Sexual Dysfunction, Erectile Impotence And Obstructive Azoospermia In Respiratory Disease: Relevance of Lung-mediated Regulation of Prostaglandine

Abstract

To the Editor: It has been reported that more than 50 percent of men with primary azoospermia have respiratory tract defects including bronchitis, bronchiectasis and sinusitis.1Young D. Surgical treatment of male infertility.J Reprod Fertility. 1970; 23: 541-542Crossref PubMed Scopus (69) Google Scholar Sexual dysfunction and erectile impotence have been reported to occur in chronic obstructive pulmonary disease.2Fletcher EL Martin RJ. Sexual dysfunction and erectile impotence in COPD.Chest. 1982; 81: 413-421Abstract Full Text Full Text PDF PubMed Scopus (72) Google Scholar I suggest that lung-mediated regulation of prostaglandins could explain the sexual dysfunction and azoospermia. Dihomogammalinolenic acid (DGLA) gives rise to prostaglandins (PGs) of the 1-series, notably PGE1. Arachidonic acid produces PGs of the 2-series including PGE2, PGF2, prostacyclin and the related thromboxane A2. There seems to be a reciprocal relationship between the 1-series PGs derived from DGLA and the 2-series PGs derived from arachidonic acid. PGE1, by regulating cyclic AMP formation, keeps production of the 2-series PGs in check by inhibiting the enzyme which mobilizes arachidonic acid from its stores in cell membranes.3Horrobin DF. The regulation of prostaglandin biosynthesis: negative feedback mechanisms and the selective control of formation of 1 and 2 series prostaglandins: Relevance to inflammation and immunity..Med Hypoth. 1980; 6: 687-709Abstract Full Text PDF PubMed Scopus (90) Google Scholar The lungs regulate concentration of PGs reaching systemic circulation and protect the organism from excessive levels of PGs.4Mathe AA Hedquist P. Strandberg K. Leslie C. Aspects of prostaglandin function in the lung (part 1).N Engl J Med. 1977; 296: 850-855Crossref PubMed Scopus (63) Google Scholar,5Mathe AA Hedquist P. Strandberg K. Leslie C. Aspects of prostaglandin function in the lung (part 2).N Engl J Med. 1977; 296: 910-914Crossref PubMed Scopus (41) Google Scholar PG release in the lungs is increased after hyperventilation, mechanical stimulation and respiratory alkalosis6Said S. The lung in relation to vasoactive hormones.Fed Proc. 1973; 32: 1972PubMed Google Scholar and increased by hypoxia.7Said S. Yoshida T. Kitamura S. Vreim C. Pulmonary alveolar hypoxia:Release of prostaglandins and other humoral mediators.Science. 1974; 185: 1181Crossref PubMed Scopus (72) Google Scholar Many agents increase the plasma and tissue concentrations of PGs by inhibiting the activity of prostaglandin dehydrogenase and prostaglandin reductase which are responsible for their metabolic inactivation.8Giri SN Hollinger MA Schiedt MJ. The effects of ozone and paraquat on PGF2 alpha levels in plasma and combined pleural effusion and lung lavage of rats..Environ Res. 1980; 21: 467-476Crossref PubMed Scopus (32) Google Scholar PGE2 is known to cause a decrease in sperm count and cause inhibition of spermatogenesis9Dev NK Mangat H. Possible effects of PGE2 on hypothalamohypophyseal-gonadal axis in male rhesus monkeys (Macaca mullatta).Int J Fertil. 1982; 27: 29-35PubMed Google Scholar and to lower testosterone levels.10Didolkar AK Gurjar A. Joshi VM Sheth AR Roychowdbury D. Effect of prostaglandins A1, E2, and F2 alpha on blood plasma levels of testosterone, LH, and FSH in male rats..Andrologia. 1981; 13: 50-55Crossref PubMed Scopus (10) Google Scholar A recent review on aspects of male reproductive pharmacology and toxicology dealt with calcium ion movement into the cell in maintaining acrosome stability and the blood-testis barrier to testicular toxicity.11Jackson H. Schnieden H. Aspects of male reproductive pharmacology and toxicology.Rev Pure and Appl Pharmacol Sci. 1982; 3: 1PubMed Google Scholar Prostaglandins are involved in the regulation of calcium at the cell membrane and probably in the regulation of permeability factors affecting the blood-testis barrier since PGE1 prevents rises in vascular permeability due to immune complexes. C3a, histamine and serotonin.12Fantone JC Kunkel SL Ward PA Zurier RB. Suppression of human polymorphonuclear function after intravenous infusions of protaglandin E1.Prostaglandins and Med. 1981; 7: 195-198Abstract Full Text PDF PubMed Scopus (44) Google Scholar Thus, it is tempting to suggest that perhaps due to respiratory disease, metabolic inactivation of PGE2 is incomplete allowing PGE2 to enter as a systemic circulating hormone lowering PGE1 in the process and directly or indirectly affecting sexual function and/or spermatogenesis.