Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

eNOS-uncoupling in age-related erectile dysfunction

Abstract

Aging is associated with ED. Although age-related ED is attributed largely to increased oxidative stress and endothelial dysfunction in the penis, the molecular mechanisms underlying this effect are not fully defined. We evaluated whether endothelial nitric oxide synthase (eNOS) uncoupling in the aged rat penis is a contributing mechanism. Correlatively, we evaluated the effect of replacement with eNOS cofactor tetrahydrobiopterin (BH4) on erectile function in the aged rats. Male Fischer 344 ‘young’ (4-month-old) and ‘aged’ (19-month-old) rats were treated with a BH4 precursor sepiapterin (10 mg/kg intraperitoneally) or vehicle for 4 days. After 1-day washout, erectile function was assessed in response to electrical stimulation of the cavernous nerve. Endothelial dysfunction (eNOS uncoupling) and oxidative stress (thiobarbituric acid reactive substances, TBARS) were measured by conducting western blot in penes samples. Erectile response was significantly reduced in aged rats, whereas eNOS uncoupling and TBARS production were significantly increased in the aged rat penis compared with young rats. Sepiapterin significantly improved erectile response in aged rats and prevented increase in TBARS production, but did not affect eNOS uncoupling in the penis of aged rats. These findings suggest that aging induces eNOS uncoupling in the penis, resulting in increased oxidative stress and ED.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Garban H, Vernet D, Freedman A, Rajfer J, Gonzalez-Cadavid N . Effect of aging on nitric oxide-mediated penile erection in rats. Am J Physiol 1995; 268: H467–H475.

    CAS  PubMed  Google Scholar 

  2. Haas C, Seftel AD, Razmjouei K, Ganz MB, Hampel N, Ferguson K . Erectile dysfunction in aging: upregulation of endothelial nitric oxide synthase. Urology 1998; 51: 516–522.

    Article  CAS  Google Scholar 

  3. Melman A, Biggs G, Davies K, Zhao W, Tar MT, Christ GJ . Gene transfer with a vector expressing Maxi-K from a smooth muscle-specific promoter restores erectile function in the aging rat. Gene Ther 2008; 15: 364–370.

    Article  CAS  Google Scholar 

  4. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol 1994; 151: 54–61.

    Article  CAS  Google Scholar 

  5. Carrier S, Nagaraju P, Morgan DM, Baba K, Nunes L, Lue TF . Age decreases nitric oxide synthase-containing nerve fibers in the rat penis. J Urol 1997; 157: 1088–1092.

    Article  CAS  Google Scholar 

  6. Aversa A, Bruzziches R, Francomano D, Natali M, Gareri P, Spera G . Endothelial dysfunction and erectile dysfunction in the aging man. Int J Urol 2010; 17: 38–47.

    Article  Google Scholar 

  7. Hannan JL, Blaser MC, Oldfield L, Pang JJ, Adams SM, Pang SC et al. Morphological and functional evidence for the contribution of the pudendal artery in aging-induced erectile dysfunction. J Sex Med 2010; 7: 3373–3384.

    Article  Google Scholar 

  8. Bakircioglu ME, Sievert KD, Nunes L, Lau A, Lin CS, Lue TF . Decreased trabecular smooth muscle and caveolin-1 expression in the penile tissue of aged rats. J Urol 2001; 166: 734–738.

    Article  CAS  Google Scholar 

  9. Davila HH, Rajfer J, Gonzalez-Cadavid NF . Corporal veno-occlusive dysfunction in the aging rat: evaluation by cavernosometry and cavernosography. Urology 2004; 64: 1261–1266.

    Article  CAS  Google Scholar 

  10. Ferrini MG, Magee TR, Vernet D, Rajfer J, Gonzalez-Cadavid NF . Aging-related expression of inducible nitric oxide synthase and markers of tissue damage in the rat penis. Biol Reprod 2001; 64: 974–982.

    Article  CAS  Google Scholar 

  11. Ferrini MG, Davila H, Valente EG, Gonzalez-Cadavid NF, Rajfer J . Aging-related induction of inducible nitric oxide synthase (NOS2A) is vasculo-protective in the arterial media. Cardiovasc Res 2004; 61: 796–805.

    Article  CAS  Google Scholar 

  12. Pu XY, Wang XH, Gao WC, Yang ZH, Li SL, Wang HP et al. Insulin-like growth factor-1 restores erectile function in aged rats: modulation the integrity of smooth muscle and nitric oxide-cyclic guanosine monophosphate signaling activity. J Sex Med 2008; 5: 1345–1354.

    Article  CAS  Google Scholar 

  13. Rajasekaran M, Kasyan A, Jain A, Kim SW, Monga M . Altered growth factor expression in the aging penis: the Brown-Norway rat model. J Androl 2002; 23: 393–399.

    CAS  PubMed  Google Scholar 

  14. Jin L, Liu T, Lagoda GA, Champion HC, Bivalacqua TJ, Burnett AL . Elevated RhoA/Rho-kinase activity in the aged rat penis: mechanism for age-associated erectile dysfunction. FASEB J 2006; 20: 536–538.

    Article  CAS  Google Scholar 

  15. Champion HC, Bivalacqua TJ, Hyman AL, Ignarro LJ, Hellstrom WJ, Kadowitz PJ . Gene transfer of endothelial nitric oxide synthase to the penis augments erectile responses in the aged rat. Proc Natl Acad Sci USA 1999; 96: 11648–11652.

    Article  CAS  Google Scholar 

  16. Bivalacqua TJ, Champion HC, Mehta YS, Abdel-Mageed AB, Sikka SC, Ignarro LJ et al. Adenoviral gene transfer of endothelial nitric oxide synthase (eNOS) to the penis improves age-related erectile dysfunction in the rat. Int J Impot Res 2000; 12 (3 suppl): S8–S17.

    Article  Google Scholar 

  17. Musicki B, Kramer MF, Becker RE, Burnett AL . Age-related changes in phosphorylation of endothelial nitric oxide synthase in the rat penis. J Sex Med 2005; 2: 347–357.

    Article  CAS  Google Scholar 

  18. Bivalacqua TJ, Burnett AL, Hellstrom WJ, Champion HC . Overexpression of arginase in the aged mouse penis impairs erectile function and decreases eNOS activity: influence of in vivo gene therapy of anti-arginase. Am J Physiol Heart Circ Physiol 2007; 292: H1340–H1351.

    Article  CAS  Google Scholar 

  19. Musicki B, Champion HC, Becker RE, Liu T, Kramer MF, Burnett AL . Erection capability is potentiated by chronic sildenafil treatment: role of blood flow-induced endothelial nitric oxide synthase phosphorylation. Mol Pharmacol 2005; 8: 26–232.

    Google Scholar 

  20. Hedlund P, Aszodi A, Pfeifer A, Alm P, Hofmann F, Ahmad M et al. Erectile dysfunction in cylic GMP-dependent kinase I-deficient mice. Proc Natl Acad Sci USA 2000; 97: 2349–2354.

    Article  CAS  Google Scholar 

  21. Bivalacqua TJ, Armstrong JS, Biggerstaff J, Abdel-Mageed AB, Kadowitz PJ, Hellstrom WJ et al. Gene transfer of extracellular SOD to the penis reduces O2-* and improves erectile function in aged rats. Am J Physiol Heart Circ Physiol 2003; 284: H1408–H1421.

    Article  CAS  Google Scholar 

  22. Touyz RM, Schiffrin EL . Reactive oxygen species in vascular biology: implications in hypertension. Histochem Cell Biol 2004; 122: 339–352.

    Article  CAS  Google Scholar 

  23. Channon KM . Tetrahydrobiopterin: regulator of endothelial nitric oxide synthase in vascular disease. Trends Cardiovasc Med 2004; 14: 323–327.

    Article  CAS  Google Scholar 

  24. Katusic ZS, d’Uscio LV, Nath KA . Vascular protection by tetrahydrobiopterin: progress and therapeutic prospects. Trends Pharmacol Sci 2009; 30: 48–54.

    Article  CAS  Google Scholar 

  25. Musicki B, Liu T, Strong T, Jin L, Laughlin MH, Turk JR et al. Low-fat diet and exercise preserve eNOS regulation and endothelial function in the penis of early atherosclerotic pigs: a molecular analysis. J Sex Med 2008; 5: 552–561.

    Article  CAS  Google Scholar 

  26. Musicki B, Liu T, Lagoda GA, Strong TD, Sezen SF, Johnson JM et al. Hypercholesterolemia-induced erectile dysfunction: endothelial nitric oxide synthase (eNOS) uncoupling in the mouse penis by NAD(P)H oxidase. J Sex Med 2010; 7: 3023–3032.

    Article  CAS  Google Scholar 

  27. Wang S, Xu J, Song P, Wu Y, Zhang J, Chul Choi H et al. Acute inhibition of guanosine triphosphate cyclohydrolase 1 uncouples endothelial nitric oxide synthase and elevates blood pressure. Hypertension 2008; 52: 484–490.

    Article  CAS  Google Scholar 

  28. Wood KC, Hebbel RP, Lefer DJ, Granger DN . Critical role of endothelial cell-derived nitric oxide synthase in sickle cell disease-induced microvascular dysfunction. Free Radic Biol Med 2006; 40: 1443–1453.

    Article  CAS  Google Scholar 

  29. Hurt KJ, Musicki B, Palese MA, Crone JK, Becker RE, Moriarity JL et al. Akt-dependent phosphorylation of endothelial nitric-oxide synthase mediates penile erection. Proc Natl Acad Sci USA 2002; 99: 4061–4066.

    Article  CAS  Google Scholar 

  30. Sindler AL, Delp MD, Reyes R, Wu G, Muller-Delp JM . Effects of aging and exercise training on eNOS uncoupling in skeletal muscle resistance arterioles. J Physiol 2009; 587: 3885–3897.

    Article  CAS  Google Scholar 

  31. Yang YM, Huang A, Kaley G, Sun D . eNOS uncoupling and endothelial dysfunction in aged vessels. Am J Physiol Heart Circ Physiol 2009; 297: H1829–H1836.

    Article  CAS  Google Scholar 

  32. Delp MD, Behnke BJ, Spier SA, Wu G, Muller-Delp JM . Ageing diminishes endothelium-dependent vasodilatation and tetrahydrobiopterin content in rat skeletal muscle arterioles. J Physiol 2008; 586: 1161–1168.

    Article  CAS  Google Scholar 

  33. Eskurza I, Myerburgh LA, Kahn ZD, Seals DR . Tetrahydrobiopterin augments endothelium-dependent dilatation in sedentary but not in habitually exercising older adults. J Physiol 2005; 568: 1057–1065.

    Article  CAS  Google Scholar 

  34. Del Rio D, Stewart AJ, Pellegrini N . A review of recent studies on malondialdehyde as toxic molecule and biological marker of oxidative stress. Nutr Metab Cardiovasc Dis 2005; 15: 316–328.

    Article  Google Scholar 

  35. Drummen GP, van Liebergen LC, Op den Kamp JA, Post JA . C11-BODIPY(581/591), an oxidation-sensitive fluorescent lipid peroxidation probe: (micro)spectroscopic characterization and validation of methodology. Free Radic Biol Med 2002; 33: 473–490.

    Article  CAS  Google Scholar 

  36. Catala A . Lipid peroxidation of membrane phospholipids generates hydroxy-alkenals and oxidized phospholipids active in physiological and/or pathological conditions. Chem Phys Lipids 2009; 157: 1–11.

    Article  CAS  Google Scholar 

  37. Peterson TE, d’Uscio LV, Cao S, Wang XL, Katusic ZS . Guanosine triphosphate cyclohydrolase I expression and enzymatic activity are present in caveolae of endothelial cells. Hypertension 2009; 53: 189–195.

    Article  CAS  Google Scholar 

  38. Hyland K . Inherited disorders affecting dopamine and serotonin: critical neurotransmitters derived from aromatic amino acids. J Nutr 2007; 137 (6 Suppl 1): 1568S–1572S.

    Article  CAS  Google Scholar 

  39. Gangula PR, Mukhopadhyay S, Ravella K, Cai S, Channon KM, Garfield RE et al. Tetrahydrobiopterin (BH4), a cofactor for nNOS, restores gastric emptying and nNOS expression in female diabetic rats. Am J Physiol Gastrointest Liver Physiol 2010; 298: G692–G699.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by NIH/NIDDK grant DK075782 to Biljana Musicki.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B Musicki.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Johnson, J., Bivalacqua, T., Lagoda, G. et al. eNOS-uncoupling in age-related erectile dysfunction. Int J Impot Res 23, 43–48 (2011). https://doi.org/10.1038/ijir.2011.2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijir.2011.2

Keywords

Search

Quick links