Cited by 1,006Sexual function and dysfunction studiesNitric Oxide and Endothelin EffectsUrinary Bladder and Prostate Research

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Nitric Oxide as a Mediator of Relaxation of the Corpus Cavernosum in Response to Nonadrenergic, Noncholinergic Neurotransmission

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Rajfer, Jacob, Aronson, William J., Bush, Peggy A., Dorey, Frederick J., Ignarro, Louis J.·1992·New England Journal of Medicine

DOI 10.1056/nejm199201093260203

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Abstract

BACKGROUND: Nitric oxide has been identified as an endothelium-derived relaxing factor in blood vessels. We tried to determine whether it is involved in the relaxation of the corpus cavernosum that allows penile erection. The relaxation of this smooth muscle is known to occur in response to stimulation by nonadrenergic, noncholinergic neurons. METHODS: We studied strips of corpus cavernosum tissue obtained from 21 men in whom penile prostheses were inserted because of impotence. The mounted smooth-muscle specimens were pretreated with guanethidine and atropine and submaximally contracted with phenylephrine. We then studied the smooth-muscle relaxant responses to stimulation by an electrical field and to nitric oxide. RESULTS: Electrical-field stimulation caused a marked, transient, frequency-dependent relaxation of the corpus cavernosum that was inhibited in the presence of N-nitro-L-arginine and N-amino-L-arginine, which selectively inhibit the biosynthesis of nitric oxide from L-arginine. The addition of excess L-arginine, but not D-arginine, largely reversed these inhibitory effects. The specific liberation of nitric oxide (by S-nitroso-N-acetylpenicillamine) caused rapid, complete, and concentration-dependent relaxation of the corpus cavernosum. The relaxation caused by either electrical stimulation or nitric oxide was enhanced by a selective inhibitor of cyclic guanosine monophosphate (GMP) phosphodiesterase (M&B 22,948). Relaxation was inhibited by methylene blue, which inhibits cyclic GMP synthesis. CONCLUSIONS: Our findings support the hypothesis that nitric oxide is involved in the nonadrenergic, noncholinergic neurotransmission that leads to the smooth-muscle relaxation in the corpus cavernosum that permits penile erection. Defects in this pathway may cause some forms of impotence.

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Authors: Rajfer, J., Aronson, W. J., Bush, P. A., Dorey, F. J., & Ignarro, L. J.
Affiliations: University of California, Los Angeles (US)
ORCID: Aronson, William J.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 1992-01-09
Volume: 326
Issue: 2
Pages: 90-94
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejm199201093260203
OpenAlex: W2056147576
Cited by: 1,006
References: 30
Citations by year: 2026: 4 · 2025: 8 · 2024: 5 · 2023: 11 · 2022: 12 · 2021: 11 · 2020: 13 · 2019: 14 · 2018: 15 · 2017: 17 · 2016: 17 · 2015: 17 · 2014: 26 · 2013: 22 · 2012: 30
FWCI: 50.38
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01hl040922-11, 5r01hl035014-12)
National Heart, Lung, and Blood Institute (HL-35014, HL 40922)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
Keywords: nitric oxide, corpus cavernosum, penile erection, non-adrenergic non-cholinergic neurotransmission, smooth muscle relaxation, erectile dysfunction, cyclic GMP, L-arginine, methylene blue, penile prosthesis, electrical field stimulation
MeSH terms: Adult, Aged, Arginine, Electric Stimulation, Cyclic GMP, Humans, Erectile Dysfunction, Male, Methylene Blue, Middle Aged, Muscle Relaxation, Muscle, Smooth, Synaptic Transmission, Nitric Oxide, Organ Culture Techniques, Penile Erection, Penis, Purinones, Nitroarginine

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Nitric Oxide as a Mediator of Relaxation of the Corpus Cavernosum in Response to Nonadrenergic, Noncholinergic Neurotransmission

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