title: Atorvastatin improves erectile dysfunction in patients initially irresponsive to Sildenafil by the activation of endothelial nitric oxide synthase.
abstract: This study aimed at comparing the effects of atorvastatin and vitamin E on erectile dysfunction in patients initially irresponsive to sildenafil, with investigation into the underlying possible mechanisms. Sixty patients were randomly divided into three groups: the atorvastatin group received 80 mg daily, the vitamin E group received 400 IU daily and the control group received placebo capsules. Patients were examined both before and after 6 weeks of treatment for biochemical tests; Superoxide dismutase (SOD), glutathione peroxidase (GPO), C-reactive protein (CRP), interleukin-6 (IL-6), nitric oxide (NO) and endothelial nitric oxide synthase (eNOS) and for erectile function tests; International index of erectile function (IIEF-5) scores and Rigiscan. Both atorvastatin and vitamin E showed a statistically significant GPO increase (P<0.05) and a statistically significant IL-6 decrease (P<0.05). Only atorvastatin showed a statistically significant increase in NO (15.19%, P<0.05), eNOS (20.58%, P<0.01), IIEF-5 score (53.1%, P<0.001) and Rigiscan rigidity parameters (P<0.01), in addition to a statistically significant decrease in CRP (57.9%, P<0.01). However, SOD showed a statistically significant increase only after vitamin E intake (23.1%, P<0.05). Both atorvatstain and vitamin E had antioxidant and anti-inflammatory activities. Although activating eNOS by atorvastatin was the real difference, and expected to be the main mechanism for NO increase and for improving erectile dysfunction. Atorvastatin, but not vitamin E, is a promising drug for sildenafil nonresponders.
authors: Professor of Pharmacology and Toxicology, Pharmacology Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt.
authors: A A
authors: AA
authors: El-Sisi
authors: S K
authors: SK
authors: Hegazy
authors: K A
authors: KA
authors: Salem
authors: K S
authors: KS
authors: AbdElkawy
mesh_terms: D000328:Adult; D000069059:Atorvastatin; D002097:C-Reactive Protein / Q000032:analysis; D004351:Drug Resistance; D004789:Enzyme Activation / Q000187:drug effects; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000378:metabolism; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D052250:Nitric Oxide Synthase Type III / Q000097:blood*; D010410:Penile Erection / Q000187:drug effects; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use*; D010919:Placebos; D011687:Purines / Q000627:therapeutic use; D011758:Pyrroles / Q000008:administration & dosage*; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D013482:Superoxide Dismutase / Q000097:blood; D014810:Vitamin E / Q000008:administration & dosage
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D015850:Interleukin-6; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D010919:Placebos; D011687:Purines; D011758:Pyrroles; D013450:Sulfones; D014810:Vitamin E; D009569:Nitric Oxide; D002097:C-Reactive Protein; D000069059:Atorvastatin; D000068677:Sildenafil Citrate; D052250:Nitric Oxide Synthase Type III; D013482:Superoxide Dismutase