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GYY4137 attenuates functional impairment of corpus cavernosum and reduces fibrosis in rats with STZ-induced diabetes by inhibiting the TGF-β1/Smad/CTGF pathway - 16/04/21

Doi : 10.1016/j.biopha.2021.111486 
Bedoor Qabazard a, , Mariam Yousif b, Alyaa Mousa c, Oludotun Adebayo Phillips d
a Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Kuwait University, Kuwait 
b Department of Pharmacology and Toxicology, Faculty of Medicine, Kuwait University, Kuwait 
c Department of Anatomy, Faculty of Medicine, Kuwait University, Kuwait 
d Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Kuwait University, Kuwait 

Corresponding author.

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Abstract

Erectile dysfunction (ED) is a common diabetic complication. Recent evidence has illuminated the role of hydrogen sulfide (H2S) as a dynamic mediator of the erection process. H2S is a potent endogenous relaxant gas. It has been shown to relax human and animal penile tissue in vitro and induce erection in animals in vivo. The reported penile expression of H2S-synthesizing enzymes also supports the potential role of the endogenous L-cysteine/H2S pathway in penile homeostasis. Several pathological changes take place in the diabetic penile tissue, including inflammation, oxidative stress, neuropathy and fibrosis of the corpus cavernosum (CC), the major erectile structure of the penis. The present study is experimental and has been performed in the diabetic rat model. The study will investigate the role of H2S as a potential protective mediator against diabetes-induced structural and functional alterations in the CC by examining if it: (1) reduces corporal contraction and/or enhances corporal relaxation following pharmacological stimulation, (2) attenuates fibromuscular changes in diabetic CC, and (3) whether there is a link with H2S plasma/urine level and CC tissue generation, as well as studying the expression of some proteins in the transforming growth factor (TGF)-β1-associated pathway. The major findings of the study reveal that- compared to the nondiabetic controls - the diabetic animals CC showed: (1) augmented contraction and attenuated relaxation in response to phenylephrine and carbachol, respectively, (2) marked fibromuscular degeneration with a significantly lower smooth muscle/collagen ratio and upregulation of TGF-β-1/Smad/CTGF fibrosis signaling pathway, (3) reduced H2S plasma and urinary levels and cavernosal tissue generation. Chronic GYY4137 treatment prevented most of these pathological changes in diabetic CC, thus may be considered a potential new strategy for the prevention and/or treatment of diabetes-induced ED.

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Highlights

GYY4137 did not affect the blood glucose level of the STZ-induced diabetic rats, indicating that it does not act through improving glycemic control.
Phenylephrine-induced contraction was augmented and carbachol-induced relaxation was attenuated in the cavernosum strips from diabetic rats, indicating the presence of functional impairment. These effects were prevented with GYY4137, thus revealing a potential protective effect.
Plasma and urinary H2S levels and H2S enzymatic generation in isolated CC tissues were significantly lower in diabetic animals, suggesting a possible involvement of the endogenous H2S in diabetes-induced erectile impairment.
Penile tissues from diabetic rats exhibited marked degenerative changes in the smooth muscle cells and a significantly lower smooth muscle/collagen ratio. GYY4137-treated diabetic rats show significant increase in smooth muscle/collagen ratio compared to untreated diabetic rats, indicating a potential protective effect for GYY4137.
Diabetic CC showed an upregulation of TGF-β-1/Smad/CTGF signaling pathway involved in tissue fibrosis, which was prevented by GYY4137.

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Keywords : GYY4137, Hydrogen sulfide, Corpus cavernosum, Erectile dysfunction, Diabetes


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