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Carella MC, Forleo C, Stanca A, Carulli E, Basile P, Carbonara U, Amati F, Mushtaq S, Baggiano A, Pontone G, Ciccone MM, Guaricci AI. Heart Failure and Erectile Dysfunction: a Review of the Current Evidence and Clinical Implications. Curr Heart Fail Rep 2023; 20:530-541. [PMID: 37962749 PMCID: PMC10746762 DOI: 10.1007/s11897-023-00632-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE OF REVIEW Heart failure (HF) and erectile dysfunction (ED) are two common conditions that affect millions of men worldwide and impair their quality of life. ED is a frequent complication of HF, as well as a possible predictor of cardiovascular events and mortality. ED deserves more attention from clinicians and researchers. RECENT FINDINGS The pathophysiology of ED in HF involves multiple factors, such as endothelial dysfunction, reduced cardiac output, neurohormonal activation, autonomic imbalance, oxidative stress, inflammation, and drug side effects. The diagnosis of ED in HF patients should be based on validated questionnaires or objective tests, as part of the routine cardiovascular risk assessment. The therapeutic management of ED in HF patients should be individualized and multidisciplinary, considering the patient's preferences, expectations, comorbidities, and potential drug interactions. The first-line pharmacological treatment for ED in HF patients with mild to moderate symptoms (NYHA class I-II) is phosphodiesterase type 5 inhibitors (PDE5Is), which improve both sexual function and cardiopulmonary parameters. PDE5Is are contraindicated in patients who use nitrates or nitric oxide donors for angina relief, and these patients should be advised to avoid sexual activity or to use alternative treatments for ED. Non-pharmacological treatments for ED, such as psychotherapy or couples therapy, should also be considered if there are significant psychosocial factors affecting the patient's sexual function or relationship. This review aims to summarize the most recent evidence regarding the prevalence of ED, the pathophysiology of this condition with an exhaustive analysis of factors involved in ED development in HF patients, a thorough discussion on diagnosis and management of ED in HF patients, providing practical recommendations for clinicians.
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Affiliation(s)
- Maria Cristina Carella
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Cinzia Forleo
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Alessandro Stanca
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Eugenio Carulli
- Cardiology Unit, Madonna Delle Grazie Hospital, Matera, Italy
| | - Paolo Basile
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Umberto Carbonara
- Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation-Urology, University of Bari Aldo Moro, Bari, Italy
| | - Fabio Amati
- Department of Basic Medicine Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Saima Mushtaq
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Andrea Baggiano
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Gianluca Pontone
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Marco Matteo Ciccone
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Andrea Igoren Guaricci
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy.
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Kataoka T, Hotta Y, Kimura K. A review of experimental techniques for erectile function researches and development of medical technology using animal erectile dysfunction models in sexual and reproductive medicine. Reprod Med Biol 2023; 22:e12513. [PMID: 37020643 PMCID: PMC10069627 DOI: 10.1002/rmb2.12513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/09/2023] [Accepted: 03/16/2023] [Indexed: 04/05/2023] Open
Abstract
Background Erectile dysfunction (ED) is one of the causes of male infertility and is a disease that requires treatment. The first‐line drugs for ED are phosphodiesterase 5 (PDE‐5) inhibitors, and further treatment options are currently limited. Medical technologies, such as genetic control and regenerative medicine, are developing rapidly. Research on erectile function is progressing rapidly, coupled with technological innovations in other areas. Methods A PubMed search using the keywords “animal (rat, mouse, rabbit, dog, and monkey)” and “erectile” was conducted, and all relevant peer‐reviewed English results were evaluated. Main findings The methods for evaluating erectile function include intracavernous pressure (ICP) measurements, isometric tension studies, and dynamic infusion cavernosometry. Papers also reported various disease model animals for the study of diabetes mellitus, cavernous nerve injury, and drug‐induced ED. Conclusion Basic research on ED treatment has progressed rapidly over the past 20 years. In particular, research on the mechanism of ED has been accelerated by the publication of a study on the evaluation of erectile function using ICP measurements in rats. In addition, molecular biological experimental methods such as polymerase chain reaction (PCR) and western blotting have become relatively easy to perform due to technological progress, thus advancing research development.
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Affiliation(s)
- Tomoya Kataoka
- Department of Pharmacology, Graduate School of Pharmaceutical SciencesChiba Institute of Science15‐8 Shiomi‐choChoshiChiba288‐0025Japan
- Department of Hospital Pharmacy, Graduate School of Pharmaceutical SciencesNagoya City University3‐1 Tanabe‐dori, Mizuho‐kuNagoya467‐8603Japan
| | - Yuji Hotta
- Department of Hospital Pharmacy, Graduate School of Pharmaceutical SciencesNagoya City University3‐1 Tanabe‐dori, Mizuho‐kuNagoya467‐8603Japan
| | - Kazunori Kimura
- Department of Hospital Pharmacy, Graduate School of Pharmaceutical SciencesNagoya City University3‐1 Tanabe‐dori, Mizuho‐kuNagoya467‐8603Japan
- Department of Clinical Pharmaceutics, Graduate School of Medical SciencesNagoya City University1‐Kawasumi, Mizuho‐cho, Mizuho‐kuNagoya467‐8601Japan
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Efficacy of resveratrol in male urogenital tract dysfunctions: an evaluation of pre-clinical data. Nutr Res Rev 2021; 36:86-97. [PMID: 34776039 DOI: 10.1017/s0954422421000354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Resveratrol is a polyphenol found naturally in fruits and plants. Recently, studies in humans and animal models have suggested beneficial properties of this polyphenol, such as improvements to metabolic and lipid profiles, along with antioxidant, anti-inflammatory and anti-proliferative effects. In the urogenital tract (UGT), resveratrol has also been tested clinically and experimentally as a therapeutic drug in several diseases; however, the translational efficacy of resveratrol, especially in UGT, is still a matter of debate. In the present review, we address the pre-clinical efficacy of resveratrol in UGT-related dysfunctions, focusing on lower urinary tract symptoms, non-cancerous prostatic disease (benign prostatic hyperplasia and prostatitis) and erectile dysfunction. In vitro studies indicate that resveratrol reduces inflammatory markers and oxidative stress, and improves endothelial function in UGT organs and cells isolated from humans and animals. Despite displaying low oral bioavailability, in vivo administration of resveratrol largely improves erectile dysfunction, benign prostatic hyperplasia, prostatitis and voiding impairments, as evidenced in different animal models. Resveratrol also acts as a microbiota modulator, which may explain some of its beneficial effects in vivo. In contrast to the large amount of pre-clinical data, there are insufficient clinical trials to establish resveratrol treatment efficacy in human UGT-related diseases. In summary, we provide an overview of the in vivo and in vitro efficacy of resveratrol in animal and human UGT dysfunctions, which may support future clinical trials.
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Shirai M, Miyoshi Y, Ogasa T, Miyoshi M, Ishikawa K, Hiramatsu I, Uesaka Y, Nozaki T, Koyama T, Tsujimura A. Oral Testofen, L-Citrulline, Resveratrol, and Caffeine Supplement Drink Improves Sexual Function in Men with Phosphodiesterase 5 Inhibitors: Randomized, Double-Blind, Placebo-Controlled Crossover Pilot Study. World J Mens Health 2021; 39:733-739. [PMID: 33151048 PMCID: PMC8443991 DOI: 10.5534/wjmh.200129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/24/2020] [Accepted: 10/05/2020] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Sexuality is very important for men's health. Currently, phosphodiesterase type 5 inhibitors (PDE5i) remain the first-line therapy for erectile dysfunction, and no other oral drugs or drinks are approved and used clinically to treat male libido or orgasm dysfunction. In reference to a pharmaceutical dosage document, growing health consciousness is said to have boosted yearly sales of supplement drinks to more than 170 billion yen (1.58 billion US dollars) in Japan. We have created a supplement drink comprised of testofen, L-citrulline, resveratrol, and caffeine. We hypothesized that our supplement drink would be effective for men with sexual dysfunction, and especially libido dysfunction. MATERIALS AND METHODS In this study, men with sexual dysfunction received a placebo drink for 14 days or our supplement drink (testofen, 600 mg/d; L-citrulline, 800 mg/d; resveratrol, 300 mg/d; and caffeine, 40 mg/d) for another 14 days separated by a 7-day washout period. Patients continued on-demand use of PDE5i. The International Index of Erectile Function (IIEF) score and adverse events were assessed. RESULTS Twenty patients aged 30-7 years old were enrolled in and concluded the study with no adverse events experienced. The IIEF domains of desire frequency, erection frequency, erection firmness, erection confidence, intercourse satisfaction, ejaculation frequency, orgasm frequency, and overall satisfaction were significantly improved with our supplement drink. CONCLUSIONS This is the first study to show that our supplement drink may not only be effective for erection but also for libido, orgasm, and ejaculation.
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Affiliation(s)
- Masato Shirai
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Yuto Miyoshi
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
- Department of Urology, Juntendo University, Graduate School of Medicine, Chiba, Japan
| | - Taiki Ogasa
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
- Department of Urology, Juntendo University, Graduate School of Medicine, Chiba, Japan
| | - Miho Miyoshi
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
- Department of Urology, Juntendo University, Graduate School of Medicine, Chiba, Japan
| | - Keisuke Ishikawa
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
- Department of Urology, Juntendo University, Graduate School of Medicine, Chiba, Japan
| | - Ippei Hiramatsu
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
- Department of Urology, Juntendo University, Graduate School of Medicine, Chiba, Japan
| | - Yuka Uesaka
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Taiji Nozaki
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | | | - Akira Tsujimura
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.
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The Role of Resveratrol in Mammalian Reproduction. Molecules 2020; 25:molecules25194554. [PMID: 33027994 PMCID: PMC7582294 DOI: 10.3390/molecules25194554] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/20/2020] [Accepted: 09/30/2020] [Indexed: 12/18/2022] Open
Abstract
Resveratrol is one of the most investigated natural polyphenolic compounds and is contained in more than 70 types of plants and in red wine. The widespread interest in this polyphenol derives from its antioxidant, anti-inflammatory and anti-aging properties. Several studies have established that resveratrol regulates animal reproduction. However, the mechanisms of action and the potential therapeutic effects are still unclear. This review aims to clarify the role of resveratrol in male and female reproductive functions, with a focus on animals of veterinary interest. In females, resveratrol has been considered as a phytoestrogen due to its capacity to modulate ovarian function and steroidogenesis via sirtuins, SIRT1 in particular. Resveratrol has also been used to enhance aged oocyte quality and as a gametes cryo-protectant with mainly antioxidant and anti-apoptotic effects. In males, resveratrol enhances testes function and spermatogenesis through activation of the AMPK pathway. Furthermore, resveratrol has been supplemented to semen extenders, improving the preservation of sperm quality. In conclusion, resveratrol has potentially beneficial effects for ameliorating ovarian and testes function.
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Aqueous extract of Lespedeza cuneata improves male menopause by increase of nitric oxide and dihydrotestosterone. Food Sci Biotechnol 2019; 28:253-260. [PMID: 30815317 DOI: 10.1007/s10068-018-0434-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/20/2018] [Accepted: 07/04/2018] [Indexed: 10/28/2022] Open
Abstract
This study aimed to evaluate the effect of aqueous extract of Lespedeza cuneata (ALC) on men menopause induced erectile dysfunction (ED) and testosterone deficiency syndrome (TDS) in vitro and in vivo. Nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) have been fundamental factors of ED, and free testosterone such as dihydrotestosterone (DHT) has a crucial role in mitigation of TDS. ALC increased the production of NO in a dose-dependent manner in vitro and in vivo. The level of neuronal nitric oxide synthase and cGMP was increased in the ALC group. The level of DHT and 17-beta hydroxysteroid dehydrogenases (17β-HSD) was also increased in the ALC group. There was no significant change of hepatotoxicity, renal toxicity, lipid metabolism, and glucose. These results suggest that ALC enhanced NO, cGMP and free testosterone which could be developed as a health supplement for improving male menopause.
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Shirai M, Hiramatsu I, Aoki Y, Shimoyama H, Mizuno T, Nozaki T, Fukuhara S, Iwasa A, Kageyama S, Tsujimura A. Oral L-citrulline and Transresveratrol Supplementation Improves Erectile Function in Men With Phosphodiesterase 5 Inhibitors: A Randomized, Double-Blind, Placebo-Controlled Crossover Pilot Study. Sex Med 2018; 6:291-296. [PMID: 30150102 PMCID: PMC6302103 DOI: 10.1016/j.esxm.2018.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/24/2018] [Accepted: 07/12/2018] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Phosphodiesterase type 5 inhibitors (PDE5i) are first-line therapy for most men with erectile dysfunction (ED). If ineffective, vacuum erection devices, intracavernous injections, and penile prosthesis implantation are suitable as second- or third-line therapies. However, very few patients select these therapies. It is critically important to improve erectile function with oral administration of effective agents. Administration of L-citrulline or transresveratrol in animal experiments has been reported to improve erectile function, but few such experiments have been performed on humans with ED. AIM We aimed to investigate the efficacy of combination therapy of L-citrulline and transresveratrol in patients with ED despite their use of PDE5i. METHODS In this randomized, double-blind, placebo-controlled crossover pilot study, men with ED (Sexual Health Inventory for Men [SHIM] score below 16) despite on-demand use of PDE5i received a placebo for 1 month or the active treatment (L-citrulline 800 mg/day and transresveratrol 300 mg/day) for another month. Patients continued on-demand use of PDE5i. MAIN OUTCOME MEASURE The SHIM score, Erection Hardness Score (EHS), Aging Male Symptoms Scale-sexual domain (AMS-SD), and adverse events were examined. RESULTS 20 patients ages 29-78 years were enrolled, and after 6 men withdrew, 13 concluded the study without adverse events. Mean SHIM score for the active treatment increased significantly (10.96 ± 1.21) compared with baseline (8.32 ± 1.21) and placebo (8.31 ± 1.23) (both P < .05). Mean EHS score for the active treatment (2.56 ± 0.26) also increased from baseline (2.31 ± 0.26), but not significantly (P = .79). Mean AMS-SD score was not significantly different in either group. CONCLUSION To our knowledge, this is the first study to show that combination therapy of L-citrulline and transresveratrol is effective for ED treatment in men with added on-demand use of PDE5i. This combination supplement may be added if PDE5i is insufficient. Shirai M, Hiramatsu I, Aoki Y, et al. Oral L-citrulline and Transresveratrol Supplementation Improves Erectile Function in Men With Phosphodiesterase 5 Inhibitors: A Randomized, Double-Blind, Placebo-Controlled Crossover Pilot Study. Sex Med 2018;6:291-296.
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Affiliation(s)
- Masato Shirai
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Ippei Hiramatsu
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan; Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Yusuke Aoki
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan; Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Hirofumi Shimoyama
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan; Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Taiki Mizuno
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Taiji Nozaki
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Shinichiro Fukuhara
- Department of Urology, Osaka University, Graduate School of Medicine, Osaka, Japan
| | | | | | - Akira Tsujimura
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.
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Yazir Y, Demirtaş Şahin T, Furat Rençber S, Gacar G, Halbutoğulları ZS, Utkan T, Aricioglu F. Restorative effect of resveratrol on expression of endothelial and neuronal nitric oxide synthase in cavernous tissues of chronic unpredictable mild stress-exposed rats: an impact of inflammation. Int J Impot Res 2018; 30:318-326. [DOI: 10.1038/s41443-018-0048-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/24/2018] [Accepted: 05/26/2018] [Indexed: 11/09/2022]
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Yazir Y, Utkan T, Şahin TD, Gocmez SS. Improvement of penile neurogenic and endothelial relaxant responses by chronic administration of resveratrol in rabbits exposed to unpredictable chronic mild stress. Int J Impot Res 2018; 30:163-170. [DOI: 10.1038/s41443-018-0016-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 11/17/2017] [Accepted: 12/24/2017] [Indexed: 01/26/2023]
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Pan F, Qiu XF, Yu W, Zhang QP, Chen Q, Zhang CY, Chen Y, Pan LJ, Zhang AX, Dai YT. MicroRNA-200a is up-regulated in aged rats with erectile dysfunction and could attenuate endothelial function via SIRT1 inhibition. Asian J Androl 2016; 18:74-9. [PMID: 25966629 PMCID: PMC4736360 DOI: 10.4103/1008-682x.154991] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
MiR-200a was shown to be upregulated in the corpus cavernosum (CC) of rats with aging-related erectile dysfunction (A-ED) in our previous study. Among its target genes, SIRT1 was also reported as a protective factor in erectile function by our groups previously. Thus, miR-200a might attenuate the erectile function in A-ED via SIRT1 inhibition. In the present study, three animal groups were included: aged rats with ED (group AE, n = 8), aged rats with normal erectile function (group AN, n = 8), and young rats as normal controls (group YN, n = 8). CCs from each group were collected for histological and molecular measurements to validate the dysregulation of miR-200a and SIRT1. After that, the cavernous endothelial cells (CECs) from CC of aged rats with normal erectile function were transfected with miR-200a in vitro. Then the expression of SIRT1 and molecules within the eNOS/NO/PKG pathway were measured to investigate whether the transfection could imitate the attenuated process of erectile function in the aged. As a result, miR-200a was upregulated while the SIRT1, the levels of eNOS and cGMP were all downregulated in the CCs from AE group. After transfection in vitro, the miR-200a was upregulated while the SIRT1 and levels of eNOS and cGMP were obviously downregulated. Finally, based on the results of our previous study, we further verify that up-regulation of miR-200a could participate in the mechanisms of A-ED via SIRT1 inhibition, and mainly attenuate endothelial function via influencing the eNOS/NO/PKGpathway.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ai-Xia Zhang
- State Key Laboratory of Reproductive Medicine, Department of Andrology, Nanjing Maternity and Child Health Care Hospital, Affiliated to Nanjing Medical University, Nanjing, China
| | - Yu-Tian Dai
- Department of Andrology, Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, China
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Boydens C, Pauwels B, Vanden Daele L, Van de Voorde J. Protective effect of resveratrol and quercetin on in vitro-induced diabetic mouse corpus cavernosum. Cardiovasc Diabetol 2016; 15:46. [PMID: 26993793 PMCID: PMC4797116 DOI: 10.1186/s12933-016-0366-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 03/11/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Hyperglycemia and increased levels of methylglyoxal (MGO) can trigger the development of vascular complications in diabetes. Resveratrol and quercetin are red wine polyphenols with known beneficial cardiovascular properties, including an antioxidant capacity. This study evaluated whether resveratrol and/or quercetin could prevent in vitro-induced diabetic changes in neurogenic and vascular relaxant responses of mouse arteries and corpora cavernosa. METHODS Isometric tension of isolated aorta, mesenteric arteries and corpora cavernosa was measured using organ bath systems. Diabetic conditions were mimicked in vitro by co-incubating the tissues for 2 h with high glucose (HG, 30 mM) and MGO (120 µM). RESULTS The presence of HG and MGO significantly blunted acetylcholine (Ach)-induced relaxations in corpora cavernosa and mesenteric arteries but not in aorta. Electrical field stimulated (EFS) responses of corpora cavernosa were also significantly inhibited by these diabetic conditions. In corpora cavernosa 2 h co-incubation with resveratrol (30 µM) or quercetin (30 µM) significantly attenuated HG and MGO-induced deficits in Ach- and EFS-responses. CONCLUSIONS Our study demonstrates that in mouse arteries, HG and MGO rather affect endothelium derived hyperpolarizing factor-mediated than nitric oxide (NO)-mediated relaxations. In corpora cavernosa HG and MGO interfere with NO release. Resveratrol and quercetin protect mouse corpora cavernosa from diabetic-induced damage to NO-mediated relaxant responses. This might rely on their antioxidant capacity.
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Affiliation(s)
- Charlotte Boydens
- Department of Pharmacology, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Bart Pauwels
- Department of Pharmacology, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Laura Vanden Daele
- Department of Pharmacology, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Johan Van de Voorde
- Department of Pharmacology, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.
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Yetik-Anacak G, Dereli MV, Sevin G, Ozzayım O, Erac Y, Ahmed A. Resveratrol Stimulates Hydrogen Sulfide (H2S) Formation to Relax Murine Corpus Cavernosum. J Sex Med 2015; 12:2004-12. [DOI: 10.1111/jsm.12993] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Resveratrol and sildenafil synergistically improve diabetes-associated erectile dysfunction in streptozotocin-induced diabetic rats. Life Sci 2015; 135:43-8. [PMID: 26006044 DOI: 10.1016/j.lfs.2015.04.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 04/14/2015] [Accepted: 04/22/2015] [Indexed: 11/22/2022]
Abstract
AIMS Despite effective control of blood glucose levels in diabetic patients, complaints of diabetes-associated erectile dysfunction (ED) persist. Resveratrol has been indicated to possess anti-diabetic effects and therapeutic potential for ED. This study was conducted to observe the effect of resveratrol alone or in combination with sildenafil on ED in streptozotocin (STZ)-induced diabetic rats. MAIN METHOD Among 58 adult male STZ-induced (60 mg/kg) diabetic Sprague-Dawley rats, 48 STZ-induced diabetic rats were randomized equally to four groups: untreated diabetic rats, resveratrol (25mg/kg), sildenafil (5mg/kg) or resveratrol (25mg/kg) plus sildenafil (5mg/kg) through oral gavage for 8 weeks. Additionally, 12 age-matched rats were chosen as controls. Intracavernous pressure (ICP) and mean arterial blood pressure (MAP) were used to measure erectile function. The cavernous level of cyclic guanosine monophosphate (cGMP), protein and mRNA of endothelial NO synthase (eNOS), neuronal NOS (nNOS), and phosphodiesterase-5 (PDE5) was measured. KEY FINDINGS Treatment with either resveratrol or sildenafil improved ICP/MAP compared to the untreated diabetic rats (P<0.05). Treatment with resveratrol increased nNOS and eNOS expression, inhibited PDE5 expression, and increased the cavernous cGMP level compared to the untreated diabetic rats. Resveratrol significantly decreased superoxide anion and ROS production. Two-way ANOVA indicated that resveratrol in combination with sildenafil therapy had a significant synergistic effect in improving ICP/MAP and cavernous cGMP levels. SIGNIFICANCE Resveratrol improves diabetes-associated ED in rats. Combination therapies with resveratrol and sildenafil have a synergistic effect in improving ED. The mechanisms might be attributed to its anti-oxidative properties and NO-cGMP signaling pathway upregulation.
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Boydens C, Pauwels B, Decaluwé K, Brouckaert P, Van de Voorde J. Relaxant and Antioxidant Capacity of the Red Wine Polyphenols, Resveratrol and Quercetin, on Isolated Mice Corpora Cavernosa. J Sex Med 2015; 12:303-12. [DOI: 10.1111/jsm.12786] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Park EJ, Pezzuto JM. The pharmacology of resveratrol in animals and humans. Biochim Biophys Acta Mol Basis Dis 2015; 1852:1071-113. [PMID: 25652123 DOI: 10.1016/j.bbadis.2015.01.014] [Citation(s) in RCA: 192] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 01/01/2015] [Accepted: 01/21/2015] [Indexed: 12/12/2022]
Abstract
In addition to thousands of research papers related to resveratrol (RSV), approximately 300 review articles have been published. Earlier research tended to focus on pharmacological activities of RSV related to cardiovascular systems, inflammation, and carcinogenesis/cancer development. More recently, the horizon has been broadened by exploring the potential effect of RSV on the aging process, diabetes, neurological dysfunction, etc. Herein, we primarily focus on the in vivo pharmacological effects of RSV reported over the past 5 years (2009-2014). In addition, recent clinical intervention studies performed with resveratrol are summarized. Some discrepancies exist between in vivo studies with animals and clinical studies, or between clinical studies, which are likely due to disparate doses of RSV, experimental settings, and subject variation. Nevertheless, many positive indications have been reported with mammals, so it is reasonable to advocate for the conduct of more definitive clinical studies. Since the safety profile is pristine, an added advantage is the use of RSV as a dietary supplement. This article is part of a Special Issue entitled: Resveratrol: Challenges in translating pre-clinical findings to improved patient outcomes.
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Affiliation(s)
- Eun-Jung Park
- The Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, Hilo, HI 96720, USA
| | - John M Pezzuto
- The Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, Hilo, HI 96720, USA.
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Yetik-Anacak G, Sorrentino R, Linder AE, Murat N. Gas what: NO is not the only answer to sexual function. Br J Pharmacol 2014; 172:1434-54. [PMID: 24661203 DOI: 10.1111/bph.12700] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/18/2014] [Accepted: 03/17/2014] [Indexed: 01/08/2023] Open
Abstract
The ability to get and keep an erection is important to men for several reasons and the inability is known as erectile dysfunction (ED). ED has started to be accepted as an early indicator of systemic endothelial dysfunction and subsequently of cardiovascular diseases. The role of NO in endothelial relaxation and erectile function is well accepted. The discovery of NO as a small signalling gasotransmitter led to the investigation of the role of other endogenously derived gases, carbon monoxide (CO) and hydrogen sulphide (H2 S) in physiological and pathophysiological conditions. The role of NO and CO in sexual function and dysfunction has been investigated more extensively and, recently, the involvement of H2 S in erectile function has also been confirmed. In this review, we focus on the role of these three sister gasotransmitters in the physiology, pharmacology and pathophysiology of sexual function in man, specifically erectile function. We have also reviewed the role of soluble guanylyl cyclase/cGMP pathway as a common target of these gasotransmitters. Several studies have proposed alternative therapies targeting different mechanisms in addition to PDE-5 inhibition for ED treatment, since some patients do not respond to these drugs. This review highlights complementary and possible coordinated roles for these mediators and treatments targeting these gasotransmitters in erectile function/ED.
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Affiliation(s)
- G Yetik-Anacak
- Department of Pharmacology, Faculty of Pharmacy, Ege University, İzmir, Turkey
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Kataoka T, Hotta Y, Maeda Y, Kimura K. Assessment of androgen replacement therapy for erectile function in rats with type 2 diabetes mellitus by examining nitric oxide-related and inflammatory factors. J Sex Med 2014; 11:920-929. [PMID: 24467772 DOI: 10.1111/jsm.12447] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) has become a major public health issue and is considered a risk factor for erectile dysfunction (ED). T2DM is also associated with androgen deficiency. However, there have been few basic studies on androgen replacement therapy (ART) for ED treatment in T2DM animal models, and the mechanism underlying the effect of ART on T2DM-induced ED is unclear. AIM To investigate the effect of ART on ED in T2DM rats by examining inflammatory and nitric oxide (NO)-related factors. METHODS Otsuka Long-Evans Tokushima Fatty (OLETF) rats and their controls, Long-Evans Tokushima Otsuka (LETO) rats, were distributed into three groups: LETO, OLETF, and ART. In the ART group, OLETF rats were treated daily with testosterone (3 mg/kg/day, subcutaneously) from 20 to 25 weeks of age; LETO and OLETF rats received vehicle only. MAIN OUTCOME MEASURES We measured erectile function by using measurements of the ratio between intracavernosal pressure (ICP) and mean arterial pressure (MAP) following electrical stimulation of the cavernous nerve and by evaluating the endothelial function of the corpus cavernosum in an isometric tension study. Expression of endothelial NO synthase (eNOS), inducible NO synthase (iNOS), sirtuin-1 (Sirt1), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) mRNA was detected using polymerase chain reaction. RESULTS The ICP/MAP ratio in the OLETF group was significantly decreased and that in the ART group was significantly improved (P < 0.01). The response to acetylcholine was significantly decreased in the OLETF group and improved in the ART group (P < 0.01). Although expression of eNOS and Sirt1 mRNA was decreased and that of iNOS, IL-6, and TNF-α mRNA was increased in the OLETF group, ART improved mRNA expression. CONCLUSIONS ART suppressed inflammation in rats with T2DM and metabolic disorders and improved their endothelial and erectile functions. ART could be effective for T2DM-induced ED and may be considered a potential ED treatment method.
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Affiliation(s)
- Tomoya Kataoka
- Department of Hospital PharmacyGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Yuji Hotta
- Department of Hospital PharmacyGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Yasuhiro Maeda
- Department of Hospital PharmacyGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
| | - Kazunori Kimura
- Department of Hospital PharmacyGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan; Department of Clinical PharmacyGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan.
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Decaluwé K, Pauwels B, Boydens C, Van de Voorde J. Treatment of erectile dysfunction: new targets and strategies from recent research. Pharmacol Biochem Behav 2013; 121:146-57. [PMID: 24291648 DOI: 10.1016/j.pbb.2013.11.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/18/2013] [Indexed: 12/15/2022]
Abstract
In recent years, research on penile erection has increasingly been centered on the molecular mechanisms involved. Major progress has been made in the field and at present a whole number of neurotransmitters, chemical effectors, growth factors, second-messenger molecules, ions, intercellular proteins, and hormones have been characterized as components of the complex process of erection. This knowledge has led to the discovery of several new therapeutic targets and multiple medical approaches for the treatment of erectile dysfunction (ED). This review focuses on the progress made in this field within the last few years.
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Affiliation(s)
- K Decaluwé
- Department of Pharmacology, Ghent University, Ghent, Belgium
| | - B Pauwels
- Department of Pharmacology, Ghent University, Ghent, Belgium
| | - C Boydens
- Department of Pharmacology, Ghent University, Ghent, Belgium
| | - J Van de Voorde
- Department of Pharmacology, Ghent University, Ghent, Belgium.
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Zamorano-León JJ, Olivier C, de Las Heras N, Mateos-Cáceres PJ, Brime Menéndez R, Rodríguez-Sierra P, Martín Palacios N, Manso LSJ, Modrego J, Segura A, Macaya C, López-Farré AJ. Vardenafil improves penile erection in type 2 diabetes mellitus patients with erectile dysfunction: role of tropomyosin. J Sex Med 2013; 10:3110-20. [PMID: 24112450 DOI: 10.1111/jsm.12324] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Evidences have been suggested that phosphodiesterase type 5 (PDE5) inhibition promotes vasculoprotective benefits in patients with cardiovascular diseases. AIM The aim of this study is to analyze the systemic effect of PDE5 inhibition in type 2 diabetes mellitus patients with erectile dysfunction (ED) determining changes in the expression levels of plasma proteins. METHODS Seventeen patients with controlled type 2 diabetes mellitus and ED were included in the study. Patients received vardenafil hydrochloride 20 mg on demand during 12 weeks. At the beginning and 12 weeks after vardenafil administration, plasma samples were collected and analyzed using proteomics. MAIN OUTCOME MEASURES International Index of Erectile Function-Erectile Function Domain (IIEF-EFD) and plasma protein expression before and after vardenafil administration. Nitrate/nitrite release, PDE5, and soluble guanylate cyclase (sGC) expression and cyclic guanosine monophosphate (cGMP) content in cultured bovine aortic endothelial cells (BAECs). RESULTS The IIEF-EFD score was markedly improved after 12 weeks of vardenafil administration. Plasma levels of alpha 1-antitrypsin isotypes 4 and 6 and β-tropomyosin were decreased, whereas apolipoprotein AI isoype 5 was increased 12 weeks after vardenafil administration. Only β-tropomyosin plasma levels were inversely correlated with IIEF-EFD score. Tropomyosin has been added to cultured BAECs and after 24 hours reduced the protein expression level of sGC-β1 subunit and decreased the cGMP content. Tropomyosin did not modify PDE5 expression and nitric oxide release in BAECs as compared with control BAECs. Vardenafil (10 μg/mL) did not modify sGC-β1 subunit expression in tropomyosin + vardenafil-incubated BAECs; however, vardenafil significantly reversed the reduction of cGMP content induced by tropomyosin. CONCLUSION Vardenafil administration improved erectile functionality in controlled type 2 diabetes mellitus patients with ED, which was associated with reduction of circulating plasma β-tropomyosin levels. Tropomyosin affected by itself the cGMP generating system suggesting a possible new mechanism involved in ED. Vardenafil reversed the reduction effect of cGMP content elicited by tropomyosin in BAECs.
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Affiliation(s)
- Jose J Zamorano-León
- Cardiovascular Research Unit, Cardiology Department of Hospital Clínico San Carlos de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Resveratrol, an activator of SIRT1, restores erectile function in streptozotocin-induced diabetic rats. Asian J Androl 2013; 15:646-51. [PMID: 23792339 DOI: 10.1038/aja.2013.60] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 03/28/2013] [Accepted: 04/20/2013] [Indexed: 01/05/2023] Open
Abstract
The high incidence of erectile dysfunction (ED) in diabetes highlights a need for effective treatment strategies. Resveratrol, an activator of silent information regulator 2-related enzymes 1 (sirtuin1, SIRT1), has received attention for its valuable effects in cancer, neurodegenerative diseases, longevity and cardiovascular disease. To explore the effects of resveratrol in diabetes-induced ED, resveratrol was administered to rats with streptozocin (65 mg kg(-1))-induced diabetes. Erectile function, cavernous structure, tissue protein expression of silent information regulator 2-related enzymes 1 (sirtuin1, SIRT1), p53 and forkhead transcription factor O 3a (FOXO3a), superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels in the corpora cavernosa were studied. We found that SIRT1 was expressed in cavernosal tissue, and it was downregulated in the corpora of diabetic rats. The administration of resveratrol upregulated the expression of SIRT1 and restored erectile function. In contrast, resveratrol downregulated the expression of p53 and FOXO3a, which regulate apoptosis and oxidative stress. Furthermore, the resveratrol-treated group showed an improvement in smooth muscle content, SOD activity and MDA levels when compared with the diabetic group. Therefore, the ability of resveratrol to improve diabetes-induced ED is likely related to its activation of SIRT1 expression, thus causing the suppression of apoptosis and resistance towards oxidative stress.
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Tomada I, Tomada N, Almeida H, Neves D. Androgen depletion in humans leads to cavernous tissue reorganization and upregulation of Sirt1-eNOS axis. AGE (DORDRECHT, NETHERLANDS) 2013; 35:35-47. [PMID: 22052036 PMCID: PMC3543737 DOI: 10.1007/s11357-011-9328-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Accepted: 10/15/2011] [Indexed: 05/22/2023]
Abstract
Aging and physiological androgen decay leads to structural changes in corpus cavernosum (CC) that associate with erectile function impairment. There is evidence that such changes relate to nitric oxide (NO) bioavailability, an endothelial compound produced by the action of endothelial NO synthase (eNOS), and is regulated by sirtuin-1 (Sirt1), a NAD(+)-dependent protein deacetylase. Taking into account the reduced NO synthesis observed in aging and erectile dysfunction, we aimed to characterize human CC of androgen-deprived, young, and aged individuals postulating that androgen deprivation induces modifications similar to those observed in aging. Human penile fragments were collected from young individuals submitted to male-to-female sex reassignment procedure, who undergone an androgen deprivation chemical regimen, from young organ donors and from aged patients submitted to penile deviation surgery. They were processed for histomorphometric analysis of smooth muscle (SM) and connective tissues (CT), and dual-immunofluorescence of alpha-actin/vWf or Sirt1, and endothelin-1/eNOS. Estrogen receptors were analyzed by immunohistochemistry and semiquantification of Sirt1, eNOS, and phospho-Akt was assayed by Western blotting. Androgen withdrawal, similarly to aging, leads to a noteworthy reduction of SM-to-CT ratio in CC. However, in contrast to young and aged, a significant increase in penile Sirt1 expression accompanied by an increase in total eNOS expression was observed in androgen-depleted individuals. No changes were evidenced in phospho-Akt system and estrogen receptors were undetectable. These findings indicate that Sirt1 regulates the expression of eNOS in human CC employing mechanisms influenced by androgen depletion.
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Affiliation(s)
- Inês Tomada
- Department of Experimental Biology, Faculty of Medicine of Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal.
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Hotta Y, Ohno R, Kataoka T, Mikumo M, Takahata Y, Ohno M, Maeda Y, Kimura K. Effects of Chronic Vardenafil Treatment Persist after End of Treatment in Rats with Acute Arteriogenic Erectile Dysfunction. J Sex Med 2012; 9:1782-8. [DOI: 10.1111/j.1743-6109.2012.02742.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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