Editorial Comment on: Antioxidant Treatment Associated with Sildenafil Reduces Monocyte Activation and Markers of Endothelial Damage in Patients with Diabetic Erectile Dysfunction: A Double-Blind, Placebo-Controlled Study

Abstract

Abstract Objective To investigate the synergic effect of propionyl L-carnitine (PLC) plus sildenafil in reducing monocyte oxidative activity and endothelial dysfunction markers in diabetic patients with erectile dysfunction (ED). Methods Thirty-two type 2 diabetic patients with ED (according to the International Index of Erectile Function-5 [IIEF-5]) were randomized to receive PLC (2g/d) alone ( n =8) or combined with sildenafil (50mg/d twice weekly) ( n =8), sildenafil alone (50mg/d twice weekly) ( n =8), or placebo ( n =8) in a double-blind, fixed-dose study. Monocyte oxidative activity (stimulation index [SI]), intercellular adhesion molecule-1 [ICAM-1], P-selectin, advanced glycation end product (AGE) levels, Doppler sonography (recording peak systolic velocity [PSV]; end diastolic velocity [EDV]; systolic wave time [SWT]; resistive index [RI]), and IIEF score were evaluated before and after 12 wk of treatment; IIEF-5 was evaluated again 4 wk posttreatment. Results SI was reduced by treatment with PLC alone or combined with sildenafil ( p p p p p p p =0.05). In patients on PLC treatment (with or without sildenafil), SI was correlated with IIEF-5 ( p p p Conclusion PLC plus sildenafil was more effective in reducing SI and endothelial dysfunction markers in patients with type 2 diabetes and ED.