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This study reports that “Erectile
dysfunction (ED) is caused by a variety of pathogenic factors,
particularly impaired formation and action of
NO.”
Nitric
oxide and penile erectile function.
N. Toda, K. Ayajiki, and T.
Okamura,Department of Pharmacology, Shiga University of Medical
Science, Otsu,
Japan.
n.toda.toyama-bldg@orion.ocn.ne.jp,
Pharmacol Ther. 2005 May;106(2):233-66. Epub 2005 Mar 2.
The discovery of nitric oxide
(NO) as an intercellular messenger or neurotransmitter opened a new
era for identifying the important
mechanisms underlying physiological and pathophysiological events
in autonomically innervated organs and tissues; it also provided the
way
for development of new therapeutics based on a novel concept of molecule
and cell interaction. Endothelium-derived relaxing factor
(EDRF) discovered by Furchgott and Zawadzki has been proved to be NO, a
labile gaseous molecule, that modulates vascular tone,
platelet aggregation and adhesion, and vascular smooth muscle
proliferation. Later, NO was determined to act as a non-adrenergic,
non-
cholinergic (NANC) neurotransmitter of postganglionic parasympathetic
nerve fibers, innervating a variety of smooth muscles including the
penile corpus cavernosum (CC). The nerve is called "nitrergic" or "nitroxidergic". Although
CC sinusoidal endothelial cells also produce and
liberate NO in response to chemical and possibly physical stimuli,
roles of neurogenic NO in penile erection appear to be more
attractive
and convincing. NO is formed from L-arginine via catalysis by NO synthase
(NOS) isoforms, neuronal (nNOS), endothelial (eNOS), and
inducible NOS. NO from nerves and possibly endothelia plays a crucial role
in initiating and maintaining intracavernous pressure increase,
penile vasodilatation, and penile erection that are dependent on cyclic
GMP synthesized with activation of soluble guanylyl cyclase by NO
in smooth muscle cells. Erectile dysfunction
(ED) is caused by a variety of pathogenic factors, particularly
impaired formation
and action of NO. Thus, replenishment of this molecule or intracellular
cyclic GMP is expected so far to be the most
promising therapeutic measures for patients with ED. This
article includes recent advances in research on physiological roles
and
pathophysiological implications of NO in penile erection and on
novel therapy
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