27. Ulusal, 2. Uluslararası Farmakoloji Kongresi, Antalya, Türkiye, 23 - 26 Kasım 2023, ss.14-15
TFD2023 kongresi “Recent Advances in Andrology Research”
panel
Gunay
Yetik-Anacak, Prof.
Acibadem Mehmet
Ali Aydinlar University, Faculty of Pharmacy, Department of Pharmacology
Istanbul-Turkiye
Erectile
physiology is interplay of vascular, neurologic and endocrine factors leading
to increase or facilitate the vasodilation (tumescence) and/or reduce the
contraction (detumescence) of the corpus cavernosum smooth muscle (CCSM) cells.
Deficiency in any or all of these systems results in erectile dysfunction.
Erectile dysfunction (ED) is defined as “a man's persistent or recurring
inability to achieve and/or maintain a penile erection sufficient for sexual
performance” (1). The risk of ED increases with age (2). ED of organic origin
is usually caused by hormonal, hemodynamic, neurological or vascular
pathologies.
ED started to be accepted
as an early indicator for systemic endothelial dysfunction and subsequent of
cardiovascular diseases (3). The role of nitric oxide (NO) in endothelial
relaxation and erectile function is well accepted. The discovery of NO as small
signaling gasotransmitter led to investigate the role of other endogenously
derived gases; carbon monoxide (CO) and hydrogen sulfide (H2S) in
physiological and pathophysiological conditions. The role of NO and CO in sexual
function and dysfunction has been investigated more extensively and the involvement
of H2S in the erectile function has also been confirmed.
The role of soluble
guanylyl cyclase /cyclic GMP pathway is a common target of these 3 gasotransmitters.
Several studies proposed alternative therapies
targeting different mechanisms additional to phosphodiesterase-5 inhibition for
ED treatment, since there are patients not responding to these drugs. Therefore
these mediators are complementary
and possibly coordinated physiologic roles in erectile function and
treatments targeting these gasotransmitters in ED are required. When “NO” is
not enough, the other sister gases may assist sexual function in representing potentials, as a new
therapeutic targets for ED.