Publication
The renin-angiotensin system (RAS) is a key regulator of the cardiovascular system. Furthermore, clear compelling evidence indicates that this system is an essential modulator of penile erectile. Higher levels of angiotensin (Ang) II, the main component of RAS, are found in the corpus cavernosum when compared to the systemic circulation. Moreover, emerging findings indicate increased activity between Ang II and the Ang type 1 (AT1) receptor, possibly contributing to the development of erectile dysfunction (ED). Alternatively, angiotensin-converting enzyme inhibitors (ACEi) and Ang receptor blockers (ARBs) demonstrated protective effects on erection. In the last decade, parallel pathways within RAS have been described, expanding our current understanding of this system and opening novel opportunities. Contrary to Ang II, the Ang-(1–7) peptide produces cardiovascular-protective responses through the activation of Mas receptor. Within the corpus cavernosum, Ang-(1–7) increases NO production and facilitates penile erection and is considered a key component of the pro-erectile axis of the RAS. This chapter aims to summarize the current literature addressing the pathophysiological role of RAS in erectile function.