title: Endothelial antioxidant compound prolonged the endothelial antiapoptotic effects registered after tadalafil treatment in patients with arterial erectile dysfunction.
abstract: This study evaluated the effects of a chronic treatment with tadalafil, a  specific phosphodiesterase V inhibitor, on endothelial apoptosis through  changes in the serum concentration of endothelial microparticles (EMP). EMPs  were arbitrarily chosen as a marker of endothelial apoptosis, and the changes  in their concentration were monitored before and after treatment.  Additionally, administration of endothelial antioxidant compound (EAC) during  the follow-up, after discontinuation of tadalafil, was evaluated to determine  whether this treatment improved the potential effects of tadalafil on the  endothelium. Seventy-five patients with arterial erectile dysfunction were  evaluated at baseline and after administration of tadalafil (5 mg once daily  for 90 days). The International Index of Erectile Function questionnaire was  administered, and penile dynamic Doppler and flow-cytometric (serum  concentrations of EMPs) analyses were performed before (T0) and after  treatment. Time points after tadalafil discontinuation: T1, after 1 week; T2,  after 3 months; and T3, after 6 months. Three different schemes of follow-up  were evaluated: group A, follow-up with EAC administration, after tadalafil  discontinuation, for 6 months; group B, follow-up without other treatment; and  group C, follow-up with placebo during the follow-up, after tadalafil  cessation. The events  CD45(neg)/CD144(pos)/annexinV(pos) were defined  EMPs. Patients treated with tadalafil showed a significant decrease in serum  EMPs 1 week after discontinuing tadalafil (16.4% ± 3.6% vs 7.1%  ± 3.3%). This effect was maintained for up to 3 months in the group  without other treatment during follow-up and was maintained for up to 6 months  in the group treated with EAC during follow-up. Chronic treatment with  tadalafil reduces endothelial apoptosis in patients with arterial erectile  dysfunction. Further, EAC treatment prolongs and stabilizes the duration of  antiapoptotic effects on the endothelium that are initially promoted by  tadalafil treatment.
authors.affiliation: Section of Endocrinology, Andrology, and Internal Medicine, Department of Internal Medicine and Systemic Diseases, Catania University, Policlinico G. Rodolico, S Sofia 78th St, Bldg 4, Rm 2C82, 95123 Catania, Italy. sandrolavignera@email.it
authors.forename: Sandro
authors.initials: S
authors.lastname: La Vignera
authors.forename: Rosita
authors.initials: R
authors.lastname: Condorelli
authors.forename: Enzo
authors.initials: E
authors.lastname: Vicari
authors.forename: Rosario
authors.initials: R
authors.lastname: D'Agata
authors.forename: Aldo E
authors.initials: AE
authors.lastname: Calogero
mesh_terms: D000704:Analysis of Variance; D000975:Antioxidants / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects*; D001120:Arginine / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002243:Carbolines / Q000627:therapeutic use*; D002331:Carnitine / Q000031:analogs & derivatives / Q000627:therapeutic use; D055252:Cell-Derived Microparticles / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D042783:Endothelial Cells / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D005434:Flow Cytometry; D006801:Humans; D018783:Impotence, Vasculogenic / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D007558:Italy; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000627:therapeutic use; D010410:Penile Erection / Q000187:drug effects*; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D000068581:Tadalafil; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D002243:Carbolines; D004338:Drug Combinations; D058986:Phosphodiesterase 5 Inhibitors; C003223:propionylcarnitine; D009525:Niacin; D000068581:Tadalafil; D001120:Arginine; D002331:Carnitine