Department of Urology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, 250014, China.
Endocrine. 2018 Sep;61(3):372-382. doi: 10.1007/s12020-018-1610-8. Epub 2018 May 2.
Aldosterone is an old hormone that has been discovered for more than fifty years. The clinical application of its receptors' inhibitors, especially spirolactone, has benifited patients for decades worldwide. In this review, we briefly summarized the molecular mechanism of aldosterone/mineralocorticoid receptors (Ald-MRs) signaling in cardiovascular diseases and its emerging role in erectile dysfunction.
We searched PubMed, Web of Science, and Scopus for manuscripts published prior to December 2017 using key words " aldosterone " AND " erectile dysfunction " OR " cardiovascular disease " OR " mineralocorticoid receptors ". Related literature and clinical perspectives were collated, summarized and discussed in this review.
The increase of reactive oxygen species production, inhibition of endothelial nitric oxide synthase system, and induction of inflammation are ubiquitous in vascular endothelial cells or vascular smooth muscle cells after the activation of Ald-MRs pathway. In addition, in cardiovascular diseases with over-active Ald-MRs signaling, MRs blockade could reverse the injury and improve the prognosis. Notably, multiple studies have correlated aldosterone and MRs to the pathogenesis of erectile function, while the mechanism is largely unperfectly identified.
In conclusion, we summarize the current evidence to highlight the potential role of aldosterone in erectile dysfunction and provide critical insights into the treatment of the disease.
醛固酮是一种已有五十多年历史的古老激素。其受体抑制剂，特别是螺内酯，在全球范围内已经使数十年的患者受益。在这篇综述中，我们简要总结了醛固酮/盐皮质激素受体（Ald-MRs）信号在心血管疾病中的分子机制及其在勃起功能障碍中的新作用。
我们使用关键词“醛固酮”和“勃起功能障碍”或“心血管疾病”或“盐皮质激素受体”，在 PubMed、Web of Science 和 Scopus 中搜索了截至 2017 年 12 月之前发表的文献。我们整理、总结并讨论了这篇综述中的相关文献和临床观点。
Ald-MRs 通路激活后，血管内皮细胞或血管平滑肌细胞中普遍存在活性氧产物的产生增加、内皮型一氧化氮合酶系统的抑制和炎症的诱导。此外，在 Ald-MRs 信号过度活跃的心血管疾病中，MRs 阻断可逆转损伤并改善预后。值得注意的是，多项研究将醛固酮和 MRs 与勃起功能障碍的发病机制相关联，而其机制在很大程度上尚未明确。
总之，我们总结了目前的证据，以强调醛固酮在勃起功能障碍中的潜在作用，并为该疾病的治疗提供了关键的见解。
