Gene therapy: future strategies and therapies

Significant advances have been made in the past decade concerning the mechanistic basis for the control of penile erection and the etiology of erectile failure. The combined efforts and accumulated wisdom of urologic scientists and clinicians around the world have ensured that these basic advances have translated into the remarkable success recently observed in the treatment of erectile dysfunction. In fact, erectile function can now be effectively restored in every man with the requisite level of desire and motivation. Nonetheless, all of the currently available treatment options have either limited efficacy, significant and untoward side effects, or both. There is clearly room for improvement. However, improved therapy of erectile dysfunction is dependent on garnering even more precise details concerning the regulation of human corporal smooth muscle tone, and furthermore, on the identification of relevant molecular targets. The next generation of erectile dysfunction therapies, therefore, will necessarily require the application of molecular technologies to the study of erectile physiology/dysfunction. One such application is the utilization of gene therapy approaches. This report outlines the overall goals and promise of gene therapy for the treatment of human erectile dysfunction and briefly reviews a few initial strategies to that end.