Toward personalized sexual medicine: where is the evidence?

Abstract

The impaired erectile response in spontaneously hypertensive rats (SHR) is caused by increased signaling of RhoA/Rho‐kinase and decreased signaling of nitric oxide (NO). Icariin improves erectile function via upregulating multitargets in NO/cyclic guanosine monophosphate (NO/cGMP) pathway, which breviscapine accomplishes by downregulating RhoA/Rho‐kinase pathway.To investigate the effect and mechanism of icariin combined with breviscapine on the erectile function of SHR.Five 12‐week‐old male Wistar‐Kyoto (WKY) rats and 20 age‐matched male SHR were evenly randomized into WKY rats control group, SHR control group, icariin‐treated group, breviscapine‐treated group, and combined treatment group treated by vehicle, icariin, breviscapine, and icariin plus breviscapine, respectively, by gavage for four successive weeks. Maximum intracavernosal pressure/mean arterial pressure (ICPmax/MAP) and the expression of endothelial nitric oxide synthase (eNOS), neuronal nitric oxide synthase (nNOS), phosphodiesterase type 5 inhibitors (PDE5), and Rho‐associated, coiled‐coil containing protein kinase 1 and 2 (ROCK1 and ROCK2) in the cavernous tissues were determined.The ICPmax/MAP in the combined treatment group was significantly increased compared with SHR control group, icariin‐treated group, and breviscapine‐treated group. The expression of eNOS and nNOS was significantly higher in the combined treatment group than in SHR control group, icariin‐treated group, and breviscapine‐treated group (P < 0.05). The expression of PDE5 was significantly lower in the icariin‐treated group than in SHR control group (P < 0.05). The expression of ROCK1 was significantly lower in the combined treatment group than in other groups (P < 0.05). The expression of ROCK2 was significantly higher in SHR control group than in WKY rats control group, icariin‐treated group, and combined treatment group (P < 0.05). Among these groups, the expression of eNOS and nNOS was the strongest, and ROCK1 was the lowest in WKY rats control group.Icariin combined with breviscapine has synergistic effects on erectile function of SHR through different signal pathways. Li Y, Jiang J, He Y, Jiang R, Liu J, Fan Z, and Cheng Y. Icariin combined with Breviscapine improves the erectile function of spontaneously hypertensive rats. J Sex Med 2014;11:2143‐2152.