Folic acid supplementation improves erectile function in patients with idiopathic vasculogenic erectile dysfunction by lowering peripheral and penile homocysteine plasma levels: a case‐control study

Elshahid, Ahmed R.; Shahein, Ibraheim Mohammed; Mohammed, Yaser; Ismail, Nabil; Zakarria, H. B. Abd El-Razek; Din, Sameh Fayek GamalEl

doi:10.1111/andr.12672

Cited by 21 publications

(17 citation statements)

References 31 publications

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“…Dermcidin level was significantly low in the studied cohort of acne vulgaris patients and both isotretinoin regimens significantly raised dermcidin levels compared to pretreatment values. No significant difference in relapse rate over a 12-month follow-up period was noted among the two isotretinoin regimens (El Aziz Ragab, Omar, Collier, El-Wafa, & Gomaa, 2018).…”

Section: Indications Of Low-dose Isotretinoin In Dermatologymentioning

confidence: 76%

“…Very recently, folic acid administration demonstrated a significant decrease in peripheral and penile homocysteine plasma levels in Egyptian patients with idiopathic vasculogenic erectile dysfunction (Elshahid et al, ). Deficiency in folate may pose a much greater risk for the development of peripheral neuropathy, particularly patients younger than 40 years (Taverner et al, ).…”

Section: Safety Of Low‐dose Isotretinoinmentioning

confidence: 99%

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Low dose of isotretinoin: A comprehensive review

Abdelmaksoud

Lotti

Anadolu

et al. 2020

Dermatologic Therapy

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Isotretinoin is a first‐generation retinoid initially approved for the treatment of severe cases of acne vulgaris (nodulocystic acne). Because of its broad anti‐inflammatory and immunomodulatory properties, it has been used beyond its initial approval in a myriad of other indications. Adverse effects of isotretinoin vary from xerosis to teratogenicity. Herein, we reviewed the literature, through date‐unlimited PubMed search, from inception till December 2019, using the following search terms: “low‐dose isotretinoin” and “dermatology,” “isotretinoin and safety,” “isotretinoin, off‐label uses,” “isotretinoin and male fertility,” “isotretinoin, iPLEDGE system,” aiming to deliver a therapeutic update relevant to clinical practice. All English‐language articles were considered with no limitation based on the articles' type. Low‐dose isotretinoin is not limited to old and novel dermatological conditions, but also showed promising results in the field of infertility and safety in the field of gastroenterology. We also highlight on the safety profile of the drug and experts' recommendations to enhance safety measures to decrease fetal risk while on isotretinoin.

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Section: Indications Of Low-dose Isotretinoin In Dermatologymentioning

confidence: 76%

Section: Safety Of Low‐dose Isotretinoinmentioning

confidence: 99%

Low dose of isotretinoin: A comprehensive review

Abdelmaksoud

Lotti

Anadolu

et al. 2020

Dermatologic Therapy

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“…with no abnormalities in routine investigations except decreased FA levels. In various studies, age has not been significantly different between the groups and also did not correlate with FA levels (Elshahid et al, 2020;Karabakan et al, 2016;Sansone et al, 2017;Yang et al, 2014). Study by Attia et al (2019) demonstrated negative correlations between FA levels and age.…”

Section: Discussionmentioning

confidence: 89%

Novel predictive risk factor for Erectile Dysfunction: Serum folic acid

et al. 2020

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Erectile dysfunction (ED) is defined as the persistent inability to attain or maintain an erection sufficient to permit satisfactory sexual activity (Hatzimouratidis et al., 2016). Penile erection is a complex neurovascular phenomenon, and ED may result from various abnormalities arising from vasculogenic, neurogenic, hormonal, anatomical, drug-induced and psychogenic causes (Zhengyan et al., 2014). Endothelial dysfunction (EDys) has been found to be central to atherosclerosis which is one of the most common causes of ED (Gandaglia et al., 2014; Shah et al., 2016). EDys has also been linked to various risk factors like hypertension, diabetes, smoking and other oxidative stressors (Vlachopoulos et al., 2007). Thus, ED has been suggested to be an early marker of cardiovascular disease (CVD) (Shah et al., 2016). Endothelial cells have nitric oxide synthase (eNOS) which is responsible for the formation of nitric oxide (NO) which acts as a relaxing factor and plays a major role in activation and maintenance of the erection process (Aversa et al., 2010). Hyperhomocysteinaemia (HHcy) has a marked inhibitory effect on eNOS and promotes NOS uncoupling (Zhang et al., 2016). Folic acid (FA) has been demonstrated to play an important role in the metabolism of NO by potentially inverting NOS uncoupling (Stoll et al., 2010; Yang et al., 2014). FA supplementation has been found to improve endothelial dysfunction in patients with DM or hypertension (Cui et al., 2017; Hamidi Madani et al., 2013). Compared to the western countries, Asian population differ in genetic makeup, dietary and lifestyle profiles. It has also been found that nutritional deficiencies in FA account for increased

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“…The changes of the IIEF-5 after the folic acid administration only were reported in two articles. 23 , 24 Fixed-effect model was used to calculate the SMD owing to the no significant heterogeneity (I 2 = 0.00%, P = .645). The SMD was 1.89 with the 95%CI (1.60, 2.17).…”

Section: Resultsmentioning

confidence: 99%

Serum Folic Acid and Erectile Dysfunction: A Systematic Review and Meta-Analysis

Zhang

Dai

et al. 2021

Sexual Medicine

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Introduction The association between folic acid (FA) and erectile dysfunction (ED) was contradictory in the published original articles, and no meta-analysis was conducted to pool these data. Aim To verify the role of FA in the pathology of ED and explore the treatment efficacy of FA for ED patients. Methods An extensive search was performed on PubMed, Cochrane Library, and Web of Science to obtain all relevant studies published up to October 31, 2020. Studies comparing the serum FA level between ED patients and healthy controls, or comparing the score of the IIEF-5, or IIEF before and after folic acid therapy alone or combination in ED patient were eligible for our meta-analysis. The Newcastle-Ottawa Scales (NOS) was used to qualify included studies. Main Outcome Measures The standardized mean differences (SMD) and their corresponding 95% confidence intervals (95% CIs) were calculated to pool our data. Results Nine studies were eligible for our meta-analysis to verify the association between FA and ED, and to explore the treatment efficacy of FA for ED patients. The pooled SMD of the FA level difference between ED patients and healthy subjects was -0.94 (95% CI: -1.59, -0.30, P = .004). Moreover, the level of folic acid in healthy subjects, Mild ED patients, Moderate ED patients and Severe ED patients was 11.847 (95%CI = 9.671, 14.022), 9.496 (95%CI = 8.425, 10.567), 6.597 (95%CI = 5.187, 8.007) and 5.623 (95%CI = 3.535, 7.711) respectively. The SMD of changes in score of IIEF-5 was 1.89 with 95%CI (1.60, 2.17) after FA administration in ED patients. Our analysis also showed that combination therapy of FA plus tadalafil changed the score of IIEF with 0.90 (95%CI = 0.44, 1.36) comparing to combination of placebo plus tadalafil. Conclusion This novel meta-analysis demonstrated that FA was an independent risk factor for ED and FA supplement may have potentially positive effects in the treatment of ED patients. Zhang Y, Zhang W, Dai Y, et al. Serum Folic Acid and Erectile Dysfunction: A Systematic Review and Meta-Analysis. Sex Med 2021;9:100356.

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Folic acid supplementation improves erectile function in patients with idiopathic vasculogenic erectile dysfunction by lowering peripheral and penile homocysteine plasma levels: a case‐control study

Cited by 21 publications

References 31 publications

Low dose of isotretinoin: A comprehensive review

Low dose of isotretinoin: A comprehensive review

Novel predictive risk factor for Erectile Dysfunction: Serum folic acid

Serum Folic Acid and Erectile Dysfunction: A Systematic Review and Meta-Analysis

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