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Volume 10, Issue 1 (January 2008) 10, 54–59; 10.1111/j.1745-7262.2008.00368.x

Emerging neuromodulatory molecules for the treatment of neurogenic erectile dysfunction caused by cavernous nerve injury

Anthony J Bella, Guiting Lin, Ilias Cagiannos and Tom F Lue

1.Department of Surgery, Division of Urology, Ottawa Health Research Institute, University of Ottawa, Ottawa K1Y4E9, Canada
2.Department of Neuroscience, Ottawa Health Research Institute, University of Ottawa, Ottawa K1Y4E9, Canada
3.Knuppe Molecular Urology Laboratory, University of California, San Francisco, CA 94143, USA
4.Department of Urology, University of California, San Francisco, CA 94143, USA

Correspondence: Dr Anthony J Bella, The Ottawa Hospital, Civic Campus, B3-Division of Urology, 1053 Carling Avenue, Ottawa K1Y 4E9, Canada. Fax: +1-613-761-5305. E-mail: anthonybella@gmail.com

Advance online publication 1 January 2008


Advances in the neurobiology of growth factors, neural development, and prevention of cell death have resulted in a heightened clinical interest for the development of protective and regenerative neuromodulatory strategies for the cavernous nerves (CNs), as therapies for prostate cancer and other pelvic malignancies often result in neuronal damage and debilitating loss of sexual function. Nitric oxide released from the axonal end plates of these nerves within the corpora cavernosa causes relaxation of smooth muscle, initiating the haemodynamic changes of penile erection as well as contributing to maintained tumescence; the loss of CN function is primarily responsible for the development of erectile dysfunction (ED) after pelvic surgery and serves as the primary target for potential neuroprotective or regenerative strategies. Evidence from pre-clinical studies for select neuromodulatory approaches is reviewed, including neurotrophins, glial cell line-derived neurotrophic factors (GDNF), bone morphogenic proteins, immunophilin ligands, erythropoetin (EPO), and stem cells.

Keywords: erectile dysfunction, prostate cancer, radical prostatectomy, postoperative complications, neuroprotection, nerve regeneration, neurotrophins, brain-derived nerve growth factor, immunophilin ligands, stem cells

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