meal in physically active and inactive adults. Appl Physiol Nutr Metab 2011; 36(3): 368-75.
[] [PMID: 21574775]
Nappo F, Esposito K, Cioffi M, et al. Postprandial endothelial activation in healthy subjects and in type 2 diabetic patients: role of fat and carbohydrate meals. J Am Coll Cardiol 2002; 39(7): 1145-50.
[] [PMID: 11923038]
Lopez-Garcia E, Hu FB. Nutrition and the endothelium. Curr Diab Rep 2004; 4(4): 253-9.
[] [PMID: 15265466]
Esposito K, Giugliano D. Diet and inflammation: a link to metabolic and cardiovascular diseases. Eur Heart J 2006; 27(1): 15-20.
[] [PMID: 16219650]
McKeown NM, Meigs JB, Liu S, Saltzman E, Wilson PW, Jacques PF. Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care 2004; 27(2): 538-46.
[] [PMID: 14747241]
de la Garza AL, Etxeberria U, Haslberger A, Aumueller E, Martínez JA, Milagro FI. Helichrysum and grapefruit extracts boost weight loss in overweight rats reducing inflammation. J Med Food 2015; 18(8): 890-8.
[] [PMID: 25599391]
Muniyappa R, Quon MJ. Insulin action and insulin resistance in vascular endothelium. Curr Opin Clin Nutr Metab Care 2007; 10(4): 523-30.
[] [PMID: 17563474]
Beavers KM, Ambrosius WT, Nicklas BJ, Rejeski WJ. Independent and combined effects of physical activity and weight loss on inflammatory biomarkers in overweight and obese older adults. J Am Geriatr Soc 2013; 61(7): 1089-94.
[] [PMID: 23772804]
Kadoglou NP, Iliadis F, Angelopoulou N, et al. The anti-inflammatory effects of exercise training in patients with type 2 diabetes mellitus. Eur J Cardiovasc Prev Rehabil 2007; 14(6): 837-43.
[] [PMID: 18043308]
Dekker MJ, Lee S, Hudson R, et al. An exercise intervention without weight loss decreases circulating interleukin-6 in lean and obese men with and without type 2 diabetes mellitus. Metabolism 2007; 56(3): 332-8.
[] [PMID: 17292721]
Goldhammer E, Tanchilevitch A, Maor I, Beniamini Y, Rosenschein U, Sagiv M. Exercise training modulates cytokines activity in coronary heart disease patients. Int J Cardiol 2005; 100(1): 93-9.
[] [PMID: 15820291]
Balducci S, Zanuso S, Nicolucci A, et al. Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss. Nutr Metab Cardiovasc Dis 2010; 20(8): 608-17.
[] [PMID: 19695853]
Miller EG, Sethi P, Nowson CA, Dunstan DW, Daly RM. Effects of progressive resistance training and weight loss versus weight loss alone on inflammatory and endothelial biomarkers in older adults with type 2 diabetes. Eur J Appl Physiol 2017; 117(8): 1669-78.
[] [PMID: 28597102]
Hu Y, Niu X, Wang G, Huang J, Liu M, Peng B. Chronic prostatitis/chronic pelvic pain syndrome impairs erectile function through increased endothelial dysfunction, oxidative stress, apoptosis, and corporal fibrosis in a rat model. Andrology 2016; 4(6): 1209-16.
[] [PMID: 27565759]
Nunes KP, Bomfim GF, Toque HA, Szasz T, Clinton Webb R. Toll-like receptor 4 (TLR4) impairs nitric oxide contributing to Angiotensin II-induced cavernosal dysfunction. Life Sci 2017; 191: 219-26.
[] [PMID: 29032115]
Qiao H, Zhang Y, Lin W, et al. Decreased expression of pigment epithelium-derived factor within the penile tissues contributes to erectile dysfunction in diabetic rats. Clin Sci (Lond) 2018; 132(20): 2175-88.
[] [PMID: 30232174]
Şahin TD, Yazır Y, Utkan T, Göçmez SS, Bayramgürler D. Penile constitutive nitric oxide synthase expression in rats exposed to unpredictable chronic mild stress: role of inflammation. Int J Impot Res 2017; 29(2): 76-81.
[] [PMID: 27904147]
Matsui H, Sopko NA, Hannan JL, et al. M1 macrophages are predominantly recruited to the major pelvic ganglion of the rat following cavernous nerve injury. J Sex Med 2017; 14(2): 187-95.
[] [PMID: 28161077]
Demirtaş Şahin T, Yazir Y, Utkan T, Gacar G, Halbutoğulları ZS, Gocmez SS. Depression induced by chronic stress leads to penile cavernosal dysfunction: protective effect of anti-TNF-α treatment. Can J Physiol Pharmacol 2018; 96(9): 933-42.
[] [PMID: 30052465]
Zhao HF, Li X, Jiang XZ. Heat shock protein 9-mediated inflammation reaction in patients with chronic prostatitis with erectile dysfunction. Eur Rev Med Pharmacol Sci 2016; 20(20): 4185-9.
[PMID: 27831659]
Leite LN, do Vale GT, Simplicio JA, De Martinis BS, Carneiro FS, Tirapelli CR. Ethanol-induced erectile dysfunction and increased expression of pro-inflammatory proteins in the rat cavernosal smooth muscle are mediated by NADPH oxidase-derived reactive oxygen species. Eur J Pharmacol 2017; 804: 82-93.
[] [PMID: 28315342]
Tomada I, Negrão R, Almeida H, Neves D. Long-term high-fat consumption leads to downregulation of Akt phosphorylation of eNOS at Ser1177 and upregulation of Sirtuin-1 expression in rat cavernous tissue. Age (Dordr) 2014; 36(2): 597-611.
[] [PMID: 24105250]
Toblli JE, Cao G, Angerosa M, Rivero M. Long-term phosphodiesterase 5 inhibitor administration reduces inflammatory markers and heat-shock proteins in cavernous tissue of Zucker diabetic fatty rat (ZDF/fa/fa). Int J Impot Res 2015; 27(5): 182-90.
[] [PMID: 26202338]
Lamina S, Okoye CG, Dagogo TT. Therapeutic effect of an interval exercise training program in the management of erectile dysfunction in hypertensive patients. J Clin Hypertens (Greenwich) 2009; 11(3): 125-9.
[] [PMID: 19302423]
El-Sisi AA, Hegazy SK, Salem KA. AbdElkawy KS. Atorvastatin improves erectile dysfunction in patients initially irresponsive to Sildenafil by the activation of endothelial nitric oxide synthase. Int J Impot Res 2013; 25(4): 143-8.
[] [PMID: 23324897]

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Year: 2020
Published on: 23 September, 2020
Page: [3955 - 3972]
Pages: 18
DOI: 10.2174/1381612826666200424161018
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