Building on Arthur Burnett’s years of research in neuroprotection and recovery of erectile function after radical prostatectomy, Trinity J. Bivalacqua M.D., Ph.D., has discovered a chemical chain of events that takes place when critical nerves around the prostate are injured. His research may lead to new drugs that can block these highly specific events, and prevent nerve damage. His work was published in the Journal of Urology. Bivalacqua and colleagues have found that when the nerves surrounding the prostate are hurt, the body starts making more of a particular enzyme, called RhoA/RO CK (for “RhoA/Rho-kinase”). What happens next is a bad domino chain of nerve degeneration and death. “When RhoA/RO CK is increased in the penis and cavernous nerves after nerve injury” (the kind that occurs in prostatectomy), “erectile function is impaired,” Bivalacqua says. Research of spinal cord damage has shown that the Rho pathway, activated by injury, prevents nerve axons (the long, spindly parts of nerves that send signals to other nerve cells or organs) from regrowing, or repairing themselves.
When Bivalacqua and colleagues blocked RhoA/RO CK in animals with erectile dysfunction after cavernous nerve injury, these nerves fared noticeably better. “We saw nerve regeneration and protection of the blood vessels of the penis, resulting in the restoration of erectile function.” He believes that understanding this RhoA/ RO CK signaling cascade, and being able to block it, will lead to new strategies for treating erectile dysfunction — or, better yet, helping to prevent it.