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Gargallo-Benedicto A, Clemente-Tomás R, Pastor-Espuig M, Alías-Alegre EG, Navarro-Casado MN. Bilateral neurosensory retinal detachment secondary to tadalafil treatment. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:234-238. [PMID: 35523471 DOI: 10.1016/j.oftale.2020.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/21/2020] [Indexed: 06/14/2023]
Abstract
A 53-year-old male with no systemic disorders, other than controlled arterial hypertension, presented with asymptomatic, bilateral neurosensory retinal detachment (NRD) detected during a routine revision. The patient reported the use of tadalafil (a phosphodiesterase-5 inhibitor [PDE5I]) for erectile dysfunction. Following suspension of the drug, subretinal fluid reabsorption was confirmed, with the persistence of chronic alterations in the optical coherence tomography (OCT) and the visual field. PDE5Is have ocular side effects, including exudative retinal detachment. Although no direct causal relationship has been confirmed, PDE5 inhibition at chorioretinal level produces vasodilatation, increased choroid hydrostatic pressure, and exudation into the subretinal space. In cases of NRD, a thorough assessment of the drug treatment history is crucial. Patients who use PDE5I drugs should be alerted to their potential ocular side effects.
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Affiliation(s)
| | - R Clemente-Tomás
- Servicio de Oftalmología, Hospital General Obispo Polanco, Teruel, Spain
| | - M Pastor-Espuig
- Servicio de Oftalmología, Hospital General Obispo Polanco, Teruel, Spain
| | - E G Alías-Alegre
- Servicio de Oftalmología, Hospital General Obispo Polanco, Teruel, Spain
| | - M N Navarro-Casado
- Servicio de Oftalmología, Hospital General Obispo Polanco, Teruel, Spain
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Gargallo-Benedicto A, Clemente-Tomás R, Pastor-Espuig M, Alías-Alegre EG, Navarro-Casado MN. Bilateral neurosensory retinal detachment secondary to tadalafil treatment. Arch Soc Esp Oftalmol (Engl Ed) 2021; 97:S0365-6691(20)30488-3. [PMID: 33483171 DOI: 10.1016/j.oftal.2020.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/05/2020] [Accepted: 11/21/2020] [Indexed: 06/12/2023]
Abstract
A 53-year-old male with no systemic disorders, other than controlled arterial hypertension, presented with asymptomatic, bilateral neurosensory retinal detachment (NRD) detected during a routine revision. The patient reported the use of tadalafil (a phosphodiesterase-5 inhibitor [PDE5I]) for erectile dysfunction. Following suspension of the drug, subretinal fluid reabsorption was confirmed, with the persistence of chronic alterations in the optical coherence tomography (OCT) and the visual field. PDE5Is have ocular side effects, including exudative retinal detachment. Although no direct causal relationship has been confirmed, PDE5 inhibition at chorioretinal level produces vasodilatation, increased choroid hydrostatic pressure, and exudation into the subretinal space. In cases of NRD, a thorough assessment of the drug treatment history is crucial. Patients who use PDE5I drugs should be alerted to their potential ocular side effects.
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Bhatia P, Singh N. Tadalafil ameliorates memory deficits, oxidative stress, endothelial dysfunction and neuropathological changes in rat model of hyperhomocysteinemia induced vascular dementia. Int J Neurosci 2020; 132:384-396. [PMID: 32859137 DOI: 10.1080/00207454.2020.1817009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM The present study investigates the potential of Tadalafil, a phosphodiesterase-5 inhibitor, in a rat model of hyperhomocysteinemia induced vascular dementia. METHODS Hyperhomocysteinemia induced vascular dementia in Wistar rats was produced by administering l-Methionine (1.7 g/kg/day; p.o.×8 weeks). Learning and memory was assessed by employing Morris water maze (MWM) test. Endothelial dysfunction was assessed through acetylcholine-induced endothelial-dependent vasorelaxation and serum nitrite levels. Various other biochemical and histopathological estimations were also performed. RESULTS l-Methionine produced significant impairment in acetylcholine-induced endothelium-dependent vasorelaxation and a decrease in serum nitrite levels indicating endothelial dysfunction. Further, these animals performed poorly on Morris water maze, depicting impairment of learning and memory. There was a significant rise in brain oxidative stress level (indicated by an increase in brain thiobarbituric acid reactive species and a decrease in reduced glutathione levels). Increase in brain acetylcholinesterase activity; brain myeloperoxidase activity and brain neutrophil infiltration (a marker of inflammation) were also observed. Tadalafil (5 and 10 mg/kg, p.o.)/Donepezil (0.5 mg/kg, i.p., serving as standard) treatment ameliorated l-Methionine induced endothelial dysfunction; memory deficits; biochemical and histopathological changes in a significant manner. CONCLUSIONS It may be concluded that tadalafil has shown efficacy in the rat model of l-Methionine induced vascular dementia and that phosphodiesterase-5 can be considered as an important therapeutic target for the treatment of vascular dementia.
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Affiliation(s)
- Pankaj Bhatia
- CNS Research Lab., Pharmacology Division, Department of Pharmaceutical Sciences and Drug Research, Faculty of Medicine, Punjabi University, Patiala, Punjab, India
| | - Nirmal Singh
- Department of Pharmaceutical Sciences and Drug Research, Faculty of Medicine, Punjabi University, Patiala, Punjab, India
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Duarte-Silva E, Filho AJMC, Barichello T, Quevedo J, Macedo D, Peixoto C. Phosphodiesterase-5 inhibitors: Shedding new light on the darkness of depression? J Affect Disord 2020; 264:138-149. [PMID: 32056743 DOI: 10.1016/j.jad.2019.11.114] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 11/22/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Phosphodiesterase-5 inhibitors (PDE5Is) are used to treat erectile dysfunction (ED). Recently, the antidepressant-like effect of PDE5Is was demonstrated in animal models of depression. In clinical settings, PDE5Is were studied only for ED associated depression. Hence, there are no studies evaluating the effects of PDE5Is for the treatment of major depressive disorder (MDD) without ED. In this review article, we aimed to discuss the use of PDE5Is in the context of MDD, highlighting the roles of PDE genes in the development of MDD, the potential mechanisms by which PDE5Is can be beneficial for MDD and the potentials and limitations of PDE5Is repurposing to treat MDD. METHODS We used PubMed (MEDLINE) database to collect the studies cited in this review. Papers written in English language regardless the year of publication were selected. RESULTS A few preclinical studies support the antidepressant-like activity of PDE5Is. Clinical studies in men with ED and depression suggest that PDE5Is improve depressive symptoms. No clinical studies were conducted in subjects suffering from depression without ED. Antidepressant effect of PDE5Is may be explained by multiple mechanisms including inhibition of brain inflammation and modulation of neuroplasticity. LIMITATIONS The low number of preclinical and absence of clinical studies to support the antidepressant effect of PDE5Is. CONCLUSIONS No clinical trial was conducted to date evaluating PDE5Is in depressed patients without ED. PDE5Is' anti-inflammatory and neuroplasticity mechanisms may justify the potential antidepressant effect of these drugs. Despite this, clinical trials evaluating their efficacy in depressed patients need to be conducted.
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Affiliation(s)
- Eduardo Duarte-Silva
- Laboratory of Ultrastructure, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (FIOCRUZ-PE), Recife, PE, Brazil; Graduate Program in Biosciences and Biotechnology for Health (PPGBBS), Aggeu Magalhães Institute (IAM), Recife, PE, Brazil.
| | - Adriano José Maia Chaves Filho
- Neuropsychopharmacology Laboratory, Drug Research and Development Center, Faculty of Medicine, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Tatiana Barichello
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, 1941 East Road, Houston, TX 77054, United States; Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina-UNESC, Criciúma, SC, Brazil; Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.
| | - João Quevedo
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, 1941 East Road, Houston, TX 77054, United States; Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina-UNESC, Criciúma, SC, Brazil; Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.
| | - Danielle Macedo
- Neuropsychopharmacology Laboratory, Drug Research and Development Center, Faculty of Medicine, Universidade Federal do Ceará, Fortaleza, CE, Brazil; Department of Physiology and Pharmacology, Faculty of Medicine, Universidade Federal do Ceará, Fortaleza, CE, Brazil; National Institute for Translational Medicine (INCT-TM, CNPq), Ribeirão Preto, Brazil
| | - Christina Peixoto
- Laboratory of Ultrastructure, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (FIOCRUZ-PE), Recife, PE, Brazil; National Institute of Science and Technology on Neuroimmunomodulation (INCT-NIM), Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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Adebayo AA, Oboh G, Ademosun AO. Almond-supplemented diet improves sexual functions beyond Phosphodiesterase-5 inhibition in diabetic male rats. Heliyon 2019; 5:e03035. [PMID: 31890965 PMCID: PMC6928307 DOI: 10.1016/j.heliyon.2019.e03035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/14/2019] [Accepted: 12/10/2019] [Indexed: 12/31/2022] Open
Abstract
Hyperglycemia, an important feature of diabetes, can cause oxidative stress, which is associated with varieties of diabetic complications including erectile dysfunction. Therefore, this study sought to investigate the effect of almond-supplemented diet on some biochemical indices relevant to erection in diabetic male rats. Forty-two male rats were divided into two groups: A (n = 6) and B (n = 36). Diabetes was induced in Group B via injection of a single dose of STZ (50 mg/kg) intraperitoneally and confirmed 72 h after induction. Diabetic rats (blood glucose ≥250 mg/dL) were subsequently divided into six groups (n = 6). Fourteen days after confirmation of diabetes, rats were fed with diets containing almond drupe and seeds (10 and 20% inclusion) for fourteen days. The effects of the diets on blood glucose, sexual behavior, sexual hormones, phosphodiesterase-5 activity, nitric oxide, H2S, and AGEs levels were evaluated. Significant increase in blood glucose level, phosphodiesterase-5 activity, and glycated hemoglobin was observed in diabetic rats. Furthermore, diabetes caused a significant decrease in nitric oxide, H2S, sexual hormones (testosterone, follicle-stimulating hormone and luteinizing hormone) levels, and sexual behavioral indices. However, treatment with diets supplemented with almond drupe and seeds significantly reversed these effects in diabetic rats. Findings in this study revealed that almond-supplemented diets enhance some important biomarkers relevant to erection in diabetic rats. Thus, dietary inclusion of almond (drupe and seeds) could serve as a cheap and readily available nutraceutical in the management of erectile dysfunction associated with diabetes.
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Schmeda-Hirschmann G, Burgos-Edwards A, Theoduloz C, Jiménez-Aspee F, Vargas-Arana G. Male sexual enhancers from the Peruvian Amazon. J Ethnopharmacol 2019; 229:167-179. [PMID: 30339977 DOI: 10.1016/j.jep.2018.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/02/2018] [Accepted: 10/05/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Selected Peruvian Amazon plants are macerated into sugar cane distillates to prepare alcoholic beverages used to improve male sexual performance. The tree bark from Campsiandra angustifolia Spruce ex Benth (Fabaceae), Swartzia polyphylla DC (Fabaceae), Minquartia guianensis Aubl. (Olacaceae) and Thynantus panurensis (Bureau) Sandwith (Bignoniaceae) usually are used as crude drugs in mixtures of several ingredients. AIM OF STUDY Describe the chemical composition of the most traded traditional male enhancer beverages, namely "Levántate Lazaro" and "Siete veces sin sacarla", and their single crude drug constituents, as well as their inhibitory activity towards the enzyme phosphodiesterase-5. The presence of pro-sexual drugs such as Sildenafil® and derivatives was assessed in the samples. MATERIALS AND METHODS Single plant constituents and the preparation mixtures were purchased in the Mercado Belen (Iquitos, Peru). Chemical profiling was carried out by HPLC-DAD-ESI-MS/MS. The extracts were assessed for phosphodiesterase-5 inhibition. The occurrence of pro-sexual drugs was determined by HPLC-DAD-ESI-MS/MS. RESULTS Chemical profiling allowed the identification of condensed tannins as the main constituents of C. angustifolia and S. polyphylla, hydrolysable tannins for M. guianensis, and C-glycosides for T. panurensis. The traditional preparations showed similar composition compared to the crude drugs. At 200 µg/mL, the traditional preparation "Levántate Lázaro" and "Siete veces sin sacarla" inhibited the phosphodiesterase-5 by 49.88% and 27.90%, respectively. No adulterations with pro-sexual drugs were found in the samples. From the crude drugs, low effect was found for the extracts of S. polyphylla and T. panurensis and high activity for C. angustifolia which inhibited the enzyme by 89.37% and 81.32% at 200 and 100 µg/mL, respectively. CONCLUSION The traditional preparations used to improve sexual performance in the Peruvian Amazon showed activity as phosphodiesterase-5 inhibitors. The most active ingredient of the traditional preparations was C. angustifolia, with some contribution from T. panurensis. These results encourage additional studies, including animal models to confirm the male enhancer effect of the preparations.
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Affiliation(s)
- Guillermo Schmeda-Hirschmann
- Laboratorio de Química de Productos Naturales, Instituto de Química de Recursos Naturales, Universidad de Talca, Talca, Chile; Programa de Investigación de Excelencia Interdisciplinaria en Química y Bio-orgánica de Recursos Naturales (PIEI-QUIM-BIO), Universidad de Talca, Chile.
| | - Alberto Burgos-Edwards
- Laboratorio de Química de Productos Naturales, Instituto de Química de Recursos Naturales, Universidad de Talca, Talca, Chile
| | - Cristina Theoduloz
- Programa de Investigación de Excelencia Interdisciplinaria en Química y Bio-orgánica de Recursos Naturales (PIEI-QUIM-BIO), Universidad de Talca, Chile; Laboratorio de Cultivo Celular, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Felipe Jiménez-Aspee
- Programa de Investigación de Excelencia Interdisciplinaria en Química y Bio-orgánica de Recursos Naturales (PIEI-QUIM-BIO), Universidad de Talca, Chile; Departamento de Ciencias Básicas Biomédicas, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile; Núcleo Científico Multidisciplinario, Dirección de Investigación, Universidad de Talca, Talca, Chile
| | - Gabriel Vargas-Arana
- Instituto de Investigaciones de la Amazonía Peruana - IIAP, Head, Laboratorio de Química de Productos Naturales, Peru
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Schaffner D, Lazaro A, Deibert P, Hasselblatt P, Stoll P, Fauth L, Baumstark MW, Merfort I, Schmitt-Graeff A, Kreisel W. Analysis of the nitric oxide-cyclic guanosine monophosphate pathway in experimental liver cirrhosis suggests phosphodiesterase-5 as potential target to treat portal hypertension. World J Gastroenterol 2018; 24:4356-4368. [PMID: 30344420 PMCID: PMC6189851 DOI: 10.3748/wjg.v24.i38.4356] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/03/2018] [Accepted: 08/24/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the potential effect of inhibitors of phosphodiesterase-5 (PDE-5) for therapy of portal hypertension in liver cirrhosis.
METHODS In the rat model of thioacetamide-induced liver fibrosis/cirrhosis the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway was investigated. Expression and localization of PDE-5, the enzyme that converts vasodilating cGMP into inactive 5’-GMP, was in the focus of the study. Hepatic gene expression of key components of the NO-cGMP pathway was determined by qRT-PCR: Endothelial NO synthase (eNOS), inducible NO synthase (iNOS), soluble guanylate cyclase subunits α1 and β1 (sGCa1, sGCb1), and PDE-5. Hepatic PDE-5 protein expression and localization were detected by immunohistochemistry. Serum cGMP concentrations were measured using ELISA. Acute effects of the PDE-5 inhibitor Sildenafil (0.1 mg/kg or 1.0 mg/kg) on portal and systemic hemodynamics were investigated using pressure transducers.
RESULTS Hepatic gene expression of eNOS (2.2-fold; P = 0.003), sGCa1 (1.7-fold; P = 0.003), sGCb1 (3.0-fold; P = 0.003), and PDE-5 (11-fold; P = 0.003) was increased in cirrhotic livers compared to healthy livers. Overexpression of PDE-5 (7.7-fold; P = 0.006) was less pronounced in fibrotic livers. iNOS expression was only detected in fibrotic and cirrhotic livers. In healthy liver, PDE-5 protein was localized primarily in zone 3 hepatocytes and to a lesser extent in perisinusoidal cells. This zonation was disturbed in cirrhosis: PDE-5 protein expression in perisinusoidal cells was induced approximately 8-fold. In addition, PDE-5-expressing cells were also found in fibrous septa. Serum cGMP concentrations were reduced in rats with cirrhotic livers by approximately 40%. Inhibition of PDE-5 by Sildenafil caused a significant increase in serum cGMP concentrations [+ 64% in healthy rats (P = 0.024), + 85% in cirrhotic rats (P = 0.018)]. Concomitantly, the portal venous pressure was reduced by 19% in rats with liver cirrhosis.
CONCLUSION Overexpression and abrogated zonation of PDE-5 likely contribute to the pathogenesis of cirrhotic portal hypertension. PDE-5 inhibition may therefore be a reasonable therapeutic approach for portal hypertension.
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MESH Headings
- Animals
- Cyclic GMP/blood
- Cyclic GMP/metabolism
- Cyclic Nucleotide Phosphodiesterases, Type 5/metabolism
- Guanosine Monophosphate/metabolism
- Humans
- Hypertension, Portal/blood
- Hypertension, Portal/drug therapy
- Hypertension, Portal/etiology
- Hypertension, Portal/pathology
- Liver/drug effects
- Liver/metabolism
- Liver/pathology
- Liver Cirrhosis, Experimental/blood
- Liver Cirrhosis, Experimental/chemically induced
- Liver Cirrhosis, Experimental/complications
- Liver Cirrhosis, Experimental/pathology
- Male
- Nitric Oxide/metabolism
- Nitric Oxide Synthase/metabolism
- Phosphodiesterase 5 Inhibitors/pharmacology
- Phosphodiesterase 5 Inhibitors/therapeutic use
- Rats
- Rats, Sprague-Dawley
- Rats, Wistar
- Signal Transduction/drug effects
- Sildenafil Citrate/pharmacology
- Sildenafil Citrate/therapeutic use
- Thioacetamide/toxicity
- Treatment Outcome
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Affiliation(s)
- Denise Schaffner
- Institute for Exercise-und Occupational Medicine, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
- Department of Pharmaceutical Biology and Biotechnology, University of Freiburg, Freiburg 79104, Germany
| | - Adhara Lazaro
- Institute for Exercise-und Occupational Medicine, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Peter Deibert
- Institute for Exercise-und Occupational Medicine, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Peter Hasselblatt
- Department of Medicine II, Gastroenterology, Hepatology, Endocrinology, and Infectious Diseases, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Patrick Stoll
- Anaesthesiological Practice, Freiburg 79104, Germany
| | - Lisa Fauth
- Institute of Clinical Pathology, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Manfred W Baumstark
- Institute for Exercise-und Occupational Medicine, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Irmgard Merfort
- Department of Pharmaceutical Biology and Biotechnology, University of Freiburg, Freiburg 79104, Germany
| | - Annette Schmitt-Graeff
- Institute of Clinical Pathology, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Wolfgang Kreisel
- Department of Medicine II, Gastroenterology, Hepatology, Endocrinology, and Infectious Diseases, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
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Deibert P, Lazaro A, Stankovic Z, Schaffner D, Rössle M, Kreisel W. Beneficial long term effect of a phosphodiesterase-5-inhibitor in cirrhotic portal hypertension: A case report with 8 years follow-up. World J Gastroenterol 2018; 24:438-444. [PMID: 29391766 PMCID: PMC5776405 DOI: 10.3748/wjg.v24.i3.438] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/01/2017] [Accepted: 12/04/2017] [Indexed: 02/06/2023] Open
Abstract
Non-selective beta-blockers are the mainstay of medical therapy for portal hypertension in liver cirrhosis. Inhibitors of phosphodiesterase-5 (PDE-5-inhibitors) reduce portal pressure in the acute setting by > 10% which may suggest a long-term beneficial effect. Currently, there is no available data on long-term treatment of portal hypertension with PDE-5-inhibitors. This case of a patient with liver cirrhosis secondary to autoimmune liver disease with episodes of bleeding from esophageal varices is the first documented case in which a treatment with a PDE-5-inhibitor for eight years was monitored. In the acute setting, the PDE-5-inhibitor Vardenafil lowered portal pressure by 13%. The portal blood flow increased by 28% based on Doppler sonography and by 16% using MRI technique. As maintenance medication the PDE-5-inhibitor Tadalafil was used for eight consecutive years with comparable effects on portal pressure and portal blood flow. There were no recurrence of bleeding and no formation of new varices. Influencing the NO-pathway by the use of PDE-5 inhibitors may have long-term beneficial effects in compensated cirrhosis.
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MESH Headings
- Administration, Oral
- Cholangitis, Sclerosing/complications
- Cholangitis, Sclerosing/diagnostic imaging
- Cholangitis, Sclerosing/pathology
- Computed Tomography Angiography
- Endoscopy, Digestive System
- Esophageal and Gastric Varices/diagnostic imaging
- Esophageal and Gastric Varices/etiology
- Esophageal and Gastric Varices/surgery
- Female
- Follow-Up Studies
- Gastrointestinal Hemorrhage/diagnostic imaging
- Gastrointestinal Hemorrhage/etiology
- Gastrointestinal Hemorrhage/surgery
- Hemodynamics/drug effects
- Hepatitis, Autoimmune/complications
- Hepatitis, Autoimmune/diagnostic imaging
- Hepatitis, Autoimmune/pathology
- Humans
- Hypertension, Portal/diagnostic imaging
- Hypertension, Portal/drug therapy
- Hypertension, Portal/etiology
- Hypertension, Portal/pathology
- Liver Cirrhosis/diagnostic imaging
- Liver Cirrhosis/drug therapy
- Liver Cirrhosis/etiology
- Liver Cirrhosis/pathology
- Middle Aged
- Phosphodiesterase 5 Inhibitors/pharmacology
- Phosphodiesterase 5 Inhibitors/therapeutic use
- Syndrome
- Tadalafil/pharmacology
- Tadalafil/therapeutic use
- Time Factors
- Treatment Outcome
- Vardenafil Dihydrochloride/pharmacology
- Vardenafil Dihydrochloride/therapeutic use
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Affiliation(s)
- Peter Deibert
- Faculty of Medicine, Institute for Exercise and Occupational Medicine, Department of Medicine, University Hospital, Freiburg 79106, Germany
| | - Adhara Lazaro
- Faculty of Medicine, Institute for Exercise and Occupational Medicine, Department of Medicine, University Hospital, Freiburg 79106, Germany
| | - Zoran Stankovic
- Inselspital, Interventional and Pediatric Radiology, Institute of Diagnostic, University of Bern, Bern 3010, Switzerland
| | - Denise Schaffner
- Faculty of Medicine, Institute for Exercise and Occupational Medicine, Department of Medicine, University Hospital, Freiburg 79106, Germany
- Department of Pharmaceutical Biology and Biotechnology, University of Freiburg, Freiburg 79106, Germany
| | - Martin Rössle
- Private Praxis, Praxiszentrum, Freiburg 79104, Germany
| | - Wolfgang Kreisel
- Faculty of Medicine, Endocrinology and Infectious Diseases, Department of Gastroenterology, Hepatology, University Hospital, Freiburg 79106, Germany
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Tao Y, Gu X, Li W, Cai B. Fabrication and evaluation of magnetic phosphodiesterase-5 linked nanoparticles as adsorbent for magnetic dispersive solid-phase extraction of inhibitors from Chinese herbal medicine prior to ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry analysis. J Chromatogr A 2017; 1532:58-67. [PMID: 29198447 DOI: 10.1016/j.chroma.2017.11.062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 11/09/2017] [Accepted: 11/26/2017] [Indexed: 12/27/2022]
Abstract
In the present study, the preparation of the magnetic phosphodiesterase-5 linked Fe3O4@ SiO2 nanoparticles was successfully achieved by amide reaction and the magnetic phosphodiesterase-5 linked Fe3O4@SiO2 nanoparticles were evaluated as a new adsorbent for magnetic dispersive solid-phase extraction of ligands from medicinal plant samples before the analysis by UHPLC-Q-TOF/MS. The prepared phosphodiesterase-5 linked Fe3O4@SiO2 nanoparticles were characterized by X-ray diffraction, Fourier transform infrared spectroscopy, transmission electron microscopy, vibration sample magnetometer and potential laser particle size analyzer. The effects of EDC concentration, incubation time and bead-protein ratio on the amount of immobilized protein were studied. The main experimental parameters affect extraction efficiency of ligands, such as wash times, wash solvents, incubation pH, ion strength and incubation temperature, were investigated and optimized by using echinacoside as a model compound. The absolute recovery of echinacoside was ranged from 98.36%-102.16% in Cistanche tubulosa sample under the optimal extraction conditions. Good linearity was observed in the investigated concentration range of 0.006 mgmL-1-0.97 mgmL-1(R2 = 0.9999). The limit of detection was 0.002 mgmL-1. The RSDs of within-day and between-day precision were less than 2.3%. Due to the excellent magnetic behavior of Fe3O4@SiO2 nanoparticles, the proposed method was shown to be simple and rapid. Remarkably, the magnetic phosphodiesterase-5 linked Fe3O4@SiO2 nanoparticles could be recycled for ten times with loss of 10% activity.
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Affiliation(s)
- Yi Tao
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; Jiangsu Key Laboratory of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China.
| | - Xianghui Gu
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; Jiangsu Key Laboratory of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China
| | - Weidong Li
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; Jiangsu Key Laboratory of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China
| | - Baochang Cai
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; Jiangsu Key Laboratory of Chinese Medicine Processing, Nanjing University of Chinese Medicine, Nanjing, 210023, PR China
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McCarty MF, DiNicolantonio JJ. Neuroprotective potential of high-dose biotin. Med Hypotheses 2017; 109:145-9. [PMID: 29150274 DOI: 10.1016/j.mehy.2017.10.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/28/2017] [Accepted: 10/13/2017] [Indexed: 01/28/2023]
Abstract
A recent controlled trial has established that high-dose biotin supplementation - 100 mg, three times daily - has a stabilizing effect on progression of multiple sclerosis (MS). Although this effect has been attributed to an optimization of biotin's essential cofactor role in the brain, a case can be made that direct stimulation of soluble guanylate cyclase (sGC) by pharmacological concentrations of biotin plays a key role in this regard. The utility of high-dose biotin in MS might reflect an anti-inflammatory effect of cGMP on the cerebral microvasculature, as well on oligodendrocyte differentiation and on Schwann cell production of neurotrophic factors thought to have potential for managing MS. But biotin's ability to boost cGMP synthesis in the brain may have broader neuroprotective potential. In many types of neurons and neural cells, cGMP exerts neurotrophic-mimetic effects - entailing activation of the PI3K-Akt and Ras-ERK pathways - that promote neuron survival and plasticity. Hippocampal long term potentiation requires nitric oxide synthesis, which in turn promotes an activating phosphorylation of CREB via a pathway involving cGMP and protein kinase G (PKG). In Alzheimer's disease (AD), amyloid beta suppresses this mechanism by inhibiting sGC activity; agents which exert a countervailing effect by boosting cGMP levels tend to restore effective long-term potentiation in rodent models of AD. Moreover, NO/cGMP suppresses amyloid beta production within the brain by inhibiting expression of amyloid precursor protein and BACE1. In conjunction with cGMP's ability to oppose neuron apoptosis, these effects suggest that high-dose biotin might have potential for the prevention and management of AD. cGMP also promotes neurogenesis, and may lessen stroke risk by impeding atherogenesis and hypertrophic remodeling in the cerebral vasculature. The neuroprotective potential of high-dose biotin likely could be boosted by concurrent administration of brain-permeable phosphodiesterase-5 inhibitors.
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Mande PP, Bachhav SS, Devarajan PV. Bioenhanced advanced third generation solid dispersion of tadalafil: Repurposing with improved therapy in pyelonephritis. Asian J Pharm Sci 2017; 12:569-579. [PMID: 32104370 PMCID: PMC7032132 DOI: 10.1016/j.ajps.2017.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/12/2017] [Accepted: 07/02/2017] [Indexed: 11/26/2022] Open
Abstract
Tadalafil (TDL) a BCS-II drug is recently reported for repurposing nephroprotective effect in Pyelonephritis (PN). However, poor water solubility and dissolution rate limited oral bioavailability pose serious challenges in its therapeutic applications. We present an advanced third generation Solid Dispersion (SD) of TDL comprising a polymer in combination with a Self Micro-emulsifying Composition (SMEC) to achieve high drug loading, improved stability and rapid dissolution of TDL for enhancing bioavailability and efficacy in PN. TDL-SMEC-SD was coated onto rapidly disintegrating inert tablet cores which disintegrated rapidly in water to release SD as a film. TDL-SMEC-SD was evaluated for in-vivo oral bioavailability and in-vivo efficacy in lipopolysaccharide-induced PN in rats. TDL exhibited high solubility (45.6 mg/ml) in the SMEC. TDL-SMEC-SD exhibited remarkably high TDL loading (45%w/w), exceptionally low contact angle (9°), rapid in-vitro release (t50 7.3 min), microemulsion formation (globule size ~100 nm) in aqueous dispersion, and stability as per ICH guidelines. SEM, DSC, and XRD confirmed high physical stability. A relative bioavailability of 350% and 150% compared to TDL and TDL-SD without SMEC respectively, established the superiority of TDL-SMEC-SD. A significant reduction in serum creatinine, blood urea nitrogen and nitric oxide levels in the lipopolysaccharide-induced PN confirmed the benefit of the TDL-SMEC-SD. The advanced third generation SMEC SDs presents the possibility of platform technology for bioenhancement of poorly water soluble drugs.
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Affiliation(s)
- Prashant P Mande
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, N. P. Marg, Matunga (E), Mumbai, Maharashtra, India
| | - Sagar S Bachhav
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, N. P. Marg, Matunga (E), Mumbai, Maharashtra, India
| | - Padma V Devarajan
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, N. P. Marg, Matunga (E), Mumbai, Maharashtra, India
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Abstract
cGMP-binding cGMP-specific PDE, PDE5 plays a key role in the hydrolysis of cyclic guanidine monophosphate. Because cGMP mediates vascular functions, a PDE5 inhibitor that elevates cGMP level is an attractive means for vasodilatation and treatment of erectile dysfunction. In this paper we report the elucidation of the common pharmacophore hypothesis of different classes of PDE5 inhibitors. Using LigandScout program, pharmacophore modelling studies were performed on prior reported potent PDE5 inhibitors with a variety of scaffolds in order to identify one common set of critical chemical features of these PDE5 inhibitors 1-52. The best pharmacophore model, model-1, characterized by four chemical features: one aromatic ring, one hydrophobe, one hydrogen acceptors and one hydrogen donor. Using Dock6 program, docking studies were performed in order to investigate the mode of binding of these compounds. The molecular docking study allowed confirming the preferential binding mode of different classes of PDE5 inhibitors inside the active site. The obtained binding mode was as same as that of vardenafil, X-ray ligand with different orientation with varied PDE5 inhibitors׳ scaffold.
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Affiliation(s)
- Awwad Abdoh Radwan
- King Saud University, College of Pharmacy, Department of Pharmaceutics, Riyadh 11451, Saudi Arabia ; Department of Pharmaceutical Organic Chemistry, Faculty of Pharmacy, Assiut University, Assiut 71526, Egypt
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Mittal A, Paliwal S, Sharma M, Singh A, Sharma S, Yadav D. Pharmacophore based virtual screening, molecular docking and biological evaluation to identify novel PDE5 inhibitors with vasodilatory activity. Bioorg Med Chem Lett 2014; 24:3137-41. [PMID: 24856068 DOI: 10.1016/j.bmcl.2014.05.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 04/30/2014] [Accepted: 05/02/2014] [Indexed: 11/18/2022]
Abstract
Prompted by the role of PDE5 and its closely associated cAMP and cGMP in hypertension, we have attempted to discover novel PDE5 inhibitors through ligand based virtual screening. Rigorously validated model comprising of one HBA, one HY and one RA was used as a query to search the NCI database leading to retrieval of many compounds which were screened on the basis of estimated activity, fit value and Lipinski's violation. Selected compounds were subjected to docking studies which resulted into visualization of potential interaction capabilities of NCI compounds in line to pharmacophoric features. Finally three compounds were subjected to in vitro evaluation using the isolated rat aortic model. The results showed that all three compounds are potent and novel PDE5 inhibitors with vasodilatory activity range from 10(-2) to 10(-5) M.
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Affiliation(s)
- Anupama Mittal
- Department of Pharmacy, Banasthali University, P.O. Banasthali, Rajasthan 304022, India.
| | - Sarvesh Paliwal
- Department of Pharmacy, Banasthali University, P.O. Banasthali, Rajasthan 304022, India.
| | - Mukta Sharma
- Department of Pharmacy, Banasthali University, P.O. Banasthali, Rajasthan 304022, India.
| | - Aarti Singh
- Department of Pharmacy, Banasthali University, P.O. Banasthali, Rajasthan 304022, India.
| | - Swapnil Sharma
- Department of Pharmacy, Banasthali University, P.O. Banasthali, Rajasthan 304022, India.
| | - Divya Yadav
- Department of Pharmacy, Banasthali University, P.O. Banasthali, Rajasthan 304022, India.
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Yoshida A, Mizote I, Sakata Y, Maeda T, Kanakura Y, Yamauchi-Takihara K, Komuro I. Effect of vasodilators in patient with pulmonary hypertension associated with hemolytic anemia. J Cardiol Cases 2012; 6:e75-7. [PMID: 30546718 DOI: 10.1016/j.jccase.2012.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 05/01/2012] [Accepted: 05/12/2012] [Indexed: 11/20/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) has been described to associate with hemolytic anemia in updated clinical classification of pulmonary hypertension. A 56-year-old woman, diagnosed with warm antibody autoimmune hemolytic anemia (AIHA), was treated with oral corticosteroids at the Department of Hematology, Osaka University Hospital for 30 years. Her AIHA worsened 3 months before the admission, and she was treated with rituximab and cyclosporine in combination with prednisolone. Soon after she left the hospital, she developed dyspnea on effort and leg edema, therefore she was re-admitted to the Department of Cardiovascular Medicine. Echocardiogram and cardiac catheterization demonstrated PAH associated with AIHA. She was treated with three types of vasodilatory agents, resulting in an improvement in pulmonary arterial pressure and pulmonary vascular resistance after 6 weeks. A few weeks after she left the hospital, her hemolytic anemia became in remission without intensifying AIHA therapy, and did not worsen for a year of follow-up. Although corticosteroids are the first-line treatment for AIHA, medications for PAH should be considered when the first-line therapy for AIHA failed to improve PAH.
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Neves C, Tufik S, Chediek F, Poyares D, Cintra F, Roizenblatt M, Abrantes F, Monteiro MA, Roizenblatt S. Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea. Clinics (Sao Paulo) 2010; 65:393-400. [PMID: 20454497 PMCID: PMC2862674 DOI: 10.1590/s1807-59322010000400008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Revised: 12/29/2009] [Accepted: 01/28/2010] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the effects of sildenafil on the autonomic nervous system in patients with severe obstructive sleep apnea. METHODS Thirteen male patients with severe obstructive sleep apnea (mean age 43+/-10 years with a mean body mass index of 26.7+/-1.9 kg/m(2)) received a single 50-mg dose of sildenafil or a placebo at bedtime. All-night polysomnography and heart rate variability were recorded. Frequency domain analysis of heart rate variability was performed for the central five-minute sample of the longest uninterrupted interval of slow wave and rapid eye movement sleep, as well as for one-minute samples during apnea and during slow wave and rapid eye movement sleep after resumption of respiration. RESULTS Compared to the placebo, sildenafil was associated with an increase in the normalized high-frequency (HF(nu)) components and a decrease in the low/high-frequency components of the heart rate variability ratio (LF/HF) in slow wave sleep (p<0.01 for both). Differences in heart rate variability parameters between one-minute post-apnea and apnea samples (Delta = difference between resumption of respiration and apnea) were assessed. A trend toward a decreasing magnitude of DeltaLF activity was observed during rapid eye movement sleep with sildenafil in comparison to placebo (p=0.046). Additionally, DeltaLF/HF in SWS and rapid eye movement sleep was correlated with mean desaturation (s(R =) -0.72 and -0.51, respectively, p= 0.01 for both), and DeltaHF(nu) in rapid eye movement sleep was correlated with mean desaturation (s(R=) 0.66, p= 0.02) and the desaturation index (s(R=) 0.58, p = 0.047). CONCLUSIONS The decrease in arousal response to apnea/hypopnea events along with the increase in HF(nu) components and decrease in LH/HF components of the heart rate variability ratio during slow wave sleep suggest that, in addition to worsening sleep apnea, sildenafil has potentially immediate cardiac effects in patients with severe obstructive sleep apnea.
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Affiliation(s)
- Christiane Neves
- Department of Psychobiology, Universidade Federal de São Paulo - São Paulo/SP, Brazil
- Department of Internal Medicine, Universidade Federal de São Paulo - São Paulo/SP, Brazil.
Tel: 55 16 3967.0768
| | - Sérgio Tufik
- Department of Psychobiology, Universidade Federal de São Paulo - São Paulo/SP, Brazil
| | - Felipe Chediek
- Department of Psychobiology, Universidade Federal de São Paulo - São Paulo/SP, Brazil
| | - Dalva Poyares
- Department of Psychobiology, Universidade Federal de São Paulo - São Paulo/SP, Brazil
| | - Fátima Cintra
- Department of Psychobiology, Universidade Federal de São Paulo - São Paulo/SP, Brazil
| | - Marina Roizenblatt
- Department of Psychobiology, Universidade Federal de São Paulo - São Paulo/SP, Brazil
| | - Fabiano Abrantes
- Department of Psychobiology, Universidade Federal de São Paulo - São Paulo/SP, Brazil
| | - Marina Ariza Monteiro
- Department of Psychobiology, Universidade Federal de São Paulo - São Paulo/SP, Brazil
| | - Suely Roizenblatt
- Department of Psychobiology, Universidade Federal de São Paulo - São Paulo/SP, Brazil
- Department of Internal Medicine, Universidade Federal de São Paulo - São Paulo/SP, Brazil.
Tel: 55 16 3967.0768
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