Clinical significance of serum Nesfatin-1 as a novel biomarker in premature ejaculation: its association with the serotonergic system and diagnostic value
Abstract
Premature ejaculation (PE) is a prevalent male sexual dysfunction with a complex, incompletely understood pathophysiology. The diagnosis of PE remains anchored in subjective patient reports and self-administered questionnaires. While these tools are valuable, they lack the objectivity of a measurable biological signal. This absence of a biomarker not only complicates definitive diagnosis but also impedes quantifiable tracking of treatment response. Regarding treatment, selective serotonin reuptake inhibitors (SSRIs), like dapoxetine, have established themselves as the primary pharmacological option due to their efficacy. Their therapeutic effect is broadly attributed to increasing synaptic serotonin (5-HT) levels, a neurotransmitter known to be a key regulator of ejaculatory latency.1 However, the precise mechanisms by which elevated 5-HT leads to increased ejaculatory latency, and the reasons for interindividual variability in response, remain incompletely understood. This knowledge gap points to the likely involvement of other modulating factors within the complex neurobiology of ejaculation. Our investigation turned to Nesfatin-1, a peptide originally identified for its role in appetite regulation but increasingly recognized for its broad neuroendocrine functions. Of particular interest is compelling preclinical evidence showing a close anatomical and functional interaction between Nesfatin-1 and 5-HT system in brain regions such as the dorsal raphe nucleus.2,3 Research…
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