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Nebivolol Dilates Human Penile Arteries and Reverses Erectile Dysfunction in Diabetic Rats through Enhancement of Nitric Oxide Signaling
Authors:Javier Angulo  Harold M Wright  Pedro Cuevas  Rocío González-Corrochano  Argentina Fernández  Begoña Cuevas  José M La Fuente  Sandeep Gupta  Iñigo Sáenz de Tejada
Institution:2. Investigación y Clínica Andrológicas and Instituto de Medicina Sexual, Madrid, Spain;3. Forest Research Institute, Department of Pharmacology, Jersey City, New Jersey, USA;5. Serviço de Urologia, Hospital Santo Antonio, Porto, Portugal;1. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA;2. Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA;3. Mass Spectrometry Research Center, Department of Biochemistry, Vanderbilt University Medical Center, Nashville, TN 37232, USA
Abstract:IntroductionTraditional beta-blockers have sometimes been associated with erectile dysfunction (ED). Nebivolol is a cardioselective β1-adrenoceptor antagonist that promotes vasodilation through a nitric oxide (NO)-dependent mechanism.AimWe evaluated the effects of nebivolol on the NO/cyclic guanosine monophosphate (cGMP) signaling pathway, on erectile function and dysfunction, and in human penile vascular tissues.MethodsErectile response to cavernosal nerve electrical stimulation in control and diabetes-induced ED rats were evaluated, along with serum nitrite/nitrate (NOx) concentration and plasma/tissue cGMP levels. Endothelium-dependent and sildenafil-induced relaxation of isolated human corpus cavernosum (HCC) and human penile resistance arteries (HPRA) were also determined.Main Outcome MeasuresThe effects of nebivolol on erectile function and dysfunction and on NO/cGMP-mediated responses.ResultsTreatment with nebivolol significantly potentiated erectile response in control rats, regardless of its effects on blood pressure. Nebivolol increased NOx and plasma cGMP by 3-fold and 2.75-fold, respectively, and significantly augmented the elevation of plasma cGMP produced by sildenafil. Nebivolol enhanced endothelium-dependent and sildenafil-induced relaxations of HCC tissue, and produced endothelium-dependent vasodilation of HPRA. Nebivolol, but not atenolol, significantly improved erectile response in diabetic rats (51.6%, 53.2%, and 87.1% of response at 3 Hz in nondiabetic rats, for vehicle-treated, atenolol-treated, and nebivolol-treated diabetic rats, respectively); after sildenafil administration, ED was completely reversed in nebivolol-treated diabetic rats (69.6% and 112% for diabetic rats treated with sildenafil and nebivolol plus sildenafil, respectively). Accordingly, nebivolol restored systemic NOx levels and cGMP content in penile tissue from these animals.ConclusionsNebivolol in vivo activated the NO/cGMP pathway, enhanced erectile response and reversed ED in diabetic rats. Moreover, nebivolol in vitro potentiated NO/cGMP-mediated relaxation of human erectile tissues. These effects may account for the low incidence of ED in nebivolol-treated hypertensive patients. Nebivolol therefore may have utility in the treatment of ED, particularly ED associated with diabetes. Angulo J, Wright HM, Cuevas P, González-Corrochano R, Fernández A, Cuevas B, La Fuente JM, Gupta S, and de Tejada IS. Nebivolol dilates human penile arteries and reverses erectile dysfunction in diabetic rats through enhancement of nitric oxide signaling.
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