Abstract

Background: The phosphodiesterase type 5 inhibitor (PDE5I) tadalafil, in addition to its therapeutic role, has shown antioxidant effects in different in vivo models. Supplementation with antioxidants has received interest as a suitable tool for preventing or reducing exercise-related oxidative stress, possibly leading to the improvement of sport performance in athletes. However, the use/abuse of these substances must be evaluated not only within the context of amateur sport, but especially in competitions where elite athletes are more exposed to stressful physical practice. To date, very few human studies have addressed the influence of the administration of PDE5Is on redox balance in subjects with a fitness level comparable to elite athletes; therefore, the aim of this study was to investigate for the first time whether acute ingestion of tadalafil could affect plasma markers related to cellular damage, redox homeostasis, and blood polyamines levels in healthy subjects with an elevated cardiorespiratory fitness level. Methods: Healthy male volunteers (n = 12), with a VO2max range of 40.1–56.0 mL/(kg × min), were administered with a single dose of tadalafil (20 mg). Plasma molecules related to muscle damage and redox-homeostasis, such as creatine kinase (CK), lactate dehydrogenase (LDH), total antioxidant capacity (TAC), reduced/oxidized glutathione ratio (GSH/GSSG), free thiols (FTH), antioxidant enzyme activities (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx)), as well as thiobarbituric acid reactive substances (TBARs), protein carbonyls (PrCAR), and polyamine levels (spermine (Spm) and spermidine (Spd)) were evaluated immediately before and 2, 6 and 24 hours after the acute tadalafil administration. Results: A single tadalafil administration induced an increase in CK and LDH plasma levels 24 after consumption. No effects were observed on redox homeostasis or antioxidant enzyme activities, and neither were they observed on the oxidation target molecules or polyamines levels. Conclusion: Our results show that in subjects with an elevated fitness level, a single administration of tadalafil induced a significant increase in muscle damage target without affecting plasma antioxidant status.

Highlights

  • Many healthy athletes who participate in sports which require endurance, and/or who compete in hypoxic conditions, misuse phosphodiesterase type 5 inhibitor (PDE5I) to improve performance, as these substances are not prohibited by the

  • We found that 24 hours after tadalafil ingestion, creatine kinase and lactate dehydrogenase plasma levels resulted in increased respect T0 (Table 2)

  • We demonstrated in a previous paper that a prolonged tadalafil ingestion caused an increase in malondialdehyde (TBARs) and protein carbonylation

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Summary

Introduction

Phosphodiesterase type 5 inhibitors (PDE5Is) (e.g., avanafil, sildenafil, vardenafil, tadalafil), represent a class of drugs routinely consumed worldwide, because of their great therapeutic role for the treatment of erectile dysfunction (ED) (avanafil, sildenafil, vardenafil, tadalafil), and pulmonary arterial hypertension (sildenafil and tadalafil), and for the management, in men, of moderate to severe lower urinary tract symptoms (LUTS)secondary to benign prostatic obstruction with or without ED (tadalafil) acting mainly via the nitric oxide (NO) and cyclic guanosine monophosphate (NO–cGMP) pathways [1,2,3,4,5,6,7,8].Recently, in addition to their role in the treatment of pathologies, in vitro and in vivo studies reported that PDE5Is (e.g., sildenafil, vardenafil, tadalafil) possess antioxidant effects in different tissues/organs [9,10,11,12,13,14]. In a model of a fetal rat brain with an ischemia/reperfusion injury, tadalafil was found to be more effective than sildenafil in reducing the endogenous superoxide formation by increasing the antioxidant enzyme activity of glutathione peroxidase (GPx) [16]. The phosphodiesterase type 5 inhibitor (PDE5I) tadalafil, in addition to its therapeutic role, has shown antioxidant effects in different in vivo models. Plasma molecules related to muscle damage and redox-homeostasis, such as creatine kinase (CK), lactate dehydrogenase (LDH), total antioxidant capacity (TAC), reduced/oxidized glutathione ratio (GSH/GSSG), free thiols (FTH), antioxidant enzyme activities (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx)), as well as thiobarbituric acid reactive substances (TBARs), protein carbonyls (PrCAR), and polyamine levels (spermine (Spm) and spermidine (Spd))

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