Investigation of Interactive Activity of Electro-Acupuncture on Pharmacokinetics of Sildenafil and Their Synergistic Effect on Penile Blood Flow in Rats.

Andy Huang,Yung-Yi Cheng,Tung-Hu Tsai,Navneet Dubey,Allen Chiu,Kuei-Ying Yeh

doi:10.3390/ijms19082153

Abstract

Erectile dysfunction (ED) is a disorder found in males throughout the world, which negatively affects relationships with partners with advancing age. Hence, in this study, we tested a combined novel treatment of electro-acupuncture (EA) and sildenafil citrate against ED. In addition to EA therapy, the sildenafil citrate, a phosphodiesterase 5 inhibitor, is a widely recognized drug that has achieved considerable success in the treatment of ED. However, the combined effect of both the EA and sildenafil has not yet been investigated. Hence, we aimed to examine the effect of EA on the pharmacokinetics and pharmacodynamics of sildenafil in rat plasma. The pharmacokinetic parameters were determined using ultra performance liquid chromatography (UPLC) after EA and sildenafil administration (10 mg/Kg). Following this, the pharmacodynamics was studied via blood flow pattern using developing Doppler images of the lower body and penis. The pharmacokinetic studies demonstrated that sildenafil significantly increases by administration of low-frequency EA. Further, the pharmacodynamic studies using Doppler imaging revealed an elevated blood flow in rat penis compared with lower body during combined treatment of sildenafil and low-frequency EA. These data indicate a synergistic therapeutic effect of EA and sildenafil for the treatment of ED.

Highlights

Erectile dysfunction (ED) is one of the major sexual problems throughout the world and has been reported to affect about 52% of males between the ages of 40 and 70 years [1,2]
The effect of acupuncture can be further improvised by applying some external stimulation factors, such as electrical stimulus in the form of electro-acupuncture (EA), to stimulate acupoints via pulsed electric voltage instead of providing a stimulus similar to that obtained by a manual needle [11]
The mean nominal concentration and mean observed concentration were represented by Cobs and Cnom, respectively, whereas precision was determined through relative standard deviation (RSD)

Summary

Introduction

Erectile dysfunction (ED) is one of the major sexual problems throughout the world and has been reported to affect about 52% of males between the ages of 40 and 70 years [1,2]. Various therapeutic alternatives for treatment of ED, including injection of the vasoactive drug, oral drug therapy, psychosexual therapy, revascularization, penile prostheses, and vacuum constriction devices, have been employed [3]. These therapies are limited because of their potency and related side effects like penile pain, cardiovascular disease, and deafness [4,5,6]. The EA stimulations at both high (80–100 Hz) and low frequency (2–4 Hz) have been reported for their effectiveness in the treatment of various disorders [12,13,14,15]. Though the exact mechanism of EA is not well established, it was reported that at low frequency, electrical stimulation imparts tonic response during stimulation; whereas, at high frequency, the phasic response is generated during the initial stage of stimulation [16]

Objectives

Methods

Results