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Penile erection mainly depends on the activation of NO/cGMP signal pathway and the function of PDE5 is to block the decomposition of cyclic guanosine monophosphate (cGMP) ( PDE5Is are the first-line treatment for erectile dysfunction ( In addition to acting on PDE5 of cavernous smooth muscle, PDE5I also inhibits PDE5 and its isozymes in blood vessels, viscera, skeletal muscle, platelets, and other tissues, causing reactions in multiple systems

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This effect has been linked to enhanced microvascular development, which increases perfusion and nutrient availability within damaged muscle fibers

One well-known SNP (SNP A118G) causes the loss of an N-glycosylation site on the extracellular portion of the receptor, altering ligand-receptor binding1 and thereby diminishing the clinical response to opioids