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On the other hand, PCSK9 has been found to upregulate heat shock protein 70 in vitro, leading to the upregulation of mitogen-activated protein kinase (MAPK) signaling (Xu et al., 2021), a pathway which has been implicated in the progression of human cancers (Drosten and Barbacid, 2020)

Although amelioration of penile deformity was not examined in an RCT comparing shock wave therapy alone with shock wave therapy plus PDE5Is, other investigators drew the conclusion that continuous therapy of PDE5Is may be a candidate in treatment of PD based on the significant improvement of observational parameters (Palmieri et al., 2012