Dysfonction érectile

Résumé

La dysfonction érectile, également appelée « dysérection », « insuffisance érectile » ou « trouble de l'érection » (et autrefois, quoique de façon imprécise, l'« impuissance » ; voir « Terminologie » ci-dessous), consiste, soit dans l'impossibilité durable d'obtenir une érection adéquate, soit de ne pouvoir la maintenir si elle est obtenue avec une rigidité pénienne suffisante pour l'accomplissement de l'acte sexuel au moment précis de la pénétration...ou pour atteindre l'orgasme par la masturbation. Lorsqu'elle ne consiste que dans une absence de désir sexuel, il est alors question d'aphanisis. Le diabète, le tabagisme et l'alcoolisme sont des facteurs de risque reconnus importants de dysfonction érectile, sans qu'il y ait besoin d'avoir d'autres maladies. Mais les troubles d'érection sont le plus souvent liés à des facteurs psychologiques ou interpersonnels. Terminologie La dysfonction érectile est désignée de plusi

Source officielle

https://fr.wikipedia.org/wiki/Dysfonction_%C3%A9rectile

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Aims:Diminazene aceturate, a putative ACE2 activator, is susceptible to cleavage resulting in the formation of paminobenzamidine (PAB). This study aimed to investigate the effects of PAB in addressing cardiovascular dysfunctions in spontaneously hypertensive rats (SHR). Main methods:Acute effects of PAB on mean arterial pressure (MAP), heart rate (HR), and aortic (AVC) and mesenteric vascular conductance (MVC) were evaluated in anesthetized SHR. Isolated aortic rings and the Langendorff technique were used to investigate the acute and chronic effects of PAB in the artery and heart. Chronic treatment with PAB (1 mg/kg, gavage) was carried out for 60 days. During this period, systolic blood pressure (SBP) and HR were measured by tail-cuff plethysmography. After the treatment, the left ventricle was collected for histology analyses, western blotting, and ACE2 activity. Key findings:Bolus infusion of PAB acutely reduced MAP and increased both AVC and MVC in SHR. Additionally, PAB induced coronary and aorta vasodilation in isolated organs from Wistar and SHR in an endothelialdependent manner. The chronic PAB treatment in SHR significantly attenuated the increase of SBP and improved the aorta vasorelaxation induced by acetylcholine and bradykinin-induced coronary vasodilation. In addition, chronic treatment with PAB attenuated the cardiomyocyte hypertrophy and extracellular matrix deposition in hearts from SHR. PAB did not alter the protein expression of the AT1, AT2, Mas, ACE, ACE2, or ACE2 activity. Significance:PAB induced beneficial effects on cardiovascular dysfunctions induced by hypertension, suggesting that this molecule could be used in the development of new drugs for the treatment of cardiovascular diseases.

PERGAMON-ELSEVIER SCIENCE LTD2022

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Multidisciplinary Approach to Treat Erectile Dysfunction

Mikaël Nils Sturny

Erectile dysfunction (ED) is a widespread disease affecting approximately 20% of men. With a rising incidence due to the global ageing of the world population, it is estimated that over 322 million patients will be affected in 2025. While not being a lifethreatening disease, ED has a strong detrimental impact on the patientâs quality of life, commonly leading to a reduction of work productivity, anxiety, chronic stress, depression or loss of self-esteem. Despite all the recent advances in understanding the molecular mechanisms and pathophysiology of ED, and the discovery of effective oral treatments that are the PDE5 inhibitors (such as ViagraÂ®), there is still an important portion of the population that does not respond to this therapy. Therefore, they unfortunately resort on problematic, uncomfortable, and invasive last-resort solutions due to the lack of better alternatives. In addition, current treatments are inducing assisted erection rather than handling the root cause of the disease. Considering the limited number of strategies currently existing for the treatment of ED and their drawbacks, there is an urgent need for alternative therapies. Due to the fact that both vascular and neural components are required to induce and maintain a satisfactory erectile response, as well as the multifactorial origins of ED, new therapies able to combine multidisciplinary approaches would increase the chances of new treatment success. Therefore, this thesis focuses on different multidisciplinary strategies attempting to provide novel therapies to alleviate ED or its causes. In the first part of this thesis, we have investigated the anti-fibrotic capabilities of a vasoactive endogenous peptide called Apelin-13 on a mouse model of ED, providing promising results and pointing out Apelin as a candidate for the development of fibrosis-associated ED treatments. Secondly, we have developed a novel concept enabling the neurostimulation of the cavernous nerves (CN) to induce penile erection. This thesis shows the first intraoperative proof of principle in humans, opening the way for the development of an innovative medical device for the neuromodulation of erectile function to treat neurogenic ED. Finally, we have studied further the effects of CN low-intensity electrostimulation (LIES), another application of nerve electrical stimulation, with the potential of promoting CN regeneration. We observed a significant protective effect of LIES on penile tissue structure and functions following nerve trauma in a rat model of cavernous nerve injury. Altogether, the work underwent in this thesis add to the development of more effective and comfortable treatment options to alleviate ED, which could not only improve the quality of life of patients but could also reduce the burden and cost this disease places on medical and public health systems.

EPFL2020

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Low-Intensity Electrostimulation Enhances Neuroregeneration and Improves Erectile Function in a Rat Model of Cavernous Nerve Injury

Nikolaos Stergiopulos, Mikaël Nils Sturny

Background: Neurogenic erectile dysfunction (ED) following radical prostatectomy (RP) is a frequent complication often leading to erectile tissue remodeling and permanent ED. Low-intensity electrostimulation (LIES) has been shown to enhance peripheral nerve regeneration, however, its application on cavernous nerves (CN) has never been investigated. Aims: To investigate whether LIES enhances CN regeneration, improves erectile function (EF) recovery, and prevents corpora cavernosal remodeling after CN injury, which is a principal factor for ED following RP. Methods: Adult male Sprague-Dawley rats were divided into Sham, Bilateral Cavernous Nerve Injury (BCNI), and BCNI + LIES (1V, 0.1ms, 12Hz, 1h/day). After 7days, EF was assessed (ICP measurement). Penes and CN were collected formolecular analyses of TGF-beta 1, Il-6, CRP, eNOS, ERK and AKT protein levels in corpus cavernosum (CC), and immunohistological analysis of DHE, total collagen and alpha-SMA in CC and S-100, Tub-III, DAPI, TUNEL, and nNOS in CN. Outcomes: Effects of LIES on EF, erectile tissue remodeling and CN structure. Results: EF was decreased (P < .05) 7 days after BCNI and increased (P < .05) by LIES. Intracavernosal reactive oxygen species (DHE) was increased (P < .05) after BCNI and normalized by LIES. Protein expressions of TGF-beta 1, IL-6, and CRP were increased in the penis (P < .05) after BCNI and normalized by LIES. The alpha-SMA and/or total collagen ratio was decreased (P < .05) after BCNI in the penis and normalized by LIES. Protein expression ratio of p-ERK/ERK and p-AKT/AKT did not change after BCNI but increased (P

ELSEVIER SCI LTD2022

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Multidisciplinary Approach to Treat Erectile Dysfunction

Mikaël Nils Sturny

EPFL2020