Christ G J, Lerner S E, Kim D C, Melman A
Department of Urology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
J Urol. 1995 Jun;153(6):1998-2003.
Normal erectile physiology is heavily dependent on a delicate balance between the effects of endogenous vasoconstricting and vasorelaxing hormones on the tone of the corporal smooth muscle. Recent studies indicate that endothelin-1 (ET-1) is present and physiologically active in the human corpora. The primary goal of the present investigation was to further define the role of ET-1 in corporal physiology and to ascertain whether it might play a role in augmenting corporal tone in vivo, as reported in other vascular tissues. Thus, we conducted pharmacological studies of ET-1-induced steady-state contractions in isolated human corporal smooth muscle strips to determine if there were any detectable age- or diabetes-related alterations in ET-1-induced contractions. For statistical analysis, the patient population was divided into 2 age groups, A (< or = 59 years of age; = 11 patients) and B (> or = 60 years of age; n = 7 patients), and further subdivided into 2 diagnostic categories, diabetic (n = 7 patients) and nondiabetic (n = 11 patients). Construction of cumulative concentration response curves (CRCs) for ET-1-induced contractions revealed characteristically slow onset and long-lasting responses. Endothelin-1 CRC data were computer fit to the logistic equation to derive Emax (calculated maximal response), pEC50 (negative logarithm of the concentration that elicits one-half of the calculated maximal response) and slope factor (n) values. Two-factor analysis of variance revealed no detectable age- or diabetes-related alterations, nor any age-diabetes interaction in any of the logistic parameters. Furthermore, logistic analysis of ET-1 CRC data on 14 isolated corporal tissue strips derived from 3 potent patients with documented spontaneous erections revealed no differences in ET-1 contractility from that observed for patients with organic erectile dysfunction. Importantly, despite an apparent absence of age- or diabetes-related alterations in ET-1-induced steady-state contractions, preliminary studies demonstrated that coadministration of the alpha 1-adrenergic agonist phenylephrine and ET-1 produce much greater contractile responses than those observed in the presence of phenylephrine (PE) alone. Moreover, the magnitude of the augmentation was precisely that predicted by a model for simple additivity of agonist effects. Such observations suggest that the physiological relevance of ET-1 to corporal physiology may be related to its ability to augment the contractile responses of other vasomodulators present in the human corpora, in particular, perhaps modulating the contractile responses to sympathetic activity.
正常勃起生理机能在很大程度上依赖于内源性血管收缩和血管舒张激素对海绵体平滑肌张力的微妙平衡。最近的研究表明,内皮素-1(ET-1)存在于人体海绵体中且具有生理活性。本研究的主要目的是进一步明确ET-1在海绵体生理机能中的作用,并确定它是否如在其他血管组织中所报道的那样,在增强体内海绵体张力方面发挥作用。因此,我们对ET-1诱导的离体人海绵体平滑肌条稳态收缩进行了药理学研究,以确定在ET-1诱导的收缩中是否存在任何可检测到的与年龄或糖尿病相关的改变。为了进行统计分析,将患者群体分为2个年龄组,A组(年龄≤59岁;n = 11例患者)和B组(年龄≥60岁;n = 7例患者),并进一步细分为2个诊断类别,糖尿病患者(n = 7例患者)和非糖尿病患者(n = 11例患者)。构建ET-1诱导收缩的累积浓度反应曲线(CRC)显示出特征性的起效缓慢和持久反应。将内皮素-1的CRC数据用计算机拟合到逻辑方程,以得出Emax(计算得出的最大反应)、pEC50(引发计算得出的最大反应一半的浓度的负对数)和斜率因子(n)值。双因素方差分析显示,在任何逻辑参数中均未检测到与年龄或糖尿病相关的改变,也未发现年龄-糖尿病相互作用。此外,对来自3例有记录的自发性勃起的有效患者的14条离体海绵体组织条上的ET-1 CRC数据进行逻辑分析,结果显示ET-1的收缩性与器质性勃起功能障碍患者所观察到的并无差异。重要的是,尽管在ET-1诱导的稳态收缩中明显不存在与年龄或糖尿病相关的改变,但初步研究表明,α1肾上腺素能激动剂去氧肾上腺素与ET-1联合给药所产生的收缩反应比单独使用去氧肾上腺素(PE)时观察到的反应大得多。此外,增强的幅度恰好是由激动剂效应简单相加模型所预测的。这些观察结果表明,ET-1与海绵体生理机能的生理相关性可能与其增强人体海绵体中存在的其他血管调节剂的收缩反应的能力有关,特别是可能调节对交感神经活动的收缩反应。