title: Acute effect of sildenafil on inflammatory markers/mediators in patients with vasculogenic erectile dysfunction.
abstract: BACKGROUND
  Erectile dysfunction (ED) is associated with an incremental inflammatory activation. Evidence suggests that chronic phosphodiesterase 5 (PDE-5) inhibition may have a favorable effect on inflammatory activation and surrogate markers of ED. The aim of this study is to investigate the acute effect of sildenafil on circulating pro-inflammatory markers/mediators in ED patients.
  
  
  METHODS
  The study comprised a randomized, double-blind, crossover trial carried out on two separate arms: one with sildenafil 100mg, and one with placebo. Twenty-seven subjects participated in the study (seven in the pilot and 20 in the main phase). In the main phase, blood samples were collected at baseline and at 2 and 4h after sildenafil or placebo administration to determine fibrinogen, high sensitivity C-reactive protein (hsCRP), high sensitivity interleukin-6 (hsIL-6) and tumor necrosis factor α (TNF-α).
  
  
  RESULTS
  Administration of sildenafil produced a significant sustained reduction of fibrinogen, hsCRP and hsIL-6 (maximal absolute response of -44mg/dl, 0.42mg/l and 0.68pg/ml at 4h). Likewise, TNF-α was acutely decreased after sildenafil (maximal response of -13pg/ml, 2h). The effect of sildenafil on fibrinogen, hsCRP and hsIL-6 and TNF-α was independent of the baseline values of these markers/mediators or the baseline testosterone level (all P<0.05). Soluble vascular cell adhesion molecule 1 (sVCAM-1) levels remained unchanged.
  
  
  CONCLUSIONS
  The present study shows for the first time the acute effect of sildenafil administration on pro-inflammatory markers/mediators in men with vasculogenic ED. This finding may have important implications in ED patients who are considered to be at increased cardiovascular risk.
authors.affiliation: Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece. Electronic address: cvlachop@otenet.gr.
authors.forename: Charalambos
authors.initials: C
authors.lastname: Vlachopoulos
authors.affiliation: Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Ioakeimidis
authors.affiliation: Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Rokkas
authors.affiliation: Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece.
authors.forename: Athanassios
authors.initials: A
authors.lastname: Angelis
authors.affiliation: Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Terentes-Printzios
authors.affiliation: Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece.
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
authors.affiliation: Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
mesh_terms: D015415:Biomarkers / Q000097:blood; D018592:Cross-Over Studies; D016207:Cytokines / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006801:Humans; D018783:Impotence, Vasculogenic / Q000097:blood / Q000188:drug therapy*; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage; D012307:Risk Factors; D000068677:Sildenafil Citrate / Q000008:administration & dosage*
chemical_list: D015415:Biomarkers; D016207:Cytokines; D058986:Phosphodiesterase 5 Inhibitors; D000068677:Sildenafil Citrate
keywords: Erectile dysfunction; Inflammatory markers/mediators; Phosphodiesterase-5 inhibitors; Sildenafil