Therapeutic advances of tadalafil in multi-organ systemic diseases beyond erectile dysfunction
YAO Fan
WU Junjie
SHANG Xuejun
Abstract：Phosphodiesterase type 5(PDE5)participates in the physiological functions of multiple organs by regulating the nitric oxide(NO)-cyclic guanosine monophosphate(cGMP)pathway.As a long-acting PDE5 inhibitor,tadalafil has been used clinically for over 20 years and is approved for the treatment of male erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia.Furthermore,tadalafil maintains cGMP levels by inhibiting PDE5,thereby activa-ting the downstream NO-cGMP signaling pathway to exert multiple effects,including relaxing smooth muscle,exerting antioxidant actions,regulating apoptosis,and modulating metabolism.Clinical evidence indicates that tadalafil shows promising therapeutic potential in multi-organ system diseases such as pulmonary arterial hypertension,heart failure,type 2 diabetes,cognitive impair-ment,female infertility,and fetal growth restriction.This article systematically reviews the action mechanisms and research pro-gress of tadalafil in treating diseases beyond erectile dysfunction,aiming to summarize its potential for cross-disease system clini-cal applications and provide references for optimizing treatment strategies for patients with chronic diseases.
Keywords：phosphodiesterase type 5tadalafilNO-cGMP signaling pathwaymulti-organ systemic diseases
Publication Date：2025-11-20
Online Publishing Date：2025-12-18(First online date of this platform, not the publication date of the document)
Pages：6( 1021-1026 )