Endothelial Antioxidant Administration Ameliorates the Erectile Response to PDE5 Regardless of the Extension of the Atherosclerotic Process |
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| Authors: | Enzo Vicari Sandro La Vignera Rosita Condorelli Aldo Eugenio Calogero |
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| Affiliation: | 1. Section of Endocrinology, Andrology and Internal Medicine, and Master in Andrological and Human Reproduction Sciences, Department of Biomedical Sciences, University of Catania, Catania, Italy;1. Division of Urology, Maimonides Medical Center, New York, NY, USA;2. Division of Urology, Urology Residency Training Program, Cooper Medical School of Rowan University, Camden, NJ, USA;3. Division of Urology, Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA;4. Lilly Research Laboratories, Eli Lilly and Company (Lilly USA, LLC), Indianapolis, IN, USA;2. Department of Health, Exercise Science and Recreation Management, School of Applied Sciences, The University of Mississippi University, MS, USA |
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| Abstract: | IntroductionThe lack of phosphodiesterase type 5 inhibitor effects in patients with erectile dysfunction (ED) of arterial origin may be caused by an endothelial dysfunction that causes a series of biochemical alterations leading to a reduced nitric oxide (NO) bioavailability and increased oxidative stress.AimThe aim of this study was to evaluate the effects of the treatment with endothelial antioxidant compounds (EAC) on the erectile response to sildenafil in patients with arterial ED already treated with sildenafil (100 mg twice a week for 8 weeks).Mean Outcome MeasuresA patient was considered responsive when the 5-item International Index of Erectile Function questionnaire score increased by >5 points.MethodsFifty-three patients with arterial ED, hypertension, and diabetes mellitus were randomly given, for 8 weeks, EAC (1 dose/day) and, after a wash out of 8 weeks, sildenafil (100 mg) plus EAC. The patients were divided into the following four groups: A (N = 12): patients with ED alone; B (N = 14): patients with ED plus atheromasic plaques and/or increased intima-media thickness of common carotid arteries; C (N = 14): patients with ED plus lower limb artery abnormalities; and D (N = 13): patients with ED plus carotid and lower limb artery abnormalities.ResultsThe administration of EAC plus sildenafil resulted in a significantly higher number of responsive patients (N = 36, 68%) compared with sildenafil alone (N = 24, 45%) or EAC alone (N = 17, 32%). The percentage of patients who successfully responded to the combined treatment increased in the various groups. It was 83%, 64%, 71%, and 54%, respectively, for groups A, B, C, and D. Furthermore, patients treated with EAC and sildenafil reached a successful response in a shorter length of time (3 weeks) compared with patients responsive to sildenafil (5.2 weeks) or EAC (5.7 weeks) alone.ConclusionEAC administration to patients with arterial ED improved the success rate to sildenafil. These data suggest that, in such patients, a combined treatment may be considered to increase bioavailable NO and to neutralize radical oxygen species, which in turn inactive NO. Vicari E, La Vignera S, Condorelli R, and Calogero AE. Endothelial antioxidant administration ameliorates the erectile response to PDE5 regardless of the extension of the atherosclerotic process. |
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