de Souza Iara Leão Luna, Ferreira Elba Dos Santos, Vasconcelos Luiz Henrique César, Cavalcante Fabiana de Andrade, da Silva Bagnólia Araújo
Departamento de Ciências Biológicas e da Saúde, Universidade Estadual de Roraima, Boa Vista, Brazil.
Programa de Pós-graduação em Produtos Naturais e Sintéticos Bioativos, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, Brazil.
Front Pharmacol. 2022 Jul 5;13:895044. doi: 10.3389/fphar.2022.895044. eCollection 2022.
Erectile dysfunction is increasingly affecting men, from the elderly to young adults, being a sexual disorder related to the inability to generate or maintain a penile erection. This disorder is related to psychosocial factors such as anxiety, depression, and low self-esteem, to organic factors such as the presence of preexisting conditions like hypertension, diabetes and dyslipidemia. The pathophysiology of the disease is related to changes in the neurotransmission of the autonomic or the non-cholinergic non-adrenergic nervous system, as well as the release of local mediators, such as thromboxane A and endothelin, and hormonal action. These changes lead to impaired relaxation of cavernous smooth muscle, which reduces local blood flow and impairs penile erection. Currently, therapy is based on oral vasodilation, such as sildenafil, tadalafil, vardenafil and iodenafil, or by direct administration of these agents into the corpus cavernosum or by intraurethral route, such as alprostadil and papaverine. Despite this, studies that consolidate the understanding of its pathophysiological process contribute to the discovery of new more efficient drugs for the treatment of erectile dysfunction. In this sense, in the present work an extensive survey was carried out of the mechanisms already consolidated and the most recent ones related to the development of erectile dysfunction.
勃起功能障碍正越来越多地影响着男性，从老年人到年轻人，它是一种与无法产生或维持阴茎勃起相关的性功能障碍。这种障碍与心理社会因素有关，如焦虑、抑郁和自卑，也与器质性因素有关，如存在高血压、糖尿病和血脂异常等既往疾病。该疾病的病理生理学与自主神经系统或非胆碱能非肾上腺素能神经系统的神经传递变化、局部介质（如血栓素A和内皮素）的释放以及激素作用有关。这些变化导致海绵体平滑肌舒张功能受损，从而减少局部血流并损害阴茎勃起。目前，治疗方法基于口服血管舒张药物，如西地那非、他达拉非、伐地那非和阿伐那非，或通过将这些药物直接注入海绵体或经尿道途径给药，如前列地尔和罂粟碱。尽管如此，巩固对其病理生理过程理解的研究有助于发现治疗勃起功能障碍的更有效新药。从这个意义上说，在本研究中，我们对已经确定的以及与勃起功能障碍发展相关的最新机制进行了广泛的调查。
