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ArticleNaunyn-Schmiedeberg's archives of pharmacology2026

Effects of tadalafil on endothelial, angiogenic, metabolic, and microRNA biomarker profiles in sexually active men with BPH and erectile dysfunction: a randomized controlled trial.

Ahmed Abomandour, Ehab A M El-Shoura, Basem A Fathi, Hosny Ahmed Elewa, Ahmed M Abd-Eldayem, Zeinab Alkasaby Zalat

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Article in Naunyn-Schmiedeberg's archives of pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ahmed AbomandourDepartment of Clinical Pharmacy, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut, 71524, Egypt.
Ehab A M El-ShouraDepartment of Clinical Pharmacy, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut, 71524, Egypt. ehabel-shoura@azhar.edu.eg.ORCID http://orcid.org/0000-0003-2448-7549
Basem A FathiDepartment of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hosny Ahmed ElewaPharmacy Practice Department, Faculty of Pharmacy, Hours University in Egypt, New Damietta, Egypt.
Ahmed M Abd-EldayemDepartment of Medical Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt. dr.ahmed2016@aun.edu.eg.ORCID https://orcid.org/0000-0002-3093-8572
Zeinab Alkasaby ZalatHead of Clinical Pharmacy Department, Faculty of Pharmacy, Al-Azhar University, Cairo (Girls), Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Benign prostatic hyperplasia (BPH) is increasingly linked to endothelial dysfunction, angiogenic activation, chronic inflammation, and metabolic dysregulation. This randomized controlled trial evaluated the dose-dependent effects of tadalafil on circulating endothelial, angiogenic, metabolic, and microRNA biomarkers implicated in BPH. A total of 306 sexually active men with BPH/LUTS and erectile dysfunction were randomized equally to placebo, tadalafil 2.5 mg, or tadalafil 5 mg daily for 12 weeks. Baseline demographic, clinical, biochemical, and molecular characteristics were comparable across groups. Tadalafil produced significant, dose-dependent improvements across multiple mechanistic domains. Both doses reduced circulating ANGPTL2, E-selectin, MMP-7, and PECAM-1, while increasing eNOS levels (p < 0.0001). Lipid metabolism improved, with favorable shifts in the Atherogenic Index of Plasma (AIP), decreasing from 0.65 in the placebo group to 0.62 with 2.5 mg and 0.50 with 5 mg tadalafil (p < 0.0001). Tadalafil also modulated microRNA expression, increasing hsa-miRNA-486-3p and decreasing hsa-miRNA-181a-5p in a dose-dependent manner (p < 0.0001). Clinical outcomes paralleled biomarker changes. Both tadalafil doses improved IPSS scores, with the greatest symptom relief at 5 mg. Biomarker-symptom correlations were strong, including ANGPTL2 (r = 0.6806-0.766), PECAM-1 (r = 0.892-0.896), eNOS (r = -0.655 to -0.824), hsa-miRNA-486-3p (r = -0.707 to -0.880), and HDL (r = -0.833 to -0.855). Tadalafil was well tolerated, with no treatment-related discontinuations. Tadalafil was associated with dose-dependent changes in endothelial, angiogenic, metabolic, and microRNA biomarkers. Because the study enrolled sexually active men with BPH/LUTS and erectile dysfunction, findings may not be generalizable to all men with BPH.

Indexed as

AngiogenicBenign prostatic hyperplasiaEndothelialLipidMicroRNATadalafil

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.