[Therapy of erectile dysfunction in 2005].
Erectile dysfunction (ED) management in the following 3-5 years will be dominated by substances targeting the L-arginine-NO-guanylate cyclase-cGMP-PDE-5 pathway, resulting in an intracellular elevation of the cGMP concentrations. Promising alternatives to the PDE-5 inhibitors, such as guanylate cyclase activators and Rho-kinase inhibitors, may also effectively compliment a PDE-5 inhibitor. Intranasal application of the melanocortin agonist PT 141 (Melanotan II) seems to be promising. As scheduled sexual activities are not preferred by the majority of couples, the future of ED-therapy will focus on drugs with a 1-2 day long efficacy window, or a daily bedtime application of low dosage agents which result in nocturnal reoxygenation of the cavernous bodies and in turn in functional improvement. Elevation of the cGMP levels and improvement of endothelial function as a result of this approach also promises benefits in cardiovascular diseases and in LUTS.
Porst
H
H
Hamburg. Porst20354@aol.com
D015106:3',5'-Cyclic-GMP Phosphodiesterases; D000818:Animals; D001120:Arginine / Q000627:therapeutic use; D006152:Cyclic GMP / Q000378:metabolism; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; D015507:Drugs, Investigational / Q000627:therapeutic use*; D004789:Enzyme Activation / Q000187:drug effects; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000503:physiopathology; D005544:Forecasting; D006162:Guanylate Cyclase / Q000378:metabolism; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D010727:Phosphoric Diester Hydrolases / Q000378:metabolism; D017346:Protein Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D054460:rho-Associated Kinases
D015507:Drugs, Investigational; D047908:Intracellular Signaling Peptides and Proteins; D010726:Phosphodiesterase Inhibitors; D001120:Arginine; D017346:Protein Serine-Threonine Kinases; D054460:rho-Associated Kinases; D010727:Phosphoric Diester Hydrolases; D015106:3',5'-Cyclic-GMP Phosphodiesterases; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; C517381:PDE5A protein, human; D006162:Guanylate Cyclase; D006152:Cyclic GMP