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A possible mechanism for the anti-inflammatory and antioxidant effects of Fildena may be at least in part due to suppression of the MAPKs/NF-κB pathways through the inhibition of NADPH oxidase-mediated ROS generation 156. Moreover, Fildena downregula

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These effects were attenuated by administration of L-NAME, a nonselective nitric oxide synthase inhibitor 154. NSCs proliferate in two main regions of the adult mammalian brain: the subventricular zone (SVZ) of the lateral ventricles and the subgranular zone (SGZ) of the dentate gyrus of the hippocampus 147 Neurogenesis can be influenced by several factors, including the release of growth factors, serotonin, estrogen, and glucocorticoids, among others 148 , 149 PDE-5 inhibitors have been reported to promote neurogenesis 113 , 150. Neurogenesis is the biological process of generating new neurons from progenitor or neural stem cells (NSCs).

The NO/cGMP/PKG pathway appears to play an essential role in preventing the activation of a proapoptotic pathway, thus promoting neural cell survival. A possible explanation for the seemingly conflicting effects of cAMP/PKA on NF-κB activation may lie in the existence of different PKA pools, with distinct subcellular localization and different functions (review in Gerlo et al., 2011) 126. Therefore, intracellular levels of cGMP exert a role in modulating inflammatory response 133 , 134.

The anti-inflammatory effects of NO are mediated predominantly via the activation of sGC/cGMP. Some studies indicate that NO derived from both nNOS and eNOS, but not the iNOS isoform, is critical in the regulation of leukocyte-endothelial cell interactions 129 - 131 Nitric oxide (NO) modulates leukocyte adherence and recruitment on the vascular endothelium, exerting a cytoprotective and antithrombotic role. At micromolar range, NO produced by iNOS exerts cytotoxic and proinflammatory effects that are opposite to those induced by low nanomolar concentrations of NO produced by the eNOS isoform, which exhibits anti-inflammatory effects via the cGMP-PKG pathway 129.

NO is a gaseous free radical that acts as an important sign of intra- and extracellular processes 128 and is synthesized intracellularly by three isoforms of the nitric oxide synthase enzyme (NOS): (1) dependent Ca+2 constitutive forms, consisting of the endothelial form or type III (eNOS or NOS-III) and the neuronal form or type I (n-NOS or NOS-I), present in endothelial cells, neurons, and glial cells, which produce NO under physiological conditions; (2) Ca+2 independent inducible form (i-NOS) or type II, present in macrophages, hepatocytes, smooth muscle, endothelium, and glial cells, which produce NO after immunological stimulation (i.e., IFN-γ, TNF-α, and LPS) 5. In summary, glial cells may serve as a potential therapeutic target for neuroinflammatory and neurodegenerative disorders and disturbances in learning processes and memory. Oligodendrocytes are not immunological inert cells but secrete a wide range of inflammatory mediators, expressing receptors to such factors.

The binding of TNF-α to its receptor TNF-R1 induces oligodendrocyte apoptosis, whereas the binding of IL-1β to IL-1R1 delays remyelination 118 In an attempt to repair myelin damage, oligodendrocyte precursor cells (OPCs) transform into mature oligodendrocytes, promoting remyelination.
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https://www.medicinenet.com/script/main/art.asp?articlekey=17038
https://eumedz.eu/

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