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Peppa Μ, Manta A. Sexual Dysfunction in Diabetic Patients: Τhe Role of Advanced Glycation End Products. Curr Diabetes Rev 2024; 20:e070423215531. [PMID: 37026501 DOI: 10.2174/1573399819666230407095522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/30/2023] [Accepted: 02/17/2023] [Indexed: 04/08/2023]
Abstract
Sexual dysfunction is a common but underestimated disorder of diabetic patients of both genders, entailing specific and complex pathogenesis and severely affecting reproductive health and quality of life. Hyperglycemia, dyslipidemia, hypertension, obesity, aging, and psychological factors underlie its pathogenesis. A large body of evidence indicates that advanced glycation end products and oxidative stress have a distinct impact on the pathogenesis of diabetes and its complications, including hypogonadism, which is closely related to sexual dysfunction. Advanced glycation end products seem to affect sexual function either directly by accumulation in various regions of the reproductive system and/or correlation or indirectly through oxidative stress induction via several mechanisms. They are also involved in the pathogenesis of diabetic complications, which are related to sexual dysfunction. Herein, we review the issue of sexual dysfunction in diabetic males and females, with special emphasis on the impact of advanced glycation end products in the pathogenesis of sexual dysfunction, the relationship of advanced glycation end products with low testosterone levels in diabetic subjects, which account for the proportion of disorder and the available therapeutic interventions.
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Affiliation(s)
- Μelpomeni Peppa
- Endocrine and Metabolic Disorders Unit, Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, Athens, Greece
| | - Aspasia Manta
- Endocrine and Metabolic Disorders Unit, Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, Athens, Greece
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2
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Feng Y, Shi T, Fu Y, Lv B. Traditional chinese medicine to prevent and treat diabetic erectile dysfunction. Front Pharmacol 2022; 13:956173. [PMID: 36210810 PMCID: PMC9532934 DOI: 10.3389/fphar.2022.956173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Diabetic erectile dysfunction (DED) is one of the most common complications of diabetes mellitus. However, current therapeutics have no satisfactory effect on DED. In recent years, traditional Chinese medicine (TCM) has shown good effects against DED. By now, several clinical trials have been conducted to study the effect of TCM in treating DED; yet, the underlying mechanism is not fully investigated. Therefore, in this review, we briefly summarized the pathophysiological mechanism of DED and reviewed the published clinical trials on the treatment of DED by TCM. Then, the therapeutic potential of TCM and the underlying mechanisms whereby TCM exerts protective effects were summarized. We concluded that TCM is more effective than chemical drugs in treating DED by targeting multiple signaling pathways, including those involved in oxidation, apoptosis, atherosclerosis, and endothelial function. However, the major limitation in the application of TCM against DED is the lack of a large-scale, multicenter, randomized, and controlled clinical trial on the therapeutic effect, and the underlying pharmaceutical mechanisms also need further investigation. Despite these limitations, clinical trials and further experimental studies will enhance our understanding of the mechanisms modulated by TCM and promote the widespread application of TCM to treat DED.
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Affiliation(s)
- Yanfei Feng
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Tianhao Shi
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuli Fu
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Bodong Lv
- Zhejiang Province Key Laboratory of Traditional Chinese Medicine (Laboratory of Andrology), Hangzhou, China
- Department of Urology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Bodong Lv,
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3
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Gurbuz N, Gurkan R, Ender Caylan A, Surmen Usta S, Usta MF. The therapeutic effect of ALT-711 on erectile function in rats treated with high-level AGEs (advanced glycation end products) containing diet. Int J Impot Res 2022; 34:222-228. [PMID: 33712808 DOI: 10.1038/s41443-021-00417-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 01/23/2021] [Accepted: 02/02/2021] [Indexed: 11/09/2022]
Abstract
To investigate, if advanced glycation end products (AGEs) are involved in erectile dysfunction (ED) and also ALT-711, a cross-link breaker of AGEs, has the therapeutic potential against the development of ED in rats treated with high concentrated AGEs including food. For this purpose, 30 male Harlan Spraque-Dawley rats randomly were divided into three groups; (1) control rats treated with regular diet, (2) rats treated with high-level of AGE specific diet for 6 months, and (3) rats having AGE-diet treated with ALT-711 for the final 3 months of 6 months of AGE-diet period. Erectile response to cavernosal nerve stimulation (CNS), protein expression of neuronal nitric oxide synthase (nNOS) and levels of AGEs, Malondialdehyde (MDA), cyclic guanosine monophosphate (cGMP) were determined in penile tissues. Erectile responses to CNS and penile nNOS and cGMP content were significantly reduced, while AGEs and MDA were elevated in penises of Group-2. Treatment with ALT-711 reversed ED and depletion of both nNOS and cGMP. Additionally, ALT-711 treatment reduced penile tissue AGEs and MDA expression. In present study: rats without any co-morbidity such as diabetes mellitus (DM) and chronic renal failure (CRF) were treated with high-level AGEs containing food. Our results suggest that ALT-711 may be an interesting and promising approach in the treatment of AGEs-related ED.
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Affiliation(s)
- N Gurbuz
- Department of Medical Biology, School of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - R Gurkan
- Department of Urology, Section of Andrology, School of Medicine, Akdeniz University, Antalya, Turkey
| | - A Ender Caylan
- Department of Urology, Section of Andrology, School of Medicine, Akdeniz University, Antalya, Turkey
| | - S Surmen Usta
- Health Vocational School, Bilim University, Antalya, Turkey
| | - M F Usta
- Department of Urology, Section of Andrology, School of Medicine, Akdeniz University, Antalya, Turkey.
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Nakano T, Kono M, Segawa K, Kurosaka S, Nakaoka Y, Morimoto Y, Mitani T. Effects of exposure to methylglyoxal on sperm motility and embryonic development after fertilization in mice. J Reprod Dev 2021; 67:123-133. [PMID: 33551390 PMCID: PMC8075723 DOI: 10.1262/jrd.2020-150] [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] [Indexed: 01/30/2023] Open
Abstract
Methylglyoxal (MG) is a precursor for the generation of endogenous advanced glycation end-products involved in various diseases, including infertility. The
present study evaluated the motility and developmental competence after in vitro fertilization of mouse sperm which were exposed to MG in the
capacitation medium for 1.5 h. Sperm motility was analyzed using an SQA-V automated sperm quality analyzer. Intracellular reactive oxygen species (ROS),
membrane integrity, mitochondrial membrane potential, and DNA damage were assessed using flow cytometry. The matured oocytes were inseminated with MG-exposed
sperm, and subsequently, the fertilization and embryonic development in vitro were evaluated in vitro. The exposure of sperm
to MG did not considerably affect the swim-up of sperm but resulted in a deteriorated sperm motility in a concentration-dependent manner, which was associated
with a decreased mitochondrial activity. However, these effects was not accompanied by obvious ROS accumulation or DNA damage. Furthermore, MG diminished the
fertilization rate and developmental competence, even after normal fertilization. Collectively, a short-term exposure to MG during sperm capacitation had a
critical impact on sperm motility and subsequent embryonic development after fertilization. Considering that sperm would remain in vivo for up
to 3 days until fertilization, our findings suggest that sperm can be affected by MG in the female reproductive organs, which may be associated with
infertility.
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Affiliation(s)
- Tatsuya Nakano
- Graduate School of Biology-Oriented Science and Technology, Kindai University, Wakayama 649-6493, Japan.,IVF Namba Clinic, Osaka 550-0015, Japan
| | - Mizuki Kono
- Department of Biology-Oriented Science and Technology, Kindai University, Wakayama 649-6493, Japan
| | - Kazuki Segawa
- Department of Biology-Oriented Science and Technology, Kindai University, Wakayama 649-6493, Japan
| | - Satoshi Kurosaka
- Institute of Advanced Technology, Kindai University, Wakayama 642-0017, Japan
| | | | | | - Tasuku Mitani
- Graduate School of Biology-Oriented Science and Technology, Kindai University, Wakayama 649-6493, Japan.,Department of Biology-Oriented Science and Technology, Kindai University, Wakayama 649-6493, Japan
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5
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Yang R, Liu C, Li Q, Wang W, Wu B, Chen A, Wang B, Li W, Chen J. Artificial intelligence based identification of the functional role of hirudin in diabetic erectile dysfunction treatment. Pharmacol Res 2021; 163:105244. [PMID: 33053440 DOI: 10.1016/j.phrs.2020.105244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/28/2020] [Accepted: 10/06/2020] [Indexed: 12/15/2022]
Abstract
Diabetic erectile dysfunction (DED) hugely affected the patients' sexual life quality. However, there are no satisfactory therapeutic methods and intervention targets for this subtype of erectile dysfunction (ED). Inspired by the clinical practice of traditional Chinese medicine (TCM), we found that hirudin, the main active ingredient in the leech, could ameliorate the ED symptoms of the DED mouse model. To further reveal the underlying mechanism of hirudin, we designed a novel strategy to discover potential targets based on the diagnostic system of TCM, and found that myeloperoxidase (MPO) was a promising target of hirudin. Hirudin directly interacts with MPO and inhibits its activity, thus further decreases the content of oxidized low-density lipoprotein (ox-LDL) in serum. Our results demonstrated that the hirudin could ameliorate the symptoms of DED, and revealed the underlying mechanism of hirudin in regulating the activity of MPO.
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Affiliation(s)
- Ruocong Yang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Chao Liu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Qianqian Li
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Weilu Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Bingbing Wu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Aiping Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Bin Wang
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Wei Li
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Jianxin Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China.
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Gur S, Hellstrom WJ. Harnessing Stem Cell Potential for the Treatment of Erectile Function in Men with Diabetes Mellitus: From Preclinical/Clinical Perspectives to Penile Tissue Engineering. Curr Stem Cell Res Ther 2020; 15:308-320. [DOI: 10.2174/1574888x14666190828142045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/10/2019] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
Abstract
Background::
According to the World Health Organization, more than 150 million people
are diabetic, and this number will increase twofold by the year 2025. Diabetes-related complications
affect all body organ systems, including the penis. Diabetes-induced Erectile Dysfunction (ED) is
caused by neuropathy of the penile nerves and vasculopathy involving the smooth muscle and endothelium
of the corpus cavernosum.
Objective::
This study aims to present an overview of Stem Cell (SC) research in diabetic animal models
of ED, focusing on the function, signaling, and niches that have a prominent role in the regeneration
of cavernosal cells and penile tissues. We highlight common erectile pathologies caused by diabetes
and review relevant preclinical trials. We also discuss paracrine mechanisms of various SC therapies
involved in the repair of endothelial cells and cavernous nerves in these diabetic models.
Method::
A PubMed search was performed, with dates ranging from inception until Mar 31, 2019.
Results::
This review provides a comprehensive evaluation of the various strategies that have been
investigated for improving SC delivery methods, through preclinical literature and published clinical
trials regarding ED in men with diabetes. Various cell-type applications have benefited erectile function
in diabetic models of ED.
Conclusion::
This review examines the progress and remaining challenges in diabetes-related SC research
regarding ED. Moving forward, it is only with a combined effort of basic biology and translational
work that the potential of SC-based therapies in diabetes in ED can be realized.
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Affiliation(s)
- Serap Gur
- Department of Urology, Tulane University Health Sciences Center, New Orleans, LA, United States
| | - Wayne J.G. Hellstrom
- Department of Urology, Tulane University Health Sciences Center, New Orleans, LA, United States
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Oboh G, Adebayo AA, Ademosun AO. Phenolic-rich extracts of Eurycoma longifolia and Cylicodiscus gabunensis inhibit enzymes responsible for the development of erectile dysfunction and are antioxidants. J Basic Clin Physiol Pharmacol 2018; 29:689-696. [PMID: 29777610 DOI: 10.1515/jbcpp-2017-0160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 04/03/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Herbs have been used from ages to manage male sexual dysfunction. Hence, this study sought to investigate the effects of Eurycoma longifolia (EL) and Cylicodiscus gabunensis (CG) stem bark extracts on some enzymes implicated in erectile dysfunction in vitro. METHODS The extracts were prepared, and their effects on phosphodiesterase-5 (PDE-5), arginase, and angiotensin-1-converting enzyme (ACE) as well as pro-oxidant-induced lipid peroxidation were assessed. Furthermore, phenolic contents were determined, and their components were characterized and quantified using high-performance liquid chromatography with diode array detector (HPLC-DAD). RESULTS The results revealed that the extracts inhibited PDE-5, arginase, and ACE in a concentration-dependent manner. However, IC50 values revealed that CG had higher inhibitory potential on PDE-5 (IC50=204.4 μg/mL), arginase (IC50=39.01 μg/mL), and ACE (IC50=48.81 μg/mL) than EL. In addition, the extracts inhibited pro-oxidant-induced lipid peroxidation in penile tissue homogenate. HPLC-DAD analysis showed that CG is richer in phenolic compounds than EL, and this could be responsible for higher biological activities observed in CG than EL. CONCLUSIONS Hence, the observed antioxidant property and inhibitory action of CG and EL on enzymes relevant to erectile dysfunction in vitro could be part of possible mechanisms underlying their involvement in traditional medicine for the management of male sexual dysfunction.
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Affiliation(s)
- Ganiyu Oboh
- Functional Foods and Nutraceutical Research Unit, Department of Biochemistry, Federal University of Technology, P.M.B. 704, Akure, Nigeria, Phone: +2347031388644
| | - Adeniyi A Adebayo
- Functional Foods and Nutraceutical Research Unit, Department of Biochemistry, Federal University of Technology, Akure, Nigeria
| | - Ayokunle O Ademosun
- Functional Foods and Nutraceutical Research Unit, Department of Biochemistry, Federal University of Technology, Akure, Nigeria
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Ozbek E. Re: Role of endothelin receptors and relationship with nitric oxide synthase in impaired erectile response in diabetic rats. Alkan E, Ugan RA, Basar MM, Halici Z, Karakus E, Balbay MD, Un H.Andrologia. 2016 May 4. doi: 10.1111/and.12607. Andrologia 2018. [DOI: 10.1111/and.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- E. Ozbek
- Department of Urology; Istanbul University Cerrahpasa Medical School; Istanbul Turkey
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9
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Tao M, Tasdemir C, Tasdemir S, Shahabi A, Liu G. Penile alterations at early stage of type 1 diabetes in rats. Int Braz J Urol 2017; 43:753-761. [PMID: 28338308 PMCID: PMC5557453 DOI: 10.1590/s1677-5538.ibju.2016.0454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/11/2016] [Indexed: 11/22/2022] Open
Abstract
Objective Diabetes affects the erectile function significantly. However, the penile alterations in the early stage of diabetes in experimental animal models have not been well studied. We examined the changes of the penis and its main erectile components in diabetic rats. Materials and methods Male Sprague-Dawley rats were divided into 2 groups: streptozotocin (STZ)-induced diabetics and age-matched controls. Three or nine weeks after diabetes induction, the penis was removed for immunohistochemical staining of smooth muscle and neuronal nitric oxide synthase (nNOS) in midshaft penile tissues. The cross-sectional areas of the whole midshaft penis and the corpora cavernosa were quantified. The smooth muscle in the corpora cavernosa and nNOS in the dorsal nerves were quantified. Results The weight, but not the length, of the penis was lower in diabetics. The cross-sectional areas of the total midshaft penis and the corpora cavernosa were lower in diabetic rats compared with controls 9 weeks, but not 3 weeks after diabetes induction. The cross-sectional area of smooth muscle in the corpora cavernosa as percentage of the overall area of the corpora cavernosa was lower in diabetic rats than in controls 9 weeks, but not 3 weeks after diabetes induction. Percentage change of nNOS in dorsal nerves was similar at 3 weeks, and has a decreased trend at 9 weeks in diabetic rats compared with controls. Conclusions Diabetes causes temporal alterations in the penis, and the significant changes in STZ rat model begin 3-9 weeks after induction. Further studies on the reversibility of the observed changes are warranted.
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Affiliation(s)
- Mingfang Tao
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Cemal Tasdemir
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Urology, Inonu University, Medical Faculty, Malatya, Turkey
| | - Seda Tasdemir
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Pharmacology, Inonu University, Medical Faculty, Malatya, Turkey
| | - Ali Shahabi
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Guiming Liu
- Department of Urology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
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Oboh G, Adebayo AA, Ademosun AO. Erection-stimulating, anti-diabetic and antioxidant properties of Hunteria umbellata and Cylicodiscus gabunensis water extractable phytochemicals. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2017; 15:/j/jcim.ahead-of-print/jcim-2016-0164/jcim-2016-0164.xml. [PMID: 28749782 DOI: 10.1515/jcim-2016-0164] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/24/2017] [Indexed: 01/03/2023]
Abstract
Background Herbs have been used as an aphrodisiac since ages. This study was designed to investigate the effects of Hunteria umbellata (HU) seeds and Cylicodiscus gabunensis (CG) stem barks aqueous extracts on key enzymes relevant to erectile dysfunction (phosphodiesterase-5 and arginase) and type-2 diabetes (α-amylase and α-glucosidase). Methods In ascertaining the erectogenic and antidiabetic properties of the extracts, the effects of the extracts on activities of some enzymes relevant to erectile dysfunction (arginase and phosphodiesterase-5) and type-2 diabetes (α-amylase and α-glucosidase) were determined. Antioxidant properties of the extracts were assessed through several antioxidant assays (DPPH˙, OH˙). Furthermore, their phenolic constituents were estimated and quantified using HPLC. Results The results revealed that both extracts inhibited α-amylase and α-glucosidase in a concentration-dependent manner. HU showed higher α-amylase (IC50=221.30 µg/mL) and α-glucosidase (IC50=184.35 µg/mL) inhibition than CG. Also, both extracts inhibited phosphodiesterase-5 and arginase in a dose-dependent manner in vitro; nevertheless, HU showed higher inhibition [phosphodiesterase-5 (IC50=539.72 µg/mL); arginase (41.53 µg/mL)] than CG [phosphodiesterase-5 (IC50=611.35 µg/mL); arginase (47.95 µg/mL)]. In addition, the extracts possess antioxidant properties through radical (DPPH and OH) scavenging and metal (Fe2+) chelating abilities. HPLC analysis of phenolic constituents revealed the abundance of gallic acid, chlorogenic acid, caffeic acid, ellagic acid and quercetin. Conclusions The ability of samples' extract to inhibit some of key enzymes relevant to erectile dysfunction and type-2 diabetes could render them cheap, natural and alternative therapy with erectogenic and antidiabetic potentials.
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Affiliation(s)
- Ganiyu Oboh
- Functional Food and Nutraceutical Unit, Biochemistry Department, Federal University of Technology, Akure, Nigeria
| | - Adeniyi A Adebayo
- Functional Food and Nutraceutical Unit, Biochemistry Department, Federal University of Technology, Akure, Nigeria
| | - Ayokunle O Ademosun
- Functional Food and Nutraceutical Unit, Biochemistry Department, Federal University of Technology, Akure, Nigeria
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11
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Matsui H, Musicki B, Sopko NA, Liu X, Hurley PJ, Burnett AL, Bivalacqua TJ, Hannan JL. Early-stage Type 2 Diabetes Mellitus Impairs Erectile Function and Neurite Outgrowth From the Major Pelvic Ganglion and Downregulates the Gene Expression of Neurotrophic Factors. Urology 2016; 99:287.e1-287.e7. [PMID: 27639791 DOI: 10.1016/j.urology.2016.08.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/16/2016] [Accepted: 08/31/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess neurite sprouting and gene expression of neurotrophic factors, nerve markers, and apoptosis in the major pelvic ganglia (MPGs) of rats with type 2 diabetes mellitus (T2DM) as it relates to erectile function. MATERIALS AND METHODS Male rats were fed high-fat diet for 2 weeks followed by 2 low-dose injections of streptozotocin (20 mg/kg). In 3 groups (controls, 3-week, or 5-week T2DM), erectile function was measured by ratios of intracavernosal pressure to mean arterial pressure after cavernous nerve stimulation. MPGs were harvested, and gene expressions of neurotrophic factor 3, nerve growth factor, glial cell line-derived neurotrophic factor, brain-derived neurotrophic factor, caspase-1, -3, -9, beta tubulin type III, and neuronal nitric oxide synthase were quantified by quantitative polymerase chain reaction. Additional MPGs were harvested and cultured in Matrigel. Neurite outgrowth from the MPG was evaluated at 48 hours after culture. RESULTS Erectile function was significantly decreased in all rats with T2DM. Gene expressions of neurotrophic factor 3, nerve growth factor, glial cell line-derived neurotrophic factor, and brain-derived neurotrophic factor were slightly lower at 3 weeks and significantly lower at 5 weeks after T2DM induction. Gene expression of apoptotic markers caspase-1, -3, -9, and neuronal markers beta tubulin type III and neuronal nitric oxide synthase remained unchanged. Rats with T2DM had shorter neurite length and less neurite sprouting than did the control MPG. CONCLUSION Early-stage T2DM downregulates neurotrophic factors, induces erectile dysfunction, and impairs MPG neurite outgrowth, suggesting that erectile dysfunction may be prevented by supplementing neurotrophic factors at early-stage T2DM.
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Affiliation(s)
- Hotaka Matsui
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Biljana Musicki
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Nikolai A Sopko
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Xiaopu Liu
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Paula J Hurley
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Arthur L Burnett
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Trinity J Bivalacqua
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Johanna L Hannan
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC.
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12
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Gurbuz N, Kol A, Ipekci T, Ates E, Baykal A, Usta MF. Chronic administration of sildenafil improves erectile function in a rat model of chronic renal failure. Asian J Androl 2016; 17:797-801. [PMID: 25652632 PMCID: PMC4577593 DOI: 10.4103/1008-682x.146973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The relationship between erectile dysfunction (ED) and chronic renal failure (CRF) has been reported in several studies. This study aimed to investigate whether the chronic use of sildenafil could enhance the erectile capacity in CRF-induced rats. In addition, we assessed the effect of that treatment on certain molecules, which have been suggested to play crucial roles in erectile physiology and CRF-related ED as well. Three groups of animals were utilized: (1) age-matched control rats, (2) CRF-induced rats, (3) CRF-induced rats treated with chronic administration of sildenafil (5 mg kg−1 p.o. for 6 weeks [treatment started after 6 weeks of CRF induction]). At 3 months, all animals underwent cavernosal nerve stimulation (CNS) to assess erectile function. Penile tissue advanced glycation end products (AGE's)/5-hydroxymethyl-2-furaldehyde, malondialdehyde (MDA), cGMP (ELISA), inducible nitric oxide synthase (iNOS) and neuronal NOS (nNOS) (Western blot) analyses were performed in all rat groups. CRF-induced rats had a significant decrease in erectile function when compared to control rats (P < 0.05). The increase in both intracavernosal pressure (ICP) and area under the curve of CRF-induced rats treated with sildenafil (Group 3) was greater than CRF-induced rats (Group 2). Additionally, sildenafil treatment decreased AGE, MDA and iNOS levels, while it preserved nNOS and cGMP contents in CRF-induced penile tissue. Decreased AGE, MDA, iNOS and increased nNOS, cGMP levels at the sildenafil-treated group increased both ICP and Total ICP to CNS, which led to improve erectile function in CRF-induced rats. The results of the present study revealed the therapeutic effect of chronic sildenafil administration on erectile function in CRF-induced rats.
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Affiliation(s)
| | | | | | | | | | - Mustafa F Usta
- Department of Urology, Section of Andrology, Akdeniz University School of Medicine, Antalya, Turkey
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13
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Goswami SK, Gangadarappa SK, Vishwanath M, Razdan R, Jamwal R, Bhadri N, Inamdar MN. Antioxidant Potential and Ability of Phloroglucinol to Decrease Formation of Advanced Glycation End Products Increase Efficacy of Sildenafil in Diabetes-Induced Sexual Dysfunction of Rats. Sex Med 2016; 4:e104-12. [PMID: 26831914 PMCID: PMC5005294 DOI: 10.1016/j.esxm.2015.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/15/2015] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Diabetes-induced sexual dysfunction is associated with an increase in oxidative stress. Scavengers of reactive oxygen species (ROS) have been shown to reduce oxidative stress and aid in the management of sexual dysfunction in diabetes. AIM The aim of the study was to test the hypothesis that antioxidant, which scavenge ROS and reduce formation of advanced glycation end products (AGEs), can potentiate efficacy of phosphodiesterase type 5 inhibitors in diabetes-induced sexual dysfunction that is associated with oxidative stress. MATERIALS AND METHODS Effect of phloroglucinol and sildenafil on serum glucose level, sexual function, penile smooth muscle : collagen ratio, and phenylephrine precontracted corpus cavernosum smooth muscle (CCSM) was studied. The ability of phloroglucinol to reduce the formation of AGEs and its ability to scavenge 2,2-diphenyl-1-picrylhydrazyl (DPPH) and nitric oxide (NO) was also evaluated. MAIN OUTCOME MEASURES Antioxidant potential of phloroglucinol was studied in addition to its effect on diabetes-induced sexual dysfunction in presence and absence of sildenafil. RESULTS Phloroglucinol (50 mg/kg, p.o.) significantly decreased serum glucose level and increased sexual function in streptozotocin-induced diabetic rats when compared with diabetic control rats. Sildenafil (5 mg/kg, p.o.) had no effect on glycemia but significantly increased sexual function of diabetic rats. Coadministration of phloroglucinol increased the efficacy of sildenafil by improving sexual function. Treatment of diabetic rats with phloroglucinol + sildenafil maintained smooth muscle : collagen levels similar to that of normal rat penile tissue. Phloroglucinol decreased formation of AGEs and significantly scavenged DPPH radical activity in vitro. Sildenafil relaxed isolated CCSM of normal rat and diabetic rat significantly, but phloroglucinol did not show any significant effect. Phloroglucinol also inhibited human CYP3A4 enzyme activity in vitro. CONCLUSION Phloroglucinol coadministration increases efficacy of sildenafil in diabetes-induced sexual dysfunction. However, further studies are required to ascertain the benefits of phloroglucinol owing to its undesirable CYP3A4 inhibition activity.
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Affiliation(s)
- Sumanta Kumar Goswami
- Department of Pharmacology, Al-Ameen College of Pharmacy, Bangalore, India; Currently pursuing postdoctoral training at University of California, Davis, CA, USA.
| | | | | | - Rema Razdan
- Department of Pharmacology, Al-Ameen College of Pharmacy, Bangalore, India
| | - Rohitash Jamwal
- College of Pharmacy, University of Rhode Island, Kingston, RI, USA
| | - Naini Bhadri
- Department of Pharmacology, Al-Ameen College of Pharmacy, Bangalore, India
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Akın Y, Şahiner İF, Usta MF. The impact of diabetes mellitus on penile length in men undergoing inflatable penile prosthesis implantation. Turk J Urol 2015; 39:161-4. [PMID: 26328101 DOI: 10.5152/tud.2013.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 03/06/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the changing cavernosal length of patients with diabetes mellitus (DM) and organic erectile dysfunction (ED) who were treated with inflatable, three-piece penile prostheses, a current surgical treatment option in our clinic, over the course of 12 years. MATERIALS AND METHODS Between April 2000 and December 2012, we retrospectively investigated data from patients who were diagnosed with organic ED and undergone penile prosthesis implantation (PPI). Of the 239 patients, 235 of them were included in the study. Four patients who were operated on for trans-sexuality were excluded from the study. All patients were divided into two groups as those with (Group 1) or without DM (Group 2). Data, including age, body mass index (BMI) in kg/m(2), surgical history, comorbidities, International Index of Erectile Function (IIEF) questionnaire scores, combined intracavernous injection and stimulation (CIS) test results, length of corpus cavernosum while implanting the penile prosthesis, complications, operative times, mean hospital stay, and satisfaction of the patient and partner, were recorded. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis. A p-value of <0.05 was considered to be statistically signifcant. RESULTS The mean age was 57.9±10.5 years. Study population consisted of patients with DM (n=65), hypertension (n=21), DM, and hypertension (n=28), hyperlipidemia (n=5), a history of previous radical pelvic surgery with (n=4) or without DM (n=51) or cases without any comorbidity (n=62). Mean length of the corpus cavernosum was 17.277±0.1509 cm in Group 1 and 17289±0.1598 cm in Group 2 (p<0.05). Additionally, the other parameters, including age, operative time, and the satisfaction of the patient and partner, were not different between these groups (p>0.05). CONCLUSION The length of the corpus cavernosum and the destruction of cavernosal tissues do not depend only on DM. We conclude that these features may have multifactorial causes.
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Affiliation(s)
- Yiğit Akın
- Department of Urology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
| | - İlker Fatih Şahiner
- Departmet of Urology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Mustafa Faruk Usta
- Departmet of Urology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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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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Wang L, Xu Y, Li H, Lei H, Guan R, Gao Z, Xin Z. Antioxidant icariside II combined with insulin restores erectile function in streptozotocin-induced type 1 diabetic rats. J Cell Mol Med 2015; 19:960-9. [PMID: 25781208 PMCID: PMC4420599 DOI: 10.1111/jcmm.12480] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 10/01/2014] [Indexed: 12/30/2022] Open
Abstract
Erectile dysfunction (ED) worsens in patients with diabetes mellitus (DM) despite good control of blood glucose level with insulin. Recent studies imply that diabetic vascular stresses (e.g. oxidative stress) persist in spite of glucose normalization, which is defined as metabolic memory. Studies suggest that the interaction between advanced glycation end products (AGEs) and their receptor (RAGE) mediates the development of metabolic memory. To investigate the effects of the antioxidant icariside II plus insulin on erectile function in streptozotocin (STZ)- induced type 1 diabetic rats. Fifty 8-week-old Sprague-Dawley rats were randomly distributed into five groups: normal control, diabetic, insulin-treated diabetic, icariside II-treated diabetic, and insulin plus icariside II-treated diabetic. Diabetes was induced by a single intraperitoneal injection of STZ. Eight weeks after induction of diabetes, icariside II was administered by gastric lavage once a day (5 mg/kg) for 6 weeks; and 2-6 units of intermediate-acting insulin were given to maintain normal glycemia for 6 weeks. The main outcome measures were the ratio of intracavernous pressure (ICP) to mean arterial pressure (MAP); histology of penile endothelial cells and smooth muscle cells; neural nitric oxide synthase, AGEs and RAGE expression; malondialdehyde concentration; superoxide dismutase activity; and apoptosis index. Diabetic rats demonstrated a significantly lower ICP/MAP ratio, reduced penile endothelial cells, reduced smooth muscle cells, increased AGEs and RAGE, and increased apoptosis. Insulin and icariside II monotherapy partially restored erectile function and histological changes. However, the combination therapy group showed significantly better erectile parameters, cytological components and biochemistry, similar to those in the normal control group. These results suggest that, although insulin can effectively control glycemic levels, it does not completely alter the pathological changes in erectile tissues. Better efficacy could be expected with tight glycemic control plus the antioxidant icariside II. The proposed combination therapy might have the potential to eliminate metabolic memory by down-regulating the AGEs-RAGE-oxidative stress axis.
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Affiliation(s)
- Lin Wang
- Andrology Center, Peking University First Hospital, Peking University, Beijing, China
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Liu T, Peng Y, Jia C, Yang B, Tao X, Li J, Fang X. Ginsenoside Rg3 Improves Erectile Function in Streptozotocin‐Induced Diabetic Rats. J Sex Med 2015; 12:611-20. [DOI: 10.1111/jsm.12779] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Pertynska-Marczewska M, Merhi Z. Relationship of Advanced Glycation End Products With Cardiovascular Disease in Menopausal Women. Reprod Sci 2014; 22:774-82. [PMID: 25228634 DOI: 10.1177/1933719114549845] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Cardiovascular disease (CVD) represents the most significant cause of death in postmenopausal women. Advanced glycation end products (AGEs) are formed by nonenzymatic modification of proteins, lipids, and nucleic acids by glucose. This review focuses on the contribution of AGEs and their receptors to the development of CVD in menopause. Advanced glycation end products circulate and activate the proinflammatory endothelial cell surface receptor called RAGE, bind to the extracellular matrix of the cardiovascular system, or bind to the circulating anti-inflammatory soluble form of RAGE (sRAGE). Data emerging from human and animal studies suggest that AGEs and both receptors (RAGE and sRAGE) are implicated in the pathophysiology of CVD. Particular emphasis has been given to the role of AGE-RAGE axis in oxidative stress, inflammation, endothelial cell toxicity, and progression of atherosclerosis in menopause. Data accruing from human and animal studies suggest that RAGE expression level and circulating sRAGE level are associated with estradiol and are correlated with CVD risk factors, such as adiposity, dyslipidemia, insulin resistance, diabetes, and metabolic syndrome. By recognizing the impact of AGEs on atherosclerosis, pharmacological strategies targeting the AGE-RAGE pathway hold therapeutic potential for CVD in menopausal women.
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Affiliation(s)
| | - Zaher Merhi
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont College of Medicine, Burlington, VT, USA
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Wang L, Tian W, Uwais Z, Li G, Li H, Guan R, Gao Z, Xin Z. AGE-Breaker ALT-711 Plus Insulin Could Restore Erectile Function in Streptozocin-Induced Type 1 Diabetic Rats. J Sex Med 2014; 11:1452-62. [DOI: 10.1111/jsm.12533] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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20
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Neves D. Advanced glycation end-products: a common pathway in diabetes and age-related erectile dysfunction. Free Radic Res 2013; 47 Suppl 1:49-69. [PMID: 23822116 DOI: 10.3109/10715762.2013.821701] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Reactive derivatives of non-enzymatic glucose-protein condensation reactions integrate a heterogeneous group of irreversible adducts called advanced glycation end-products (AGEs). Numerous studies have investigated the role of the AGEs in cardiovascular system; however, its contribution to erectile dysfunction (ED) that is an early manifestation of cardiovascular disease has been less intensively investigated. This review summarizes the most recent advances concerning AGEs effects in the cavernous tissue of the penis and in ED onset, particularly on diabetes and aging, conditions that not only favor AGEs formation, but also increase risk of developing ED. The specific contribution of AGE on intra- and extracellular deposition of insoluble complexes, interference in activity of endothelial nitric oxide (NO) synthase, NO bioavailability, endothelial-dependent vasodilatation, as well as molecular pathways activated by receptor of AGEs are presented. Finally, the interventional actions that prevent AGEs formation, accumulation or activity in the cavernous tissue and that include nutritional pattern modulation, nutraceuticals, exercise, therapeutic strategies (statins, anti-diabetics, inhibitors of phosphodiesterase-5, anti-hypertensive drugs) and inhibitors of AGEs formation and crosslink breakers, are discussed. From this review, we conclude that despite the experiments conducted in animal models pointing to the AGE/RAGE axis as a potential interventional target with respect to ED associated with diabetes and aging, the clinical data have been very disappointing and, until now, did not provide evidence of benefits of treatments directed to AGE inactivation.
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Affiliation(s)
- D Neves
- Department of Experimental Biology, Faculty of Medicine and IBMC of Universidade do Porto, Al. Prof Hernani Monteiro, Porto, Portugal.
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21
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Evidence for a Positive Association Between Serum Carnitine and Free Testosterone Levels in Uremic Men with Hemodialysis. Rejuvenation Res 2013; 16:200-5. [DOI: 10.1089/rej.2012.1399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Yamagishi SI. Potential clinical utility of advanced glycation end product cross-link breakers in age- and diabetes-associated disorders. Rejuvenation Res 2012; 15:564-72. [PMID: 22950433 DOI: 10.1089/rej.2012.1335] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Reducing sugars can react nonenzymatically with the amino groups of proteins to form Amadori products. These early glycation products undergo further complex reactions, such as rearrangement, dehydration, and condensation, to become irreversibly cross-linked, heterogeneous fluorescent derivatives, termed advanced glycation end products (AGEs). The formation and accumulation of AGEs have been known to progress in a normal aging process and at an accelerated rate under diabetes. Nonenzymatic glycation and cross-linking of proteins not only leads to an increase in vascular and myocardial stiffness, but also deteriorates structural integrity and physiological function of multiple organ systems. Furthermore, there is accumulating evidence that interaction of AGEs with a cell-surface receptor, receptor for AGEs (RAGE), elicits oxidative stress generation and subsequently evokes inflammatory, thrombogenic, and fibrotic reactions, thereby being involved in atherosclerosis, diabetic microvascular complications, erectile dysfunction, and pancreatic β-cell apoptosis. Recently, AGE cross-link breakers have been discovered. Therefore, removal of the preexisting AGEs by the breakers has emerged as a novel therapeutic approach to various types of diseases that develop with aging. This article summarizes the potential clinical utility of AGE cross-link breakers in the prevention and management of age- and diabetes-associated disorders.
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Affiliation(s)
- Sho-ichi Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume 830-0011, Japan.
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Choi WS, Park K, Paick JS, Kim SW. Time-dependent changes of erectile function in diabetic rats: role of systemic endothelial dysfunction. World J Mens Health 2012; 30:114-22. [PMID: 23596598 PMCID: PMC3623519 DOI: 10.5534/wjmh.2012.30.2.114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 08/15/2012] [Accepted: 08/16/2012] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To understand the potential contribution of systemic endothelial dysfunction to diabetic erectile dysfunction, and the time course of erectile dysfunction in a streptozotocin (STZ)-induced diabetic rat model. MATERIALS AND METHODS Among 84, 12-week-old Sprague-Dawley rats, 48 rats received intraperitoneal STZ and were classified into six groups of diabetes by the period of observation (n=8). The remaining 36 rats were also grouped, similar to the diabetic groups, and served as normal controls. After 4, 6, 8, 10, 12, and 14 weeks of diabetes (serum glucose >250 mg%), all rats underwent cavernous nerve electrostimulation (3 V, 0.2 ms, 30 sec) with varying frequency (2.5~20 Hz). At the end of the study, 8 ml of blood was taken to measure the plasma markers of endothelial function and glycosylated hemoglobin. RESULTS Compared to the control, significant reduction of erectile response was not observed until eight weeks after diabetes induction. The diabetic rats had elevation of all plasma markers except for l-selectin. However, the correlation analysis revealed that no systemic marker of endothelial dysfunction was associated with change in erectile function. Only the level of hemoglobin A1c (HbA1c) showed a modest but significant correlation with the peak intracavernosal pressure, corrected by mean arterial pressure (ρ=-0.183), and the area under the curve of the cavernosometry (ρ=-0.207). CONCLUSIONS Significant reduction of erectile function was not observed until eight weeks after the induction of diabetes. Except for HbA1c, there was no systemic marker associated with endothelial activation and erectile function in the diabetic rats.
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Affiliation(s)
- Woo Suk Choi
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
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Pathophysiology of diabetic erectile dysfunction: potential contribution of vasa nervorum and advanced glycation endproducts. Int J Impot Res 2012; 25:1-6. [PMID: 22914567 DOI: 10.1038/ijir.2012.30] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Erectile dysfunction (ED) due to diabetes mellitus remains difficult to treat medically despite advances in pharmacotherapeutic approaches in the field. This unmet need has resulted in a recent re-focus on the pathophysiology, in order to understand the cellular and molecular mechanisms leading to ED in diabetes. Diabetes-induced ED is often resistant to PDE5 inhibitor treatment, thus there is a need to discover targets that may lead to novel approaches for a successful treatment. The aim of this brief review is to update the reader in some of the latest development on that front, with a particular focus on the role of impaired neuronal blood flow and the formation of advanced glycation endproducts.
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Xin H, Zhou F, Liu T, Li GY, Liu J, Gao ZZ, Bai GY, Lu H, Xin ZC. Icariin ameliorates streptozotocin-induced diabetic retinopathy in vitro and in vivo. Int J Mol Sci 2012; 13:866-878. [PMID: 22312291 PMCID: PMC3269725 DOI: 10.3390/ijms13010866] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 12/22/2011] [Accepted: 12/28/2011] [Indexed: 01/04/2023] Open
Abstract
This study investigated the effect of Icariin (ICA) supplementation on diabetic retinopathy (DR) in a streptozotocin-induced diabetic rat model system. Fifty Sprague Dawley rats were randomly distributed into a control group and a streptozotocin-induced diabetes group. Diabetic rats were randomly divided into two groups; one group received ICA 5 mg/kg/day for 12 weeks by oral gavage; the other group received saline gavage as a placebo. Retinal morphological changes, endothelial markers (RECA), collagen IV (Col-IV), vascular endothelial growth factor (VEGF), and neuropathic changes (Thy-1 and Brn3a expression) of the retinal ganglion cells (RGCs) were investigated. The effects of ICA at various concentrations (0, 101, 102, 103 nmol/mL) on neurite growth were investigated also in retinal ganglion cells (RGC) cultured from both diabetic and normal animals. Numerous pathological changes (deceased expression of RECA, VEGF, Thy-1, and Brn3a as well as decreased Collagen IV and Müller cell content) were noted in the retinal vessels of diabetic rats; these changes were attenuated in diabetic animals that received ICA. ICA enhanced neurite growth in RGC from both normal rats and diabetic rats in a dose dependent fashion. ICA may be useful in the treatment of diabetic retinopathy. Further investigations are indicated.
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Affiliation(s)
- Hua Xin
- Department of Ophthalmology, Beijing ChaoYang Hospital, Capital Medical University, Beijing 100043, China; E-Mail:
| | - Feng Zhou
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (F.Z.); (T.L.); (G.-Y.L.); (J.L.); (Z.-Z.G.); (G.-Y. B.)
| | - Tao Liu
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (F.Z.); (T.L.); (G.-Y.L.); (J.L.); (Z.-Z.G.); (G.-Y. B.)
| | - Guang-Yong Li
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (F.Z.); (T.L.); (G.-Y.L.); (J.L.); (Z.-Z.G.); (G.-Y. B.)
| | - Jing Liu
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (F.Z.); (T.L.); (G.-Y.L.); (J.L.); (Z.-Z.G.); (G.-Y. B.)
| | - Zhe-Zhu Gao
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (F.Z.); (T.L.); (G.-Y.L.); (J.L.); (Z.-Z.G.); (G.-Y. B.)
| | - Guang-Yi Bai
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (F.Z.); (T.L.); (G.-Y.L.); (J.L.); (Z.-Z.G.); (G.-Y. B.)
| | - Hong Lu
- Department of Ophthalmology, Beijing ChaoYang Hospital, Capital Medical University, Beijing 100043, China; E-Mail:
- Authors to whom correspondence should be addressed; E-Mails: (H.L.); (Z.-C.X.); Tel.: +86-10-8523-1488 (H.L.); +86-10-8322-2822 (Z.-C.X.); Faxes: +86-10-8523-1210 (H.L.); +86-10-8322-2822 (Z.-C.X.)
| | - Zhong-Cheng Xin
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China; E-Mails: (F.Z.); (T.L.); (G.-Y.L.); (J.L.); (Z.-Z.G.); (G.-Y. B.)
- Authors to whom correspondence should be addressed; E-Mails: (H.L.); (Z.-C.X.); Tel.: +86-10-8523-1488 (H.L.); +86-10-8322-2822 (Z.-C.X.); Faxes: +86-10-8523-1210 (H.L.); +86-10-8322-2822 (Z.-C.X.)
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Therapeutic effect of combination of alagebrium (ALT-711) and sildenafil on erectile function in diabetic rats. Int J Impot Res 2011; 24:114-21. [DOI: 10.1038/ijir.2011.54] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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27
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Liu T, Xin H, Li W, Zhou F, Li G, Gong Y, Gao Z, Qin X, Cui W, Shindel AW, Xin Z. Effects of Icariin on Improving Erectile Function in Streptozotocin‐Induced Diabetic Rats. J Sex Med 2011; 8:2761-72. [DOI: 10.1111/j.1743-6109.2011.02421.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Francis SH, Corbin JD. PDE5 inhibitors: targeting erectile dysfunction in diabetics. Curr Opin Pharmacol 2011; 11:683-8. [PMID: 21924956 DOI: 10.1016/j.coph.2011.08.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 08/24/2011] [Indexed: 12/17/2022]
Abstract
Erectile dysfunction (ED) is strongly linked to cardiovascular disease (CVD), especially in diabetics. ED is associated with deleterious changes in the overall vasculature and is recognized as an indicator of higher risk for adverse cardiovascular events. Endothelial dysfunction, vascular smooth muscle changes and increased fibrosis are indicated as major players in both ED and CVD. ED in diabetics is more refractory to acute treatment with phosphodiesterase-5 (PDE5) inhibitors (Viagra, Cialis, Levitra, Zydena) than in non-diabetics, but recent studies indicate that chronic administration of these drugs improves endothelial function, preserves vascular smooth muscle and decreases fibrotic changes. Use of PDE5 inhibitors in pre-diabetic and diabetic men may protect cardiovascular health, including vascular function in penile tissues.
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Affiliation(s)
- Sharron H Francis
- Department Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN 37232-0615, United States.
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Vardenafil, an inhibitor of phosphodiesterase-5, blocks advanced glycation end product (AGE)-induced up-regulation of monocyte chemoattractant protein-1 mRNA levels in endothelial cells by suppressing AGE receptor (RAGE) expression via elevation of cGMP. Clin Exp Med 2010; 11:131-5. [PMID: 20803229 DOI: 10.1007/s10238-010-0109-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 08/05/2010] [Indexed: 10/19/2022]
Abstract
Decreased production and/or impaired action of nitric oxide (NO) play a role in the pathogenesis of atherosclerotic cardiovascular disease and erectile dysfunction (ED) in diabetic patients. Under hyperglycemic conditions, formation and accumulation of advanced glycation end products (AGE) have been known to progress, thus contributing to tissue damage in diabetes. However, effects of inhibitors of phosphodiesterase-5 (PDE-5), an enzyme that catalyzes the degradation of cyclic guanosin-monophosphate (cGMP) and subsequently blocks the actions of NO, on AGE-exposed endothelial cells remain unknown. Therefore, this study investigated whether and how vardenafil, an inhibitor of PDE-5, could block the deleterious effects of AGE on human umbilical vein endothelial cells (HUVEC). Gene and protein expression was analyzed in quantitative real-time reverse transcription polymerase chain reaction (RT-PCR) and western blots, respectively. Intracellular formation of reactive oxygen species (ROS) was evaluated with dihydroethidium staining. AGE increased receptor for AGE (RAGE) mRNA and protein levels in HUVEC, both of which were significantly inhibited by the treatments with 30 nM vardenafil or 5 μM 8-Br-cGMP, an analogue of cGMP. Further, vardenafil reduced the AGE-induced ROS generation and subsequently inhibited up-regulation of monocyte chemoattractant protein-1 (MCP-1) mRNA levels in HUVEC. We demonstrated here for the first time that vardenafil could block the AGE-induced up-regulation of MCP-1 mRNA levels in HUVEC by suppressing RAGE expression and subsequent ROS generation via elevation of cGMP. Our present results suggest that vardenafil directly acts on endothelial cells and it could work as an anti-inflammatory agent against AGE.
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Gratzke C, Angulo J, Chitaley K, Dai YT, Kim NN, Paick JS, Simonsen U, Uckert S, Wespes E, Andersson KE, Lue TF, Stief CG. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med 2010; 7:445-75. [PMID: 20092448 DOI: 10.1111/j.1743-6109.2009.01624.x] [Citation(s) in RCA: 231] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Significant scientific advances during the past 3 decades have deepened our understanding of the physiology and pathophysiology of penile erection. A critical evaluation of the current state of knowledge is essential to provide perspective for future research and development of new therapies. AIM To develop an evidence-based, state-of-the-art consensus report on the anatomy, physiology, and pathophysiology of erectile dysfunction (ED). METHODS Consensus process over a period of 16 months, representing the opinions of 12 experts from seven countries. MAIN OUTCOME MEASURE Expert opinion was based on the grading of scientific and evidence-based medical literature, internal committee discussion, public presentation, and debate. RESULTS ED occurs from multifaceted, complex mechanisms that can involve disruptions in neural, vascular, and hormonal signaling. Research on central neural regulation of penile erection is progressing rapidly with the identification of key neurotransmitters and the association of neural structures with both spinal and supraspinal pathways that regulate sexual function. In parallel to advances in cardiovascular physiology, the most extensive efforts in the physiology of penile erection have focused on elucidating mechanisms that regulate the functions of the endothelium and vascular smooth muscle of the corpus cavernosum. Major health concerns such as atherosclerosis, hyperlipidemia, hypertension, diabetes, and metabolic syndrome (MetS) have become well integrated into the investigation of ED. CONCLUSIONS Despite the efficacy of current therapies, they remain insufficient to address growing patient populations, such as those with diabetes and MetS. In addition, increasing awareness of the adverse side effects of commonly prescribed medications on sexual function provides a rationale for developing new treatment strategies that minimize the likelihood of causing sexual dysfunction. Many basic questions with regard to erectile function remain unanswered and further laboratory and clinical studies are necessary.
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Affiliation(s)
- Christian Gratzke
- Department of Urology, Ludwig-Maximilians-Universität, München, Germany
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Gur S, Kadowitz PJ, Hellstrom WJG. A critical appraisal of erectile function in animal models of diabetes mellitus. ACTA ACUST UNITED AC 2009; 32:93-114. [DOI: 10.1111/j.1365-2605.2008.00928.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Yamagishi SI, Nakamura K, Matsui T, Ueda S, Fukami K, Okuda S. Agents that block advanced glycation end product (AGE)-RAGE (receptor for AGEs)-oxidative stress system: a novel therapeutic strategy for diabetic vascular complications. Expert Opin Investig Drugs 2008; 17:983-96. [DOI: 10.1517/13543784.17.7.983] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Sho-ichi Yamagishi
- Kurume University School of Medicine, Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume, 67 Asahi-machi, Kurume 830-0011, Japan ;
| | - Kazuo Nakamura
- Kurume University School of Medicine, Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume, 67 Asahi-machi, Kurume 830-0011, Japan ;
| | - Takanori Matsui
- Kurume University School of Medicine, Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume, 67 Asahi-machi, Kurume 830-0011, Japan ;
| | - Seiji Ueda
- Kurume University School of Medicine, Department of Medicine, Division of Nephrology, Kurume, Japan
| | - Kei Fukami
- Kurume University School of Medicine, Department of Medicine, Division of Nephrology, Kurume, Japan
| | - Seiya Okuda
- Kurume University School of Medicine, Department of Medicine, Division of Nephrology, Kurume, Japan
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Yamagishi SI, Nakamura K, Matsui T, Ueda S, Noda Y, Imaizumi T. Inhibitors of advanced glycation end products (AGEs): potential utility for the treatment of cardiovascular disease. Cardiovasc Ther 2008; 26:50-8. [PMID: 18466420 DOI: 10.1111/j.1527-3466.2007.00038.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Accelerated atherosclerosis and microvascular complications are the leading causes of coronary heart disease, stroke, blindness, and end-stage renal failure, which could account for disabilities and high mortality rates in patients with diabetes. Recent clinical studies have substantiated the concept of "hyperglycemic memory" in the pathogenesis of cardiovascular disease (CVD) in diabetes. Indeed, the Diabetes Control and Complications Trial-Epidemiology of Diabetes Interventions and Complications (DCCT-EDIC) Research, has revealed that intensive therapy during the DCCT reduces the risk of cardiovascular events by about 50% in type 1 diabetic patients 11 years after the end of the trial. Among various biochemical pathways activated under diabetic conditions, the process of formation and accumulation of advanced glycation end products (AGEs) and their mode of action are most compatible with the theory "hyperglycemic memory." Further, there is a growing body of evidence that AGEs play an important role in CVD in diabetes. These observations suggest that the inhibition of AGEs formation may be a promising target for therapeutic intervention in diabetic vascular complications. Therefore, in this article, we review several agents with inhibitory effects on AGEs formation and their therapeutic implications in CVD in diabetes.
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Affiliation(s)
- Sho-ichi Yamagishi
- Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
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Chen Y, Dai Y, Wang R. Treatment strategies for diabetic patients suffering from erectile dysfunction. Expert Opin Pharmacother 2008; 9:257-66. [PMID: 18201148 DOI: 10.1517/14656566.9.2.257] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Erectile dysfunction is a common complication of diabetes. Clinical practice has no treatment modality specifically designed for the difficult to treat diabetic erectile dysfunction due to the multifactorial and complex pathophysiology of development. PDE type 5 inhibitors are the first-line treatment option. Non-responders should have total and free testosterone checked and testosterone replacement is recommended for hypogonadal patients. For patients who cannot take PDE type 5 inhibitors, or are proven non-responders, the vacuum constriction device continues to serve as a major treatment option. Intracavernosal injection is the most effective medical therapy for diabetic erectile dysfunction despite its high dropout rate. Use of the Medicated Urethral System for Erection to overcome the disadvantages of needle injection is disappointing due to lack of effectiveness. Penile prosthesis will continue to play an important role in diabetic patients with severe erectile dysfunction in coming years.
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Affiliation(s)
- Yun Chen
- Department of Urology, Affiliated Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210008, China
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Goldstein I, Lurie AL, Lubisich JP. Bicycle riding, perineal trauma, and erectile dysfunction: Data and solutions. CURRENT SEXUAL HEALTH REPORTS 2008. [DOI: 10.1007/s11930-008-0005-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Jeyabal PVS, Kumar R, Gangula PRR, Micci MA, Pasricha PJ. Inhibitors of advanced glycation end-products prevent loss of enteric neuronal nitric oxide synthase in diabetic rats. Neurogastroenterol Motil 2008; 20:253-61. [PMID: 17971026 DOI: 10.1111/j.1365-2982.2007.01018.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Gastrointestinal dysfunction is common in diabetes, and several studies indicate that loss of neuronal nitrergic inhibition may play an important role in its pathogenesis. However, the mechanisms responsible for this effect remain largely unknown. We have previously shown that advanced glycation end-products (AGEs) formed by non-enzymatic glycation dependent processes, can inhibit the expression of intestinal neuronal nitric oxide synthase (nNOS) in vitro acting via their receptor, receptor for AGEs. We now hypothesized that this effect may also be important in experimental diabetes in vivo. We aimed to evaluate the role of AGEs on duodenal nNOS expression and the effects of aminoguanidine (a drug that prevents AGE formation) and ALT-711 (AGE cross-link breaker) in experimental diabetes. Streptozotocin induced diabetic rats were randomized to no treatment, treatment with aminoguanidine (1 g L(-1) daily through drinking water) at the induction of diabetes, or treatment with ALT-711 (3 mg kg(-1) intraperitoneally), beginning at week 6. A fourth group was used as healthy controls. We performed real time polymerase chain reaction, Western blotting and immunohistochemistry to detect nNOS expression. AGE levels were analysed using sandwich ELISA. Diabetes enhanced accumulation of AGEs in serum, an effect that was prevented by treatment with aminoguanidine and ALT-711. Further, diabetic rats showed a significant reduction in duodenal nNOS expression by mRNA, protein and immunocytochemistry, an effect that was prevented by aminoguanidine. ALT-711 had similar effects on nNOS protein and immunohistochemistry (but not on mRNA levels). The generation of AGEs in diabetes results in loss of intestinal nNOS expression and may be responsible for enteric dysfunction in this condition. This study suggests that treatment directed against AGEs may be useful for the treatment of gastrointestinal complications of diabetes.
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Affiliation(s)
- P V S Jeyabal
- The Enteric Neuromuscular Disorders and Pain (END-PAIN) Center, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
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Morano S, Mandosi E, Fallarino M, Gatti A, Tiberti C, Sensi M, Gandini L, Buchetti B, Lenti L, Jannini EA, Lenzi A. Antioxidant Treatment Associated with Sildenafil Reduces Monocyte Activation and Markers of Endothelial Damage in Patients with Diabetic Erectile Dysfunction: A Double-Blind, Placebo-Controlled Study. Eur Urol 2007; 52:1768-74. [PMID: 17478034 DOI: 10.1016/j.eururo.2007.04.042] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Accepted: 04/13/2007] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the synergic effect of propionyl L-carnitine (PLC) plus sildenafil in reducing monocyte oxidative activity and endothelial dysfunction markers in diabetic patients with erectile dysfunction (ED). METHODS Thirty-two type 2 diabetic patients with ED (according to the International Index of Erectile Function-5 [IIEF-5]) were randomized to receive PLC (2 g/d) alone (n=8) or combined with sildenafil (50 mg/d twice weekly) (n=8), sildenafil alone (50 mg/d twice weekly) (n=8), or placebo (n=8) in a double-blind, fixed-dose study. Monocyte oxidative activity (stimulation index [SI]), intercellular adhesion molecule-1 [ICAM-1], P-selectin, advanced glycation end product (AGE) levels, Doppler sonography (recording peak systolic velocity [PSV]; end diastolic velocity [EDV]; systolic wave time [SWT]; resistive index [RI]), and IIEF score were evaluated before and after 12 wk of treatment; IIEF-5 was evaluated again 4 wk posttreatment. RESULTS SI was reduced by treatment with PLC alone or combined with sildenafil (p<0.05). In patients treated with PLC plus sildenafil, a decrease in ICAM-1, P-selectin, and EDV values was observed compared with patients treated with sildenafil alone (p<0.05, p<0.01, p<0.001, respectively). IIEF-5 improved in all patients treated with PLC plus sildenafil or sildenafil alone (p<0.03, p<0.05, respectively). Four weeks posttreatment, patients treated with PLC plus sildenafil maintained the improvement of the IIEF-5 compared with patients on sildenafil alone (p=0.05). In patients on PLC treatment (with or without sildenafil), SI was correlated with IIEF-5 (p<0.001), glycemia with STW (p<0.03), and AGEs with IIEF-5 (p<0.01). CONCLUSION PLC plus sildenafil was more effective in reducing SI and endothelial dysfunction markers in patients with type 2 diabetes and ED.
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Affiliation(s)
- Susanna Morano
- Department of Clinical Sciences, "Sapienza" University, Rome, Italy.
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Goldstein I, Lurie AL, Lubisich JP. Bicycle riding, perineal trauma, and erectile dysfunction: Data and solutions. Curr Urol Rep 2007; 8:491-7. [DOI: 10.1007/s11934-007-0054-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hannan JL, Heaton JPW, Adams MA. Recovery of erectile function in aging hypertensive and normotensive rats using exercise and caloric restriction. J Sex Med 2007; 4:886-97. [PMID: 17627736 DOI: 10.1111/j.1743-6109.2007.00517.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Using aging spontaneously hypertensive rats (SHR), we established that antihypertensive drugs can improve erections and penile vascular structure, and lower arterial pressure. Using kidney cross-transplantations, our findings revealed that the benefit of this treatment resulted from drug-induced changes specific to the penile circulation, and not to the kidney-mediated lowering of pressure. AIM The objective of the present study was to determine whether increased exercise and/or caloric restriction (CR) can reverse the decline in sexual responses in aging hypertensive and normotensive rats. METHODS From 30 to 40 weeks, food intake was restricted (10-40%), and SHR, Wistar, and Sprague-Dawley rats ran on treadmills (30 minutes/day, 5 days/week). Exercise was withdrawn at 40 weeks, and CR was stopped at 50 weeks. Using a separate group of older Wistars (56 weeks) and Sprague-Dawley rats (67 weeks), the effects of 10% CR or exercise plus 10-40% CR on erectile function were determined. MAIN OUTCOME MEASURE Apomorphine-induced erectile responses and body weight were monitored weekly. RESULTS An age-related decline in erections was seen from 15 to 29 weeks of age in all strains. This decline paralleled increases in body weight, particularly in the normotensive strains. Exercise and CR induced a 10% weight loss in normotensive rats and improved erections in all animals. In SHR, increased erections occurred without decreasing body weight. Body weight and erectile responses were maintained by CR alone after exercise was withdrawn, but erectile function rapidly declined soon after CR was stopped and paralleled increases in body weight. In aged Wistar and Sprague-Dawley rats treated with exercise and CR, erectile function was also significantly improved. CONCLUSIONS Similar to previous studies, erectile function progressively decreased with age in both hypertensive and normotensive rats. Erectile responses were found to be substantially improved by an intervention involving exercise and CR, but not necessarily involving weight loss.
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Affiliation(s)
- Johanna L Hannan
- Department of Pharmacology & Toxicology, Queen's University, Kingston, Ontario, Canada
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Coughlan MT, Forbes JM, Cooper ME. Role of the AGE crosslink breaker, alagebrium, as a renoprotective agent in diabetes. Kidney Int 2007:S54-60. [PMID: 17653212 DOI: 10.1038/sj.ki.5002387] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The biochemical process of advanced glycation appears to play a central role in the development and progression of diabetic vascular complications. A number of strategies to influence this pathway have been designed, one of which involves the putative advanced glycation end-product (AGE) crosslink breaker, alagebrium which has been shown in in vitro studies to cleave preformed AGE crosslinks. This agent has been studied in various models of diabetic complications and has been shown to attenuate diabetic renal disease, cardiac dysfunction, and atherosclerosis. In addition to the ability of alagebrium to reduce tissue levels of AGEs, this drug appears to inhibit activation of certain protein kinase C isoforms. Planned clinical studies in diabetic subjects at risk of complications should assist in determining the role of alagebrium in the prevention, retardation, and reversal of diabetic micro- and macrovascular disease.
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Affiliation(s)
- M T Coughlan
- JDRF Einstein Centre for Diabetic Complications, Diabetes and Metabolism Division, Baker Heart Research Institute, Melbourne, Victoria, Australia
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Hamilton PK, Lockhart CJ, Quinn CE, McVeigh GE. Arterial stiffness: clinical relevance, measurement and treatment. Clin Sci (Lond) 2007; 113:157-70. [PMID: 17623012 DOI: 10.1042/cs20070080] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Most traditional cardiovascular risk factors alter the structure and/or function of arteries. An assessment of arterial wall integrity could therefore allow accurate prediction of cardiovascular risk in individuals. The term 'arterial stiffness' denotes alterations in the mechanical properties of arteries, and much effort has focused on how best to measure this. Pulse pressure, pulse wave velocity, pulse waveform analysis, localized assessment of blood vessel mechanics and other methods have all been used. We review the methodology underlying each of these measures, and present an evidence-based critique of their relative merits and limitations. An overview is also given of the drug therapies that may prove useful in the treatment of patients with altered arterial mechanics.
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Affiliation(s)
- Paul K Hamilton
- Department of Therapeutics and Pharmacology, Queen's University Belfast, Whitla Medical Building, Belfast, UK.
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Corona G, Mannucci E, Petrone L, Balercia G, Paggi F, Fisher AD, Lotti F, Chiarini V, Fedele D, Forti G, Maggi M. ORIGINAL RESEARCH—ENDOCRINOLOGY: NCEP-ATPIII-Defined Metabolic Syndrome, Type 2 Diabetes Mellitus, and Prevalence of Hypogonadism in Male Patients with Sexual Dysfunction. J Sex Med 2007; 4:1038-45. [PMID: 17627748 DOI: 10.1111/j.1743-6109.2007.00529.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) are characterized by insulin resistance and often associated with male hypogonadism. AIM To discriminate the specific contribution of T2DM and MetS to male hypogonadism. METHODS A consecutive series of 1,134 (mean age 52.1 +/- 13 years) male patients with sexual dysfunction was studied. MAIN OUTCOME MEASURES Several hormonal and biochemical parameters were studied along with ANDROTEST, a 12-item validated structured interview, specifically designed for the screening of hypogonadism (total testosterone [TT] <10.4 nmol/L or free testosterone [FT] <37 pmol/L) in a male population with sexual dysfunction. RESULTS Irrespective of the criteria used to define hypogonadism, MetS was associated with a significantly higher prevalence of the condition, both in subjects with and without T2DM (41% and 29% vs. 13.2% and 77.1% and 58% vs. 40.6%, respectively, for TT and FT in patients with MetS and with or without T2DM, when compared with subjects without MetS and T2DM; both P < 0.0001). Conversely, T2DM was associated with a higher prevalence of hypogonadism in subjects with MetS but not in those without MetS. Patients with MetS, with or without T2DM, also showed a higher ANDROTEST score when compared with patients without MetS. Logistic multivariate regression analysis, incorporating the five components of MetS, identified a significant association of elevated waist circumference and hypertriglyceridemia with hypogonadism both in patients, with or without T2DM. CONCLUSIONS Our study demonstrated that MetS, and in particular visceral adiposity (as assessed by increased waistline and hypertriglyceridemia), is specifically associated with hypogonadism in subjects consulting for sexual dysfunction.
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Affiliation(s)
- Giovanni Corona
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Fiale Pieraccini 6, 50139 Florence, Italy
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Goldstein I. EDITORIAL: Supporting Sexual Medicine: A Celebration of The Journal of Sexual Medicine’s Second Birthday. J Sex Med 2006. [DOI: 10.1111/j.1743-6109.2006.00269.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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