{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:39:46Z","timestamp":1788871186288,"version":"build-2803163510"},"reference-count":122,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Erectile dysfunction (ED) represents the major cause of male sexual dysfunction, which is often associated with obesity, diabetes mellitus, atherosclerotic cardiovascular disease, and cigarette smoking. Peyronie\u2019s disease is a chronic disorder associated with irreversible fibrotic damage of the tunica albuginea leading to ED, painful erection, coital disturbance, and physical and social complaints. Both conditions are characterized by chronic inflammation, oxidative stress, and significant changes in intracavernous hydrodynamics. In this scenario, oxidized lipoproteins, M1-polarized macrophages, proinflammatory cytokines (such as the tumor necrosis factor \u03b1), endothelial nitric oxide synthase, penile smooth muscle cells, and toll-like receptors represent the main triggers of the inflammatory process in ED. Phosphodiesterase-5 inhibitors are the most common treatment for ED. This treatment is used intermittently, as it is conceived as a symptomatic and not curative therapy. Moreover, not all patients respond to phosphodiesterase-5 inhibitors (35%-85%), particularly those with dysmetabolic phenotypes. Additional or alternative treatments are therefore desirable, mostly in refractory cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In this review, we describe the immune-mediated pathogenesis of ED and Peyronie\u2019s disease (PD). In our literature search we placed particular emphasis on potentially practical therapeutic approaches, including natural products (such as polyphenols), due to their anti-inflammatory and antioxidant activities, stem cell therapy, and platelet-derived preparations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed\/MEDLINE, Web of Science, Scopus, Cochrane Library, Google Scholar, and institutional websites. Original studies, narrative reviews, systematic reviews, and meta-analyses written in English were searched, screened, and selected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In animal models of ED and PD, therapeutic approaches, including anti-inflammatory and antioxidant agents, stem cell therapy, and platelet-derived preparations, have provided positive results, including improved penile function, reduced inflammation and oxidative stress, and promotion of tissue repair. However, clinical evidence of improvement in human patients is still insufficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Promising results for treating ED and PD have been shown in preclinical and pilot clinical studies, but specific clinical trials are needed to validate the efficacy of these therapeutic approaches in men with ED.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sxmrev\/qead055","type":"journal-article","created":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T17:41:42Z","timestamp":1701711702000},"page":"210-220","source":"Crossref","is-referenced-by-count":22,"title":["The pathogenic role of the immune system in erectile dysfunction and Peyronie\u2019s disease: focusing on immunopathophysiology and potential therapeutic strategies"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7073-1795","authenticated-orcid":false,"given":"Vito Angelo","family":"Giagulli","sequence":"first","affiliation":[{"name":"Interdisciplinary Department of Medicine\u2013Section of Internal Medicine , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"},{"name":"School of Medicine, University of Bari \u201cAldo Moro\u201d, Policlinico , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6521-8578","authenticated-orcid":false,"given":"Giuseppe","family":"Lisco","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine\u2013Section of Internal Medicine , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"},{"name":"School of Medicine, University of Bari \u201cAldo Moro\u201d, Policlinico , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6341-6140","authenticated-orcid":false,"given":"Anna","family":"De Tullio","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine\u2013Section of Internal Medicine , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"},{"name":"School of Medicine, University of Bari \u201cAldo Moro\u201d, Policlinico , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8666-8658","authenticated-orcid":false,"given":"Edoardo","family":"Guastamacchia","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine\u2013Section of Internal Medicine , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"},{"name":"School of Medicine, University of Bari \u201cAldo Moro\u201d, Policlinico , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6308-0528","authenticated-orcid":false,"given":"Vincenzo","family":"Triggiani","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine\u2013Section of Internal Medicine , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"},{"name":"School of Medicine, University of Bari \u201cAldo Moro\u201d, Policlinico , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2857-7106","authenticated-orcid":false,"given":"Emilio","family":"Jirillo","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine\u2013Section of Internal Medicine , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"},{"name":"School of Medicine, University of Bari \u201cAldo Moro\u201d, Policlinico , Geriatrics, Endocrinology, and Rare Diseases, , Piazza Giulio Cesare 11, 70124 Bari , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,9]]},"reference":[{"issue":"4","key":"2024040211595585600_ref1","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1111\/bju.14813","article-title":"The global prevalence of erectile dysfunction: a review","volume":"124","author":"Kessler","year":"2019","journal-title":"BJU Int"},{"issue":"8422","key":"2024040211595585600_ref2","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S0140-6736(85)92023-9","article-title":"Is impotence an arterial disorder? 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