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Phosphodiesterases (PDEs) and PDE inhibitors for treatment of LUTS
Author(s) -
Andersson KarlErik,
Uckert Stefan,
Stief Christian,
Hedlund Petter
Publication year - 2007
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.20485
Subject(s) - tadalafil , cyclic guanosine monophosphate , lower urinary tract symptoms , sildenafil , medicine , phosphodiesterase , cgmp specific phosphodiesterase type 5 , erectile dysfunction , bladder outlet obstruction , intracellular , prostate , pharmacology , endocrinology , enzyme , microbiology and biotechnology , chemistry , biology , biochemistry , cancer , nitric oxide
Abstract Lower urinary tract (LUT) smooth muscle can be relaxed by drugs that increase intracellular concentrations of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). Both of these substances are degraded by phosphodiesterases (PDEs), which play a central role in the regulation of smooth muscle tone. The distribution and functional significance of PDE enzymes vary in different tissues of the LUT. Targeting specific PDE isoenzymes should thus allow organ selectivity. PDE 4 and 5 appear to predominate in the prostate, PDE 1 and 4 are thought to influence detrusor smooth muscle function, and PDE 5 may be functionally important in the urethra and vasculature. Studies on the use of PDE inhibitors to treat various LUT symptoms (LUTS), have yielded favorable results. Thus, positive effects of the PDE 5 inhibitors sildenafil and tadalafil on symptoms and quality of life in men with LUTS, erectile dysfunction, and BPH have also been demonstrated. These effects may be due to effects on cGMP signaling and/or modification of afferent input from bladder, urethral, and prostate tissue. This review gives an update on the distribution of PDEs in structures relevant for LUT function, and discusses how inhibition of these enzymes can contribute to beneficial effects on LUTS. Information for the review was obtained from searches of the PubMed database, and from the authors' files. Neurourol. Urodynam. 26:928–933, 2007. © 2007 Wiley‐Liss, Inc.