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Role of some vasoactive mediators in patients with erectile dysfunction: their relationship with angiotensin-converting enzyme and growth hormone

International Journal of Impotence Research volume 15, pages 418–425 (2003)Cite this article

Abstract

The imbalance between vasoconstrictors and vasodilators may play an important role in the pathogenesis of erectile dysfunction (ED). A total of 36 patients with ED, organogenic [diabetic (n=12) and nondiabetic (n=12)] and psychogenic (n=12) etiology, and 12 healthy adult men as controls were included. The levels of endothelin-1 (ET-1), growth hormone (GH), angiotensin-converting enzyme activity (ACE), nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) were determined in the flaccid penis cavernosal blood of patients and in cubital blood of patients and controls. In psychogenic ED, systemic ACE activity was elevated compared to controls (P<0.05). In diabetic and nondiabetic ED patients, systemic levels of ET-1 (P<0.0001 for both) and ACE activity (P<0.01 and <0.05) were higher while GH (P<0.0001 and <0.001), NO (P<0.0001 for both) and cGMP (P<0.01 for both) levels were lower compared to controls. In diabetic patients, systemic and cavernosal ET-1 levels (P<0.0001 for both) and cavernosal ACE activity levels (P<0.05) were significantly elevated while systemic and cavernosal NO (P<0.0001 for both) and GH (<0.001 and <0.05) levels were declined compared to psychogenic. In nondiabetic patients, systemic and cavernosal ET-1 levels (P<0.0001 for both) were significantly elevated while systemic and cavernosal NO (P<0.0001 for both) and systemic GH levels (P<0.05) were declined compared to psychogenic. Systemic NO was positively correlated with GH in psychogenic (r=0.616, P<0.05), diabetic (r=0.583, P<0.05) and nondiabetic (r=0.615, P<0.05) patients and correlated positively with cGMP (r=0.605, P<0.05) but negatively with ACE activities (r=−0.585, P<0.05) in diabetic patients. In conclusion, plasma levels of ET-1, ACE activities are elevated and associated with reduction of GH, NO and cGMP levels in the systemic and cavernous blood of ED patients. This disturbance may indicate endothelial dysfunction that may hind at their significance in the pathophysiology of ED.

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Acknowledgements

We are greatly in debt for the critical and devoted review to Professor Mohamed Essam EL-Deen Osman, MD (Professor of Urology, Assiut University Hospital, Assiut, Egypt). We also thank all the volunteers who participated in the present study.

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Authors and Affiliations

  1. Department of Physiology, Faculty of Medicine, Assiut, Egypt

    EA Hamed

  2. Department of Biochemistry, Faculty of Medicine, Assiut, Egypt

    ARMA Meki

  3. Department of Urology, Faculty of Medicine, Assiut, Egypt

    AAA Gaafar

  4. Department of Neurology, Faculty of Medicine, Assiut, Egypt

    SA Hamed

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  1. EA Hamed
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Correspondence to EA Hamed.

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Hamed, E., Meki, A., Gaafar, A. et al. Role of some vasoactive mediators in patients with erectile dysfunction: their relationship with angiotensin-converting enzyme and growth hormone. Int J Impot Res 15, 418–425 (2003). https://doi.org/10.1038/sj.ijir.3901059

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