Arterial Erectile Dysfunction and Peripheral Arterial Disease: Reliability of a New Phenotype of Endothelial Progenitor Cells and Endothelial Microparticles

Abstract

The aim of this study was to evaluate whether the blood concentrations of a new immunophenotype of circulating late endothelial progenitor cells (EPC) and endothelial microparticles (EMP) varies in patients with arterial erectile dysfunction (aED) and abnormalities in other arterial districts. To accomplish this, cavernous artery peak systolic velocity (PSV), acceleration time (AT), and intima-media thickness (IMT) were determined after intracavernous administration of alprostadil by echo-color Doppler in 80 consecutive patients (age range, 50-75 years). Fifteen patients had aED alone (group A) and served as controls; 22 had aED plus atheroma plaques and/or increased IMT of the common carotid artery (group B); 20 had aED plus lower limb artery abnormalities (group C); and 23 had aED plus carotid and lower limb artery abnormalities (group D). EPC and EMP blood concentrations were evaluated by flow cytometry. Blood mononuclear cells with the immunophenotype CD45 neg /CD34 pos /CD144 pos were defined as EPCs, whereas CD45 neg /CD144 pos /annexin V pos cells were defined as EMPs. Group B and C patients had a similar PSV, AT, and IMT at the level of the cavernous arteries. Their PSV values were significantly lower and mean values of AT and IMT significantly higher compared with group A patients. Patients of group D had a significantly lower PSV and significantly higher AT and IMT compared with all other groups. As far as serum concentrations of EPCs and EMPs, group D patients had significantly higher EPC and EMP mean values compared with all other groups. Group B and C patients had similar EPC and EMP values. This study showed that a more generalized peripheral atherosclerotic process is associated with a more severe penile artery insufficiency and endothelial dysfunction. Moreover, this study confirms the diagnostic reliability of the immunophenotype of EPCs and EMPs chosen in the clinical practice.

Testosterone level and endothelial dysfunction in patients with vasculogenic erectile dysfunction

“…(Masouleh et al, 2010;Condorelli et al, 2012). The suspension then washed twice with phosphatebuffered solution (PBS) and centrifuged, and the pellet was rapidly incubated in PBS containing the appropriate monoclonal antibodies at room temperature for 20 min.…”

“…EPCs were reported as percentage of total events (Masouleh et al, 2010;Condorelli et al, 2012). Each sample was analyzed by flow cytometry (FACS Calibur BD Biosciences).…”

“…Appropriate isotype controls were used for each staining procedure as negative controls to set the appropriate regions (Van Ierssel et al, 2010;Condorelli et al, 2012). To exclude MPs originating from leukocytes, we considered only events within the CD45 negative gate.…”

“…La Vignera et al have demonstrated an increase in serum concentrations of late phenotype of ECPs (CD4S negative 'neg' /CD34 positive 'pos' /CD144 'pos' ) in patients with arterial ED (La Vignera et al, 2011a, 2012a. Furthermore, Condorelli et al reported that, the use of these markers is valuable as these changes usually ahead the structural alterations resulting from vascular damage (Condorelli et al, 2012(Condorelli et al, , 2013a. Furthermore, other study had demonstrated that patients with hypogonadism had a low number of EPCs, and their number had increased significantly after testosterone replacement therapy (Foresta et al, 2008).…”

“…Although EPCs and EMPs were previously reported of value in diagnosis and prognosis of ED with different risk factors ((Foresta et al, 2008;La Vignera et al, 2011a, 2012aCondorelli et al, 2012), however, inconsistency of the results and lack of clear homogeneity among studies prompted us to investigate the association between EPCs & EMPs and late onset hypogonadism (LOH) in patients with vasculogenic ED.…”