Molecular analysis of erection regulatory factors in sickle cell disease associated priapism in the human penis

Gwen Lagoda, Sena F. Sezen, Marcelo R. Cabrini, Biljana Musicki, Arthur L. Burnett

Research output: Contribution to journalArticlepeer-review


Purpose: Priapism is a vasculopathy that occurs in approximately 40% of patients with sickle cell disease. Mouse models suggest that dysregulated nitric oxide synthase and RhoA/ROCK signaling as well as increased oxidative stress may contribute to the mechanisms of sickle cell disease associated priapism. We examined changes in the protein expression of nitric oxide synthase and ROCK signaling pathways, and a source of oxidative stress, NADPH oxidase, in penile erectile tissue from patients with a priapism history etiologically related and unrelated to sickle cell disease. Materials and Methods: Human penile erectile tissue was obtained from 5 patients with sickle cell disease associated priapism and from 6 with priapism of other etiologies during nonemergent penile prosthesis surgery for erectile dysfunction or priapism management and urethroplasty. Tissue was also obtained from 5 control patients without a priapism history during penectomy for penile cancer. Samples were collected, immediately placed in cold buffer and then frozen in liquid nitrogen. The expression of phosphodiesterase 5, endothelial nitric oxide synthase, neuronal nitric oxide synthase, inducible nitric oxide synthase, RhoA, ROCK1, ROCK2, p47phox, p67phox, gp91phox and β-actin were determined by Western blot analysis. Nitric oxide was measured using the Griess reaction. Results: In the sickle cell disease group phosphodiesterase 5 (p <0.05), endothelial nitric oxide synthase (p <0.01) and RhoA (p <0.01) expression was significantly decreased, while gp91phox expression (p <0.05) was significantly increased compared to control values. In the nonsickle cell disease group endothelial nitric oxide synthase, ROCK1 and p47phox expression (each p <0.05) was significantly decreased compared to control values. Total nitric oxide levels were not significantly different between the study groups. Conclusions: Mechanisms of sickle cell disease associated priapism in the human penis may involve dysfunctional nitric oxide synthase and ROCK signaling, and increased oxidative stress associated with NADPH oxidase mediated signaling.

Original languageEnglish (US)
Pages (from-to)762-768
Number of pages7
JournalJournal of Urology
Issue number2
StatePublished - Feb 2013


  • anemia
  • nitric oxide
  • oxidative stress
  • penis
  • priapism
  • sickle cell

ASJC Scopus subject areas

  • Urology


Dive into the research topics of 'Molecular analysis of erection regulatory factors in sickle cell disease associated priapism in the human penis'. Together they form a unique fingerprint.

Cite this