Nitric oxide donor, linsidomine chlorhydrate (SIN-1), in the diagnosis and treatment of erectile dysfunction: Critical appraisal and review of the literature

doi:10.1007/BF02564750

Paper

Nitric oxide donor, linsidomine chlorhydrate (SIN-1), in the diagnosis and treatment of erectile dysfunction: Critical appraisal and review of the literature

Published 2007 · H. Wegner, H. Knispel, T. Meier

International Urology and Nephrology

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Abstract

Recent experimental work has demonstrated that nitric oxide (NO) is the neutrotransmitter responsible for cavernous smooth muscle relaxation. Different studies on the performance of the direct NO-donor linsidomine chlorhydrate (SIN-1) in patients with erectile dysfunction have come to conflicting results ranging from highest praise to complete dismissal. We reviewed all published studies on the use of SIN-1 for intracorporeal injection in erectile failure including our own. To this date, 3 groups published their data. Only the uncontrolled data from Hannover claim good results. The controlled data from Hamburg and Berlin on patients with erectile failure due to venous leakage, to a mixed aetiology in a double-blind fashion and to mixed aetiology with drug increase (1 mg versus 2 mg of SIN-1) showed a significantly worse performance of SIN-1 compared to the standard drug for penile injection, prostaglandin E1. We conclude that there is no place for linsidomine chlorhydrate in either the diagnosis or the treatment of erectile dysfunction.

Literature Review

Study Snapshot

Linsidomine chlorhydrate (SIN-1) has no place in the diagnosis or treatment of erectile dysfunction due to its poor performance compared to prostaglandin E1.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Nitric oxide donor, linsidomine chlorhydrate (SIN-1), in the diagnosis and treatment of erectile dysfunction: Critical appraisal and review of the literature

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References

Efficacy of linsidomine chlorhydrate, a direct nitric oxide donor, in the treatment of human erectile dysfunction: results of a double-blind cross over trial.

Linsidomine chlorhydrate is not a useful alternative to prostaglandin E1 for treating erectile dysfunction, and the combination of SIN-1 and Urapidil is equally effective but has intolerable side effects.

Levels of nitric oxide metabolites do not increase during penile erection.

Nitric oxide metabolites do not significantly change during penile erection, suggesting that alternative testing methods are needed to determine their role in erectile dysfunction.

Actions of 3-morpholinosydnonimin (SIN-1) on rabbit isolated penile erectile tissue.

SIN-1, zaprinast, and SNP effectively relax rabbit penile erectile tissue, with additional mechanisms beyond stimulation of adrenergic neurotransmission and guanylate cyclase in smooth muscle cells.

Nitric oxide synthase: a new diagnostic tool for neurogenic impotence.

Nitric oxide synthase (NOS) staining in cavernosal biopsy specimens can effectively diagnose neurogenic impotence due to cavernous nerve damage, providing valuable insight into patient cavernous nerve integrity.

Effect of nitric oxide-donor, linsidomine chlorhydrate, in treatment of human erectile dysfunction caused by venous leakage.

Linsidomine chlorhydrate (SIN-1) is not superior to prostaglandin E 1 (PGE1) in treating erectile dysfunction caused by venous leakage, and nitric oxide-mediated smooth muscle relaxation does not play a role in venous leakage.

Citations

Toll-Like Receptor 4–Mediated Nuclear Factor Kappa B Activation Is Essential for Sensing Exogenous Oxidants to Propagate and Maintain Oxidative/Nitrosative Cellular Stress

Exogenous oxidants can induce and maintain inflammation by acting mainly through a TLR4-dependent pathway, with implications in many chronic human ailments.

The Role of Nitric Oxide in Erectile Dysfunction: Implications for Medical Therapy

Nitric oxide plays a crucial role in erectile dysfunction, and oral PDE-5 inhibitors have shown high success in improving erectile function in patients.