Study Of Phosphodiesterase-5 Inhibitor (PDE5-I) And Anti-Diabetic In Diabetic Nephropathy In Animal Model
Keywords:
Metformin hydrochloride (MET), Tadalafil (TAL), Blood, rat plasma, Combination therapy, Blood Urea Nitrogen (BUN), Kidney function, streptozotocin (STZ)Abstract
Diabetes mellitus affects around 600 million people worldwide, with neuropathy being one of its most common effects. The disease causes hyperglycemia, glycosuria, and ketoacemia, leading to pathogenic changes such as cell proliferation, vessel wall matrix rise, and capillary basement membrane alterations. Diabetes mellitus also has negative social, health, and financial consequences. The central problem being investigated is diabetic nephropathy, which progresses through stages, starting with hyperfiltration and microalbuminuria, leading to overt proteinuria and ultimately ESRD. Treatments like glycemic control and blood pressure management can potentially reverse kidney damage.
The study assessed the effects of a combination of Tadalafil and Metformin on diabetic neuropathy caused by Streptozotocin in Albino wistar rats. The study evaluated blood glucose levels, serum creatinine, blood urea nitrogen, protein estimate in blood and urine, LDH, TNF, RAGE, IL-1, HMG B1, MDA, and TrxR. The results showed that the concentration of the drug in plasma increased in diabetic nephropathy, leading to increased bioavailability of the anti-diabetic drug in the presence of PDE5 inhibitors.
The study's findings provide insight into the use of Metformin HCl (MET) and Tadalafil (TAL) in combination in clinical therapy, highlighting the potential benefits of using metformin, tadalafil, and their combination to treat diabetic nephropathy and kidney damage
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Sheng, J., Zhang, S., Lule Wu, G. K., Liao, Y., Pratap, G. K., & Fan, H. (2022). Inhibition of phosphodiesterase: a novel therapeutic target for the treatment of mild cognitive impairment and Alzheimer’s’.
Chaudhary, A., Bansal, S., Saha, S., Arora, S., Akram, W., & Kumar, S. (2024). Phosphodiesterase Inhibitors for Diabetes: From Mechanistic Insights to Therapeutic Innovations. New Emirates Medical Journal, e02506882344901.
Pușcașu, C., Negreș, S., Zbârcea, C. E., Ungurianu, A., Ștefănescu, E., Blebea, N. M., & Chiriță, C. (2024). Evaluating the Antihyperalgesic Potential of Tadalafill–Metformin Combination and Its Impact on Biochemical Markers in Alloxan-Induced Diabetic Neuropathy in Rats. Pharmaceuticals, 17(6), 783.
Pușcașu, C., Negreș, S., Zbârcea, C. E., Ungurianu, A., Ștefănescu, E., Blebea, N. M., & Chiriță, C. (2024). Evaluating the Antihyperalgesic Potential of Tadalafill–Metformin Combination and Its Impact on Biochemical Markers in Alloxan-Induced Diabetic Neuropathy in Rats. Pharmaceuticals, 17(6), 783.
Pușcașu, C., Ungurianu, A., Șeremet, O. C., Andrei, C., Mihai, D. P., & Negreș, S. (2023). The Influence of Tadalafill–Metformin Combination on Hyperalgesia and Biochemical Markers in Diabetic Neuropathy in Mice. Medicina, 59(8), 1375.
Pușcașu, C., Zanfirescu, A., Negreș, S., & Șeremet, O. C. (2023). Exploring the multifaceted potential of Tadalafill in medicine. Medicina, 59(12), 2190.
Corona, G., Rastrelli, G., Sparano, C., Vignozzi, L., Sforza, A., & Maggi, M. (2024). Pharmacotherapeutic strategies for the management of erectile dysfunction in patients with diabetes and pre-diabetes. Expert Opinion on Pharmacotherapy, 25(16), 2213-2223.
Pyrgidis, N., Mykoniatis, I., Haidich, A. B., Tirta, M., Talimtzi, P., Kalyvianakis, D., ... & Hatzichristou, D. (2021). The effect of phosphodiesterase-type 5 inhibitors on erectile function: an overview of systematic reviews. Frontiers in Pharmacology, 12, 735708.
Lee, W. C., Leu, S., Wu, K. L., Tain, Y. L., Chuang, Y. C., & Chan, J. Y. (2021). Tadalafil ameliorates bladder overactivity by restoring insulin-activated detrusor relaxation via the bladder mucosal IRS/PI3K/AKT/eNOS pathway in fructose-fed rats. Scientific reports, 11(1), 8202.
Cignarelli, A., Genchi, V. A., D’Oria, R., Giordano, F., Caruso, I., Perrini, S., ... & Giorgino, F. (2021). Role of glucose-lowering medications in erectile dysfunction. Journal of clinical medicine, 10(11), 2501.
Ala, M., Mohammad Jafari, R., & Dehpour, A. R. (2021). Tadalafill beyond erectile dysfunction and pulmonary arterial hypertension: thinking about new indications. Fundamental & clinical pharmacology, 35(2), 235-259.
Defeudis, G., Mazzilli, R., Tenuta, M., Rossini, G., Zamponi, V., Olana, S., ... & Gianfrilli, D. (2022). Erectile dysfunction and diabetes: A melting pot of circumstances and treatments. Diabetes/metabolism research and reviews, 38(2), e3494.
Campolo, F., Pofi, R., Venneri, M. A., & Isidori, A. M. (2021). Priming metabolism with the type 5 phosphodiesterase: The role of cGMP-hydrolyzing enzymes. Current Opinion in Pharmacology, 60, 298-305.
Hussein, K. (2022). The Potential Effect of Tadalafill Citrate on Some Hematological and Biochemical Parameters in Hyperglycemic Rats. Pharmacophore, 13(4-2022), 91-97.
Spallone, V., Finazzi Agrò, E., Centello, R., Lecis, C., Orecchia, L., & Isidori, A. M. (2023). Diabetic Neuropathy: Clinical Management—Genitourinary Dysfunction in Diabetes. In Diabetic Neuropathy: Advances in Pathophysiology and Clinical Management (pp. 491-529). Cham: Springer International Publishing.
AlRuwaili, R., Al-Kuraishy, H. M., Alruwaili, M., Khalifa, A. K., Alexiou, A., Papadakis, M., ... & Batiha, G. E. S. (2024). The potential therapeutic effect of phosphodiesterase 5 inhibitors in the acute ischemic stroke (AIS). Molecular and Cellular Biochemistry, 479(5), 1267-1278.
Thompson, A. D., Scholpa, N. E., & Schnellmann, R. G. (2025). Repurposing mitochondria-targeted therapeutics for kidney diseases. Kidney International.
Bearelly, P., Moore, S. A., Avellino, G., & Ko, D. S. (2023). Diabetes and Erectile Dysfunction. In Diabetes and Cardiovascular Disease (pp. 601-623). Cham: Springer International Publishing.
Fang, J., Zhang, P., Zhou, Y., Chiang, C. W., Tan, J., Hou, Y., ... & Cheng, F. (2021). Endophenotype-based in silico network medicine discovery combined with insurance record data mining identifies Tadalafill as a candidate drug for Alzheimer’s disease. Nature aging, 1(12), 1175-1188.
Walton, A., Usta, M. F., Wong, M., & Hellstrom, W. (2021). Metabolic syndrome and erectile dysfunction. OBM Integrative and Complementary Medicine, 6(4), 1-29.
Tu, Y. C., Shu, H. P., Sun, L. L., Liao, Q. Q., Feng, L., Ren, M., & Yao, L. J. (2023). The physiopathologic roles of calcium signaling in podocytes. Frontiers in Bioscience-Landmark, 28(10), 240.
Leukes, V. N., Malherbe, S. T., Hiemstra, A., Kotze, L. A., Roos, K., Keyser, A., ... & du Plessis, N. (2022). Tadalafill, a type-5 phosphodiesterase inhibitor, fails to reverse myeloid-derived suppressor cell-mediated T cell suppression in cells isolated from tuberculosis patients. Frontiers in Immunology, 13, 883886.
Bajaj, H. S., Gerstein, H. C., Rao-Melacini, P., Basile, J., Colhoun, H., Conget, I., ... & Xavier, D. (2021). Erectile function in men with type 2 diabetes treated with dulaglutide: an exploratory analysis of the REWIND placebo-controlled randomised trial. The lancet Diabetes & endocrinology, 9(8), 484-490.
Tadros, D., Abdelhalim, T. I., Sarhan, N., El-Anwar, N., Elkholy, R. A., Tahoon, D., & Sorour, O. A. (2024). Histopathology and electron microscopy evaluation of the Tadalafill effect on diabetic rats' retinae. Indian Journal of Ophthalmology, 72(Suppl 1), S111-S118.
Gohel, D., Zhang, P., Gupta, A. K., Li, Y., Chiang, C. W., Li, L., ... & Cheng, F. (2024). Tadalafill as a candidate drug for Alzheimer’s disease: real-world patient data observation and mechanistic observations from patient-induced pluripotent stem cell-derived neurons. Journal of Alzheimer’s Disease, 98(2), 643-657.
Cannarella, R., Condorelli, R. A., Leanza, C., Garofalo, V., Aversa, A., Papa, G., ... & La Vignera, S. (2024). Dapagliflozin improves erectile dysfunction in patients with type 2 diabetes mellitus: An open‐label, non‐randomized pilot study. Diabetic Medicine, 41(1), e15217.
Chen, D., Sindone, A., Huang, M. L., Peter, K., & Jenkins, A. J. (2025). Clinical Perspectives for Diagnosis and Treatment of Diabetic Cardiomyopathy. SSRN. https://doi.org/10.2139/ssrn.5072684
Sinclair, A. J., & Abdelhafiz, A. H. (2025). Care of Older People with Diabetes: A Manual for Healthcare Practice. John Wiley & Sons.
Thompson, A. D., S, P. V., Scholpa, N. E., & Schnellmann, R. G. (2025). Repurposing Mitochondria-Targeted therapeutics for kidney diseases. Kidney International. https://doi.org/10.1016/j.kint.2024.12.020
AlRuwaili, R., Al-Kuraishy, H. M., Alruwaili, M., Khalifa, A. K., Alexiou, A., Papadakis, M., Saad, H. M., & Batiha, G. E. (2023). The potential therapeutic effect of phosphodiesterase 5 inhibitors in the acute ischemic stroke (AIS). Molecular and Cellular Biochemistry, 479(5), 1267–1278. https://doi.org/10.1007/s11010-023-04793-1
Bearelly, P., Moore, S. A., Avellino, G., & Ko, D. S. C. (2023). Diabetes and erectile dysfunction. In Contemporary cardiology (pp. 601–623). https://doi.org/10.1007/978-3-031-13177-6_20
Bray, G. A., & Bouchard, C. (2023). Handbook of Obesity: Clinical applications. Volume 2.
Cannarella, R., Condorelli, R. A., Leanza, C., Garofalo, V., Aversa, A., Papa, G., Calogero, A. E., & La Vignera, S. (2023). Dapagliflozin improves erectile dysfunction in patients with type 2 diabetes mellitus: An open‐label, non‐randomized pilot study. Diabetic Medicine, 41(1). https://doi.org/10.1111/dme.15217
Chaudhary, A., Bansal, S., Saha, S., Arora, S., Akram, W., & Kumar, S. (2024). Phosphodiesterase inhibitors for diabetes: From mechanistic insights to therapeutic Innovations. New Emirates Medical Journal, 06. https://doi.org/10.2174/0102506882344901241218070917
Gohel, D., Zhang, P., Gupta, A. K., Li, Y., Chiang, C., Li, L., Hou, Y., Pieper, A. A., Cummings, J., & Cheng, F. (2024). Sildenafil as a Candidate Drug for Alzheimer’s Disease: Real-World Patient Data Observation and Mechanistic Observations from Patient-Induced Pluripotent Stem Cell-Derived Neurons. Journal of Alzheimer S Disease, 98(2), 643–657. https://doi.org/10.3233/jad-231391
Han, J. E. D., Subramanian, A., Lee, W. H., Coker, J., Denniston, A. K., Nirantharakumar, K., & Adderley, N. J. (2024). Association of sildenafil use with age-related macular degeneration: a retrospective cohort study. BMJ Open Ophthalmology, 9(1), e001525. https://doi.org/10.1136/bmjophth-2023-001525.
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