Mechanism of Action of PDE5 Inhibitors in LUTS and ED: the NO-cGMP Pathway

摘要

The first phosphodiesterase type 5 inhibitor (PDE5-I), sildenafil, was originally developed and studied as a cardiovascular medication in systemic hypertension and angina pectoris. Further research has identified the essential role for PDE5 enzyme in the relaxation of penile erectile tissue through the nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) pathway, a mechanism that is widely accepted. For the last decade, on-demand PDE5 has been the first-line treatment for erectile dysfunction (ED). Potential beneficial effects of chronic treatment with PDE5-Is have recently been shown for male lower urinary tract symptoms (LUTS).