Pharmacotherapy for erectile dysfunction.
OBJECTIVE
To review advances in the pharmacological treatment of erectile dysfunction (ED) highlighting potential neuro-endocrine and molecular targets.


METHODS
A comprehensive MEDLINE and PUBMED search was utilized to investigate current novel mechanistic approaches in treating erectile dysfunction. Search criteria included, but were not limited to, erectile dysfunction (ED), cGMP, nitric oxide, Rho-kinase, phosphodiesterase, gene therapy, apomorphine, melanocortin and corpora cavernosa. Articles relating to in vitro, animal and in vivo experimental therapy were evaluated and included in this review and future directions are described.


RESULTS
Current first-line ED treatment often involves the use of phosphodiesterase inhibitors. However, many novel pharmacotherapeutic approaches under development including the use of melanocortins and Rho-kinase inhibitors as well as the introduction of gene therapy have demonstrated efficacy in animal as well as early human trials.


CONCLUSIONS
The success of oral pharmacotherapy for ED has been accompanied by renewed interest into the ED pathophysiology and signal transduction pathways. This has led to the identification of new therapeutic targets, which are poised to change the dynamic of ED management by broadening treatment alternatives to include other oral and genetic therapies.
Feifer
Andrew
A
Division of Urology, McGill University, Jewish General Hospital, 3755 Cote Ste Catherine, E-9, Montreal, Quebec, H3A 1A1, Canada.
Carrier
Serge
S
D000818:Animals; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology; D015316:Genetic Therapy; D006162:Guanylate Cyclase / Q000378:metabolism; D006801:Humans; D008297:Male; D053486:Melanocortins / Q000378:metabolism; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D026902:Potassium Channel Blockers / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D018160:Receptors, Cytoplasmic and Nuclear / Q000378:metabolism; D000071756:Soluble Guanylyl Cyclase; D054460:rho-Associated Kinases / Q000037:antagonists & inhibitors
D018491:Dopamine Agonists; D053486:Melanocortins; D010726:Phosphodiesterase Inhibitors; D026902:Potassium Channel Blockers; D018160:Receptors, Cytoplasmic and Nuclear; D054460:rho-Associated Kinases; D006162:Guanylate Cyclase; D000071756:Soluble Guanylyl Cyclase