Ferroptosis is involved in corpus cavernosum smooth muscle cells impairment in diabetes mellitus‐induced erectile dysfunction

BACKGROUNDS: Erectile dysfunction (ED) is a common andrological disorder that tends to afflict diabetic patients, among others. Pharmacological therapy of diabetes mellitus‐induced ED (DMED) is ineffective, as it is linked with smooth muscle cell loss in the corpus cavernosum. Ferroptosis is a recently identified kind of cell death evoked by lipid peroxidation, and it is connected with a number of diabetic complications. OBJECTIVES: To investigate the role of ferroptosis in DMED. MATERIALS AND METHODS: We established the rat model of DMED and conducted a combined analysis of RNA sequencing (RNA‐seq) and Gene Expression Omnibus (GEO) data to identify differentially expressed genes (DEGs). Next, DMED disease targets were determined by cross‐referencing DEGs and DMED‐related genes in the DisGeNET, GenCLiP3, and GeneCards databases. Additionally, these targets were analyzed using “clusterProfiler” in R utilizing Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) annotations. Immunohistochemistry (IHC) staining of rat penile tissues was used to validate several targets. Notably, the Cell Counting Kit‐8 assay, Western blotting, oxidative stress (OS) level, and iron concentration were tested in corpus cavernosum smooth muscle cells (CCSMCs) stimulated with high glucose (HG), and treated with Ferrostatin‐1 (Fer‐1). RESULTS: Sixty‐nine disease targets of DMED were identified. According to KEGG analysis, these targets were primarily enriched in the ferroptosis pathway. Additionally, IHC results revealed that the expression of GPX4, SLC7A11, and ACSL4 was deregulated in the DMED group compared to the control group. Significantly, HG decreased cell viability and increased OS and iron levels in CCSMCs, which could be reversed by Fer‐1 treatment. DISCUSSION AND CONCLUSION: Our study revealed that ferroptosis may indeed exist in DMED. GPX4, SLC7A11, and ACSL4 all have a role in controlling the viability of CCSMCs, making them potential therapeutic targets.