The "Hitchhiker's Guide to the Galaxy" of Endothelial Dysfunction Markers in Human Fertility

Abstract

Endothelial dysfunction is an early event in the pathogenesis of atherosclerosis and represents the first step in the pathogenesis of cardiovascular diseases. The evaluation of endothelial health is fundamental in clinical practice and several direct and indirect markers have been suggested so far to identify any alterations in endothelial homeostasis. Alongside the known endothelial role on vascular health, several pieces of evidence have demonstrated that proper endothelial functioning plays a key role in human fertility and reproduction. Therefore, this state-of-the-art review updates the endothelial health markers discriminating between those available for clinical practice or for research purposes and their application in human fertility. Moreover, new molecules potentially helpful to clarify the link between endothelial and reproductive health are evaluated herein.

Keywords: endothelial dysfunction; endothelium; female fertility; male fertility; reproduction.

Figure 1

A graphical representation of the synthesis of the estrogens and testosterone actions at endothelial level. Footnote to Figure 1: AR: androgen receptor; ER: estrogen receptor; NO: nitric oxide; VCAM: vascular cell adhesion molecules.

Figure 2

A graphical representation of the paths of endothelial markers involved in male infertility. Footnote to Figure 2: ET-1: endothelin-1; ICAM: intracellular cell adhesion molecules; IFN: interferon; TNF-α: tumor necrosis factor-alpha; VCAM: vascular cell adhesion molecules; VEGF-a: vascular endothelial growth factor-A.