Molecular Biomarkers for Monitoring Endothelial Function Repair in the Penile Corpus Cavernosum: A Review

Abstract

Erectile dysfunction (ED) is a prevalent condition often associated with endothelial dysfunction, which affects the ability to achieve and maintain an erection. This literature review aims to explore the role of molecular biomarkers in understanding and managing endothelial dysfunction within the penile corpus cavernosum. Through a qualitative, library-based research methodology, the study synthesizes findings from various articles focusing on biomarkers such as nitric oxide (NO), vascular endothelial growth factor (VEGF), and endothelin-1 (ET-1). These biomarkers play crucial roles in regulating endothelial function, with NO facilitating vasodilation, VEGF promoting endothelial regeneration, and ET-1 contributing to vasoconstriction. Additionally, recent studies have highlighted the relevance of additional molecular markers including endothelial nitric oxide synthase (eNOS), intercellular adhesion molecule-1 (ICAM-1), cyclic guanosine monophosphate (cGMP), and malondialdehyde (MDA). These biomarkers offer further insights into endothelial dysfunction and oxidative stress. Incorporating their analysis may enhance the diagnostic precision and therapeutic evaluation of pharmacological agents such as tadalafil, particularly in diabetic-induced endothelial injury. The review highlights the impact of oxidative stress and comorbidities such as diabetes and hypertension in exacerbating endothelial dysfunction and ED. While current therapies, including PDE5 inhibitors, alleviate symptoms, they do not address the underlying endothelial damage. The review emphasizes the potential of biomarker-based therapies targeting endothelial repair, offering a more comprehensive approach to ED treatment. However, challenges remain in translating these biomarkers into clinical practice, and further research is needed to validate their diagnostic and therapeutic applications. The review concludes by proposing future research directions, including the investigation of combination therapies, the validation of novel biomarkers, and the exploration of lifestyle interventions to improve endothelial health in ED patients.