Reactive oxygen species and erectile dysfunction: possible role of NADPH oxidase

Erectile dysfunction (ED) is a widespread condition, the incidence of which is increasing globally. ED is also indicative of underlying vasculopathy and represents a predictor of more serious cardiovascular disorders. Understanding the aetiology of ED may therefore provide invaluable pointers to the pathobiology of other cardiovascular diseases (CVDs) and syndromes. It follows, too, that therapeutic interventions that are successful in treating ED may, ipso facto, be effective in treating the early stages of conditions that include atherosclerosis, angina, plaque rupture and diabetic angiopathy. One common pathological denominator in both CVD and ED is oxidative stress, that is, the overproduction of reactive oxygen species (ROS), in particular, superoxide (O2•−) and hydrogen peroxide (H2O2). In this review, therefore, we consider the aetiology and pathobiology of O2•− in promoting ED and focus on NADPH oxidase as an inducible source of O2•− and H2O2. Therapeutic strategies aimed at reducing oxidative stress to improve erectile function are also discussed.