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J Sex Med. 2009 Mar;6 Suppl 3:286-91. doi: 10.1111/j.1743-6109.2008.01186.x.

The role of opiorphins (endogenous neutral endopeptidase inhibitors) in urogenital smooth muscle biology.

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Albert Einstein College of Medicine, Department of Urology and Institute of Smooth Muscle Biology, Bronx, NY 10461, USA.



The opiorphins are a newly characterized class of peptides that act as potent endogenous neutral endopeptidase (NEP) inhibitors. Recent reports have suggested that they play an important role in erectile physiology.


This article reviews recent developments that increase our understanding of the role of the opiorphin family of peptides in erectile physiology.


During a microarray screen of gene changes that occur in a rat diabetic model of erectile dysfunction (ED), Vcsa1 was one of the most down-regulated genes in the rat corpora. Quantitative real-time polymerase chain reaction demonstrated that in at least three models of diseases that result in ED (diabetes, aging, and cavernous nerve [CN] transection), Vcsa1 was down-regulated in the rat corpora. The human opiorphin family of genes (hSMR3A/B and ProL1) also acts as markers of erectile function in patients with ED.


The reader will be informed of the most current research regarding the role of opiorphins in urogenital smooth muscle biology.


These observations led to the suggestion that genes encoding opiorphins (and potentially their peptide products) can act as markers of ED. Gene transfer of plasmids overexpressing Vcsa1 in aging rats, as well as intracorporal injection of sialorphin, led to an improvement in erectile function. In organ bath studies, we demonstrated that sialorphin can cause increased rates of relaxation of corporal smooth muscle (CSM). We have also demonstrated that in vitro, Vcsa1 causes changes in the expression of G-protein-coupled receptors (GPCRs). This has led us to suggest that the action of Vcsa1 on erectile physiology may act through relaxation of CSM by its ability to act as an inhibitor of NEP, therefore prolonging the action of peptide agonists at their GPCRs.


Overall, there is a growing body of evidence that the opiorphins play a role in regulating CSM tone and thereby erectile function.

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