Abstract
Despite the development of effective oral phosphodiesterase type 5 (PDE5) inhibitors for treatment of erectile dysfunction (ED), millions of men remain refractory to this class of drug. Clearly, novel molecular targets in the corpus cavernosum smooth muscle (CCSM) need to be identified and evaluated for the potential in development of additional oral agents or gene therapy for ED. This review examines intracellular molecular mechanisms known to promote CCSM relaxation. In addition, this paper reviews CCSM contractile pathways, which when inhibited promote CCSM relaxation, along with the effects of various pathologies on the molecular components of these pathways. The data reviewed in this manuscript suggest that in addition to PDE5, there are numerous other “targetable” molecules in both the CCSM relaxation and contraction pathways that have the potential to lead to effective new therapeutic agents to treat ED in the near future.
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