Androgens Modulate Endothelial Function and Endothelial Progenitor Cells in Erectile Physiology

Abstract

The incidence of erectile dysfunction (ED) increases with age and cardiovascular disease risk factors, such as hypertension, hyperlipidemia, insulin resistance, obesity, and diabetes. These risk factors are thought to contribute to endothelial dysfunction and atherosclerosis, thus contributing to the pathophysiology of ED. The role of the endothelium in regulating erectile physiology is well established. However, the role of androgens in modulating endothelial function and endothelial repair mechanisms subsequent to vascular injury in erectile tissue remains a subject of intensive research. The clinical and preclinical evidence discussed in this review suggests that androgens regulate endothelial function and also play an important role in the development and maturation of endothelial progenitor cells (EPCs), which are thought to play a critical role in repair of endothelial injury in vascular beds. In this review, we discuss the data available on the effects of androgens on endothelial function and EPCs in the repair of vascular injury. Indeed, more research is needed to fully understand the molecular and cellular basis of androgen action in regulating the development, differentiation, maturation, migration, and homing of EPCs to the site of injury. A better understanding of these processes will be critical to the development of new therapeutic approaches to the treatment of vascular ED.

Transplantation of adipose tissue-derived stem cell-derived exosomes ameliorates erectile function in diabetic rats

“…One of pathophysiological mechanisms of DED is endothelial dysfunction. However, it is believed that the damaged endothelium can not only be repaired by the proliferation and migration of neighbouring endothelial cells, but also by endothelial progenitor cells (EPCs) (Traish & Galoosian, ; Wassmann, Werner, Czech, & Nickenig, ). Studies have demonstrated that DM reduces the number of EPCs and adversely affects the functional capacity of existing EPCs in patients with ED (Maiorino et al., ).…”

Testosterone modulates endothelial progenitor cells in rat corpus cavernosum

“…EPCs were described as a population of circulating cells capable of engrafting in areas of physiological or pathological neovascularisation, in areas of angiogenesis, and for endothelial cell repair by acquiring an endothelial phenotype . Endothelial injury is thought to be repaired by mature circulating EPCs . Circulating EPCs mainly originate from the bone marrow.…”

“…Recent studies have shown a relationship between ED and the endothelial cells that serve as a barrier between circulating blood and the surrounding tissue . Endothelial cells play a critical role in angiogenesis and vascular repair . Additionally, endothelial injury can lead to a continuous and worsening vascular injury, and finally results in ED .…”

“…Testosterone regulates cellular growth and differentiation in the penile corpus cavernosum . Traish and Galoosian suggested that androgens stimulate EPCs through a pathway mediated by the androgen receptor. They hypothesised that androgen withdrawal promotes differentiation of progenitor stromal cells into an adipocyte lineage.…”

Age-Specific Clinical Features of Erectile Dysfunction

“…Erectile dysfunction (ED) is now well-studied and thought to be a symptom of underlying disease rather than a disease itself [3]. The role of the endothelium in regulating erectile physiology is well established, and the incidence of ED increases with age, usually associating with changes in arterial structure and function [4]- [7]. People are living longer and healthier lives nowadays, and elderly people proportion in this society is increasing.…”