Pathophysiological role of the renin-angiotensin system on erectile dysfunction

Background The renin-angiotensin system (RAS) has been shown to play an active role within the erectile tissues. The aim of this narrative review is to summarize the literature addressing the pathophysiological role of RAS on erectile function. Additionally, we update evidence on recent findings on the role of the Ang-(1-7) and Mas receptor on the erectile function and its therapeutic potential for treating erectile dysfunction (ED). Materials and methods This narrative review is based on the material searched and obtained via MEDLINE and PubMed up to November 2012. The search terms we used are angiotensin, erectile dysfunction, renin, Mas receptor' in combination with pathophysiology, fibrosis, pathways'. Results The levels of angiotensin (Ang) II, the main component of this system, are increased in the corpus cavernosum as compared to those found in the systemic circulation. Moreover, emerging evidence indicates that an increased activity of Ang II via AT1 receptor might contribute to the development of ED, whereas the pharmacological blockage of Ang II/AT1 actions has beneficial effects on the erection. On the other hand, the heptapeptide Ang-(1-7), known as a major endogenous counter-regulator of Ang II actions, favours penile erection via the activation of Mas receptor. Conclusions Ang-(1-7) and Mas receptor pathway might be considered as a promising therapeutic target for the treatment of ED.