title: α1A-Adrenergic Receptor Antagonism Improves Erectile and Cavernosal Responses in Rats With Cavernous Nerve Injury and Enhances Neurogenic Responses in Human Corpus Cavernosum From Patients With Erectile Dysfunction Secondary to Radical Prostatectomy.
abstract: Cavernous nerve injury (CNI) in rats and radical prostatectomy (RP) in men result in loss of nitrergic function and increased adrenergic-neurogenic contractions of cavernosal tissue.
  
  
  
  To evaluate the modulation of the α-adrenergic system as a strategy to relieve erectile dysfunction (ED) and functional cavernosal alterations induced by CNI.
  
  
  
  A non-selective α-blocker (phentolamine 1 mg/kg daily), a selective α1A-blocker (silodosin [SILOD] 0.1 mg/kg daily), or vehicle was orally administered for 4 weeks after bilateral crush CNI (BCNI). Erectile and neurogenic responses of the corpus cavernosum (CC) were evaluated. The acute effects of SILOD also were evaluated in vivo (0.03 mg/kg intravenously) and ex vivo (10 nmol/L). The effects of SILOD and tadalafil (TAD) on nitrergic relaxations were determined in human CC from patients with ED with a vascular etiology or ED secondary to RP.
  
  
  
  Erectile responses in vivo in rats and neurogenic contractions and relaxations of rat and human CC.
  
  
  
  Long-term treatment with SILOD significantly improved erectile responses and allowed for the potentiation of erectile responses by acute treatment with TAD (0.3 mg/kg intravenously) in rats with BCNI. SILOD partly recovered nitrergic relaxations and normalized neurogenic contractions in CC from rats with BCNI. Long-term treatment with SILOD partly prevented BCNI-induced decreases in neuronal nitric oxide synthase expression. Acute administration of SILOD (0.03 mg/kg intravenously) improved erectile responses in vivo and potentiated nitrergic relaxation and decreased neurogenic contractions ex vivo in CC from rats with BCNI. In human CC from patients with ED with a vascular etiology, TAD (30 nmol/L), SILOD (10 nmol/L), or their combination increased nitrergic relaxations. Potentiation by TAD was lost in human CC from patients with ED after RP but was recovered after co-treatment with SILOD.
  
  
  
  α-Adrenergic modulation, especially selective α1A-blockade, improves erectile and cavernosal functions after BCNI. Modulation of the adrenergic system, mainly in combination strategies, could have a role in the management of ED after RP.
authors.affiliation: Servicio de Urología, Hospital Universitario Puerta de Hierro, Madrid, Spain.
authors.forename: Juan I
authors.initials: JI
authors.lastname: Martínez-Salamanca
authors.affiliation: Serviço de Urologia, Hospital Santo Antonio, Porto, Portugal.
authors.forename: José M
authors.initials: JM
authors.lastname: La Fuente
authors.affiliation: Servicio de Histología-Investigación, Unidad de Investigación Cardiovascular (IRYCIS/UFV), Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Martínez-Salamanca
authors.affiliation: Servicio de Histología-Investigación, Unidad de Investigación Cardiovascular (IRYCIS/UFV), Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Argentina
authors.initials: A
authors.lastname: Fernández
authors.affiliation: Serviço de Urologia. Hospital Fernando da Fonseca, Amadora-Sintra, Portugal.
authors.forename: Augusto J
authors.initials: AJ
authors.lastname: Pepe-Cardoso
authors.affiliation: Serviço de Urologia, Hospital Santo Antonio, Porto, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Louro
authors.affiliation: Servicio de Urología, Hospital Universitario Puerta de Hierro, Madrid, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Carballido
authors.affiliation: Servicio de Histología-Investigación, Unidad de Investigación Cardiovascular (IRYCIS/UFV), Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Madrid, Spain. Electronic address: javier.angulo@hrc.es.
authors.forename: Javier
authors.initials: J
authors.lastname: Angulo
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology*; D000818:Animals; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009409:Nerve Crush / Q000009:adverse effects; D052248:Nitric Oxide Synthase Type I / Q000378:metabolism; D010410:Penile Erection / Q000187:drug effects; D010413:Penis / Q000098:blood supply; D059348:Peripheral Nerve Injuries / Q000150:complications; D011468:Prostatectomy / Q000009:adverse effects*; D051381:Rats; D017207:Rats, Sprague-Dawley; D018340:Receptors, Adrenergic, alpha-1 / Q000187:drug effects*; D000068581:Tadalafil / Q000494:pharmacology; D020196:Trauma, Nervous System / Q000150:complications
chemical_list: D000317:Adrenergic alpha-Antagonists; D018340:Receptors, Adrenergic, alpha-1; D000068581:Tadalafil; D052248:Nitric Oxide Synthase Type I
keywords: Cavernous Nerve Injury; Erectile Dysfunction; Neurogenic Relaxation; Prostatectomy; Rat and Human Corpus Cavernosum; Silodosin; Tadalafil; Type 5 Phosphodiesterase; α-Adrenergic Receptor