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4.4 Summary of the integrated testicular-penile pathological axis The mechanisms described above suggest that varicocele may contribute to ED through a multi-level testicularpenile pathological axis centered on inflammation, oxidative stress, vascular dysfunction, smooth muscle remodeling, and neural injury (111)

[DOI] [PubMed] [Google Scholar] 44.Balzano T., Forteza J., Borreda I., Molina P., Giner J., Leone P., Urios A., Montoliu C., Felipo V

D., Muzio, F

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The innate immune system plays a critical role in modulating these processes as well as the transition from inflammation to proliferation phases, which includes a transition of inflammatory macrophages (M1) into anti-inflammatory wound healing cells (M2