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人类阴茎血管老化相关血管功能障碍的早期表现——勃起功能障碍作为全身血管疾病先兆作用的潜在解释。

Early manifestation of aging-related vascular dysfunction in human penile vasculature-A potential explanation for the role of erectile dysfunction as a harbinger of systemic vascular disease.

机构信息

Fundación de Investigación Biomédica, del Hospital Universitario de Getafe, Getafe, Spain.

Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.

出版信息

Geroscience. 2022 Feb;44(1):485-501. doi: 10.1007/s11357-021-00507-x. Epub 2021 Dec 28.


DOI:10.1007/s11357-021-00507-x
PMID:34962617
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8811115/
Abstract

Advanced age is related to functional alterations of human vasculature, but erectile dysfunction precedes systemic manifestations of vascular disease. The current study aimed to simultaneously evaluate the influence of aging on vascular function (relaxation and contraction responses) in systemic human vascular territories: aorta (HA) and resistance mesenteric arteries (HMA) and human corpus cavernosum (HCC) and penile resistance arteries (HPRA). Associations of oxidative stress and inflammation circulating biomarkers with age and functional responses were also determined. Vascular specimens were obtained from 76 organ donors (age range 18-87). Four age-groups were established: < 40, 40-55, 56-65 and > 65 years old. Increasing age was associated with a decline in endothelium-dependent relaxation induced by BK in HMA (r = -0.597, p = 0.0001), or by ACh in HCC (r = -0.505, p = 0.0022), and HPRA (r = -0.601, p = 0.0012). Significant impairment was detected at > 65 years old in HMA but earlier in penile vasculature (> 55 years old). Age-related reduction to HO-vasodilatory response started before in HCC (56-65 years old) than in HA (> 65 years old). In contrast to relaxation responses, aging-related hypercontractility to adrenergic stimulation was homogeneous: contractions significantly increased in subjects > 55 years old in all tested vessels. Although not significantly age related, circulating levels of ADMA (r = -0.681, p = 0.0052) and TNF-α (r = -0.537, p = 0.0385) were negatively correlated with endothelial vasodilation in HMA but not in HCC or HPRA. Penile vasculature exhibits an early impairment of endothelium-dependent and HO-induced vasodilations when compared to mesenteric microcirculation and aorta. Therefore, functional susceptibility of penile vasculature to the aging process may account for anticipation of erectile dysfunction to systemic manifestations of vascular disease.

摘要

年龄增长与人体血管功能的改变有关,但勃起功能障碍先于血管疾病的全身表现。本研究旨在同时评估衰老对全身血管区域的血管功能(舒张和收缩反应)的影响:主动脉(HA)和阻力肠系膜动脉(HMA)以及人体海绵体(HCC)和阴茎阻力动脉(HPRA)。还确定了氧化应激和炎症循环生物标志物与年龄和功能反应的相关性。血管标本取自 76 名器官捐献者(年龄范围 18-87 岁)。建立了四个年龄组:<40 岁、40-55 岁、56-65 岁和>65 岁。随着年龄的增长,BK 诱导的 HMA 内皮依赖性舒张(r=-0.597,p=0.0001)或 ACh 诱导的 HCC(r=-0.505,p=0.0022)和 HPRA(r=-0.601,p=0.0012)的舒张功能下降。在>65 岁时,HMA 出现显著的功能障碍,而在阴茎血管中更早(>55 岁)。HO 舒张反应与年龄相关的减少始于 HCC(56-65 岁),而不是 HA(>65 岁)。与舒张反应相反,与年龄相关的肾上腺素能刺激的高收缩性是均匀的:在所有测试的血管中,>55 岁的受试者的收缩明显增加。尽管与年龄没有显著相关性,但 ADMA(r=-0.681,p=0.0052)和 TNF-α(r=-0.537,p=0.0385)的循环水平与 HMA 中的内皮血管舒张呈负相关,但与 HCC 或 HPRA 无关。与肠系膜微循环和主动脉相比,阴茎血管的内皮依赖性和 HO 诱导的血管舒张功能较早受损。因此,阴茎血管对衰老过程的功能易感性可能是勃起功能障碍提前出现血管疾病全身表现的原因。

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本文引用的文献

[1]
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Erectile dysfunction and retinal microvascular network: an optical coherence tomography angiography study.

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J Sex Med. 2020-3-18

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Short-term pharmacological activation of Nrf2 ameliorates vascular dysfunction in aged rats and in pathological human vasculature. A potential target for therapeutic intervention.

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BJU Int. 2019-10

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Acta Cardiol. 2020-8

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