Erectile Dysfunction and Diabetes Mellitus: Mechanistic Considerations from Studies in Experimental Models
Erectile Dysfunction and Diabetes Mellitus: Mechanistic Considerations from Studies in Experimental Models
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DOI：
10.2174/157339907781368977
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发表时间：
2007-01-01
影响因子：
3.3
通讯作者：
Cotter, Mary A.
中科院分区：
文献类型：
--
作者：
Cameron, Norman E.;Cotter, Mary A.
糖尿病是勃起功能障碍的主要危险因素。这种情况会降低阴茎的神经和血管内皮控制系统。实验和流行病学证据表明高血糖和血脂异常都是病因。这些是氧化应激升高以及高级糖化和脂氧合终产物形成的驱动力，主要目标是神经和内皮的一氧化氮系统。这会导致可逆的功能丧失，然后是不可逆的退行性变化。这些机制具有直接影响，例如一氧化氮猝灭，但也许更重要的是，对一氧化氮合酶表达和活性的调节具有间接影响，这可能涉及促炎细胞信号传导途径的募集。后者包括蛋白激酶 C、丝裂原激活激酶和核因子 B 级联。糖尿病还改变对神经和内皮的营养影响。这些共同形成了针对糖尿病勃起功能乃至一般血管疾病的潜在治疗靶点。
Diabetes is a major risk factor for erectile dysfunction. The condition degrades both neural and vascular endothelium penile control systems. Experimental and epidemiological evidence suggest that both hyperglycemia and dyslipidemia contribute to the etiology. These are the driving forces for elevated oxidative stress and the formation of advanced glycation and lipoxygenation end products, the major target being the nitric oxide systems of nerve and endothelium. This causes reversible functional loss followed by less reversible degenerative changes. These mechanisms have direct effects, such as the nitric oxide quenching, but perhaps more importantly, indirect effects on the regulation of nitric oxide synthase expression and activity, which can involve recruitment of proinflammatory cell signaling pathways. The latter include protein kinase C, mitogen-activated kinases, and the nuclear factor B cascade. Diabetes also changes the trophic influences on nerve and endothelium. Together, these form potential therapeutic targets against diabetic erectile function, and indeed vascular disease in general.