sildenafil-citrate and linsidomine

Intracavernous pharmacotherapy of erectile dysfunction has been established for over 10 years, with prostaglandin E1 (PGE1) being the standard substance with the lowest rate of side effects. Recent investigations deal with the identification of intracellular mechanisms of smooth muscle relaxation in cavernous tissue as the most important aspect of penile erection. Nitric oxide and specific phosphodiesterase-isoenzymes seem to play a central role. This resulted in clinical studies with the intracavernous injected nitric oxide-donor linsidomine (SIN 1) and the orally given phosphodiesterase-inhibitor sildenafil. Furthermore new ways of pharmaco-application are tested, e.g. transdermal treatment with nitroglycerin, minoxidil or papaverine, as well as intraurethral injection of prostaglandin E1.

Topics: Alprostadil; Dosage Forms; Enzyme Inhibitors; Erectile Dysfunction; Humans; Male; Molsidomine; Muscle Relaxation; Muscle, Smooth; Penile Erection; Phosphodiesterase Inhibitors; Piperazines; Purines; Sildenafil Citrate; Sulfones; Testosterone; Vasodilator Agents

The role of nitric oxide (NO)/cyclic GMP (cGMP) pathway in regulating detrusor smooth muscle (DSM) function is still to be elucidated. We have investigated the effects of NO donors and phosphodiesterase-5 (PDE5) inhibition on spontaneous excitations in DSM.. Multibundle DSM of the guinea-pig bladder generated spontaneous phasic contractions. The effects of sodium nitroprusside (SNP) and 3-morpholinosydnonimine (SIN-1), NO donors, 8-bromo-cyclicGMP (8-Br-cGMP), a cell-permeable cGMP analog and sildenafil, a PDE5 inhibitor on these contractions were examined. The effects of these agents on spontaneous action potentials were also studied using intracellular recording technique in single-bundle DSM.. SNP and SIN-1 enhanced spontaneous contractions in multibundle DSM and increased the frequency of spontaneous action potentials in single-bundle DSM. These excitatory effects were not antagonized by 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ), an inhibitor for guanylate cyclase, but were attenuated by cyclopiazonic acid (CPA), an inhibitor of sarco- and endoplasmic Ca ATPase (SERCA). 8-Br-cGMP invariably suppressed spontaneous contractility. Sildenafil inhibited spontaneous contractions in about 65% of multibundle DSM but had no effects on the remainder. In single-bundle DSM, sildenafil had no effect on spontaneous action potentials.. These results suggested that NO caused an enhancement of spontaneous contractions in DSM by accelerating spontaneous action potentials through cGMP-independent mechanisms, which may involve the Ca release from intracellular stores, whilst cGMP itself has inhibitory effects on DSM contractility. Sildenafil may indirectly suppress DSM contractility by diminishing synchronicity between functional units of DSM bundles without inhibiting excitability of DSM themselves.

Topics: Action Potentials; Animals; Calcium; Cyclic GMP; Electrophysiology; Female; Guinea Pigs; In Vitro Techniques; Indoles; Isometric Contraction; Male; Molsidomine; Muscle Contraction; Muscle, Smooth; Nitric Oxide; Nitric Oxide Donors; Nitroprusside; Phosphodiesterase Inhibitors; Piperazines; Purines; Signal Transduction; Sildenafil Citrate; Sulfones; Urinary Bladder

The present study addressed whether combined treatment with a phosphodiesterase type 5 inhibitor, sildenafil, and a nitric oxide donor, molsidomine, prevents development of pulmonary hypertension in chronic hypoxic rats. Two weeks of hypoxia increased right ventricular systolic pressure, and right ventricular and lung weight. Treatment with either sildenafil (10 mg/kg/day) or molsidomine (15 mg/kg/day) in drinking water reduced right ventricular systolic pressure and weight, while lung weight was unchanged. Combining sildenafil and molsidomine did not have additional effects compared to molsidomine alone. The number of muscularized pulmonary arteries with diameters below 50 microm was increased in vehicle and sildenafil-treated, but not in molsidomine-treated hypoxic rats. Acetylcholine relaxation was blunted in arteries from vehicle and molsidomine-treated, but not in sildenafil-treated rats. In conclusion, both sildenafil and molsidomine blunts pulmonary hypertension and right ventricular hypertrophy in chronic hypoxic rats, but no synergistic effects were observed.

Topics: Acetylcholine; Actins; Animals; Atrial Natriuretic Factor; Body Weight; Dose-Response Relationship, Drug; Drug Synergism; Enzyme Inhibitors; Guanylate Cyclase; Heart Ventricles; Hypertension, Pulmonary; Hypoxia; Lung; Male; Molsidomine; Muscle, Smooth; Oxadiazoles; Piperazines; Pulmonary Artery; Purines; Quinoxalines; Rats; Rats, Wistar; Sildenafil Citrate; Sulfones; Systole; Vasodilation; Vasodilator Agents

Relaxation of the corpus cavernosum smooth muscle is an absolute prerequisite of penile erection. Potassium channels play a role in the physiologic regulation of corporal smooth muscle tone. Among the several subtypes of potassium channels, Ca2 +-activated potassium channel (KCa channel) subtypes are thought to be the most physiologically relevant in the regulation of corporal smooth muscle tone. The purpose of this study was to investigate the effects of nitric oxide (NO) and sildenafil on the KCa channels and elucidate the mechanisms of action on the KCa channels in smooth muscle cells of the human corpus cavernosum. The conventional patch-clamp technique was applied to short-term cultured smooth muscle cells of the human corpus cavernosum. Single-channel currents were recorded in cell-attached or inside-out patches, and whole-cell currents were recorded in perforated-patches. In cell-attached patches, sildenafil alone did not activate the KCa channels but sildenafil enhanced the NO-induced activation of KCa channels. The open probability of KCa channels was increased significantly after application of NO donor, SIN-1 (100 microM) (47 +/- 7.1%, n = 10, P=0.002). The application of sildenafil (100 nM) with SIN-1 (100 microM) markedly increased the open probability of KCa channels (148 +/- 24%, n = 8, P < 0.001). The activation by SIN-1 or sildenafil with SIN-1 was completely blocked by pretreatment of the soluble guanylate cyclase inhibitor, ODQ (10 microM). In inside-out patches. SIN-1 or sildenafil with SIN-1 failed to activate KCa channels at pCa 7.5 (n=5). SIN-1 increased the whole cell outward K+ currents in all holding potential. The increased IK by SIN-1 was inhibited by charybdotoxin (CTX) about 70%. These data provide compelling evidence consistent with the involvement of the KCa channel subtype in modulating NO-induced relaxation responses in human corporal smooth muscle. Furthermore, the activation of KCa channels is thought to be mediated by activation of soluble guanylate cyclase, leading to increased intracellular levels of cyclic GMP and the subsequent activation of protein kinase rather than direct NO effect.

Topics: Cells, Cultured; Drug Synergism; Electric Conductivity; Electrophysiology; Humans; Male; Molsidomine; Muscle, Smooth; Nitric Oxide; Nitric Oxide Donors; Penis; Piperazines; Potassium Channels; Potassium Channels, Calcium-Activated; Purines; Sildenafil Citrate; Sulfones

The functional role of nitric oxide (NO) and the guanylate cyclase/cGMP second messenger system was investigated in the mouse bladder. Electrical field stimulation and the NO-donor 3-morpholino-sydnonimin hydrochloride (SIN-1) did not induce relaxation of the carbachol-precontracted bladder. However, sodium nitroprusside (10(-3) M) was found to enhance the contractile response to electrical field stimulation by 24+/-6% (n=8; P<0.05) without affecting the contractile response to carbachol. The enhancement of bladder contractility evoked by sodium nitroprusside was inhibited by the guanylate cyclase inhibitor 1H-[1,2, 4]oxadiazolo[4,3-a]quinoxalime-1-one (ODQ; 10(-6) M). Incubation of bladder strips with SIN-1 and sodium nitroprusside caused an increase in cGMP accumulation as measured by radioimmunoassay. Immunohistochemical studies showed cGMP-immunoreactivity in nerve fibres and in stromal cells, but not in smooth muscle bundles after exposure to NO-donors. The results show that NO-donors have no inhibitory effect on smooth muscle tone in the mouse bladder, but that NO may have a functional role as an excitatory neuromodulator. The targets of endogenous NO in the bladder may be the demonstrated cGMP-positive structures, i.e., nerves and stromal cells.

Topics: Animals; Arginine; Carbachol; Cyclic AMP; Cyclic GMP; Dose-Response Relationship, Drug; Electric Stimulation; Enzyme Inhibitors; Female; In Vitro Techniques; Mice; Mice, Inbred BALB C; Molsidomine; Muscle Relaxation; Muscle, Smooth; Nitric Oxide Donors; Nitric Oxide Synthase; Nitroarginine; Nitroprusside; Phosphodiesterase Inhibitors; Piperazines; Piperidines; Purines; Quinazolines; Sildenafil Citrate; Sulfones; Urethra; Urinary Bladder