Document Detail

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.
MedLine Citation:
PMID:  17478034     Owner:  NLM     Status:  MEDLINE    
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 (2 g/d) alone (n=8) or combined with sildenafil (50 mg/d twice weekly) (n=8), sildenafil alone (50 mg/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<0.05). In patients treated with PLC plus sildenafil, a decrease in ICAM-1, P-selectin, and EDV values was observed compared with patients treated with sildenafil alone (p<0.05, p<0.01, p<0.001, respectively). IIEF-5 improved in all patients treated with PLC plus sildenafil or sildenafil alone (p<0.03, p<0.05, respectively). Four weeks posttreatment, patients treated with PLC plus sildenafil maintained the improvement of the IIEF-5 compared with patients on sildenafil alone (p=0.05). In patients on PLC treatment (with or without sildenafil), SI was correlated with IIEF-5 (p<0.001), glycemia with STW (p<0.03), and AGEs with IIEF-5 (p<0.01). CONCLUSION: PLC plus sildenafil was more effective in reducing SI and endothelial dysfunction markers in patients with type 2 diabetes and ED.
Susanna Morano; Elisabetta Mandosi; Mara Fallarino; Alessandra Gatti; Claudio Tiberti; Maurizio Sensi; Loredana Gandini; Barbara Buchetti; Luisa Lenti; Emmanuele Angelo Jannini; Andrea Lenzi
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-04-25
Journal Detail:
Title:  European urology     Volume:  52     ISSN:  0302-2838     ISO Abbreviation:  Eur. Urol.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-12     Completed Date:  2008-01-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7512719     Medline TA:  Eur Urol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  1768-74     Citation Subset:  IM    
Department of Clinical Sciences, "Sapienza" University, Rome, Italy.
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MeSH Terms
Antioxidants / administration & dosage*
Biological Markers
Carnitine / administration & dosage,  analogs & derivatives*
Diabetes Mellitus, Type 2 / complications*
Double-Blind Method
Drug Therapy, Combination
Endothelium, Vascular / drug effects*
Erectile Dysfunction / drug therapy*,  physiopathology
Hemoglobin A, Glycosylated / analysis
Middle Aged
Monocytes / drug effects*,  metabolism
Phosphodiesterase Inhibitors / administration & dosage*
Piperazines / administration & dosage*
Purines / administration & dosage
Reactive Oxygen Species / metabolism
Sulfones / administration & dosage*
Reg. No./Substance:
0/Antioxidants; 0/Biological Markers; 0/Hemoglobin A, Glycosylated; 0/Phosphodiesterase Inhibitors; 0/Piperazines; 0/Purines; 0/Reactive Oxygen Species; 0/Sulfones; 139755-83-2/sildenafil; 17298-37-2/propionylcarnitine; 541-15-1/Carnitine
Comment In:
Eur Urol. 2007 Dec;52(6):1774-5   [PMID:  17478036 ]
Eur Urol. 2007 Dec;52(6):1775-6   [PMID:  17478035 ]

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