Therapeutic Strategies to Scavenge ROS in the Penis

The effect of antioxidants on ED was evaluated in several diseased animal models. Gene transfer of SOD in aged animals was found to reduce superoxide anion formation and normalize erectile function [37]. Several antioxidants, such as SOD, vitamin E, ascorbic acid, melatonin, alpha-lipoic acid and gamma-linolenic acid, and per-oxynitrite decomposition catalyst, were found to partially or completely improve diabetic vasculopathy and autonomic neuropathy in the penis and erectile function

[46, 48, 49, 52, 118, 120-125]. SOD and catalase [96, 97] reverse hyperhomo-cysteinemia-induced superoxide production in the penis [96, 97]. More basic science and clinical studies are, however, needed to delineate the effects of antioxidant therapy on oxidative stress in the penis and ED in order to obtain scientific ground which could be exploited for therapeutic purposes. Currently, antioxidants are not considered for treatment or recommendation for therapy for ED.

It is, however, becoming increasingly recognized that removal of ROS in a non-targeted, nonspecific fashion by scavenging is not always efficacious in reversing downstream pathologies, such as cardiovascular pathologies and ED, possibly due to the low bioavailability of the antioxidants at the proper localization and at the optimal time point, and unwanted cessation of physiologic functions regulated by ROS [118,120,126]. Several randomized clinical trials demonstrate that long-term supplementation with antioxidants such as vitamin E [127] and vitamin C [128] may not prevent cardiovascular events and may even increase the risk of heart failure in patients with vascular diseases.

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