Patryk Osiński

Alpha-1 adrenergic receptor antagonists are widely used in the management of lower urinary tract symptoms, where they can induce ejaculatory dysfunction as a pharmacodynamic effect, particularly with α1A-selective agents. This observation has led to growing interest in their potential role as non-hormonal male contraceptives. This narrative review evaluates current clinical and preclinical evidence regarding the impact of α-blockers on the ejaculatory mechanism, with a focus on their potential application in male contraception. Both human and animal data were examined to contextualize the mechanistic basis for contraceptive potential. Evidence from clinical and pharmacological studies indicates that inhibition of α1-adrenoceptor-mediated smooth-muscle contraction in tissues involved in seminal emission, including the vas deferens, seminal vesicles, and prostate, can impair the emission phase of ejaculation. Agents such as tamsulosin and silodosin have been reported to induce anejaculation or markedly reduce semen volume, providing pharmacodynamic evidence of impaired seminal emission; however, these effects should not be considered equivalent to demonstrated contraceptive efficacy. Prospective clinical evidence currently includes one prospective pilot study and one randomized placebo-controlled clinical trial evaluating silodosin as a potential reversible non-hormonal male contraceptive. The prospective evidence includes marked and progressive suppression of sperm output and semen volume with repeated silodosin administration; at week 12, 94% of participants achieved a total sperm count ≤ 1 × 10⁶ per ejaculate, while the observed pregnancy incidence was 4% versus 17% with placebo. However, the available evidence remains insufficient to establish reliable contraceptive effectiveness for individual sexual exposures. Safety considerations, including cardiovascular effects and sexual dysfunction, also remain insufficiently characterized in healthy men. α1-adrenoceptor antagonists represent a biologically plausible pharmacologic strategy for male non-hormonal contraception by interfering with seminal emission and sperm delivery without directly suppressing spermatogenesis. Further pharmacokinetic–pharmacodynamic studies and rigorously designed multicentre clinical trials are required to determine the optimal dosing strategy, completeness and consistency of seminal emission suppression, contraceptive effectiveness, safety, acceptability, and reversibility of this approach.

Imidazolium salt derivatives (IMSDs) represent a structurally diverse class of compounds that has attracted increasing interest as a source of novel anticancer agents due to their tunable chemical architecture and broad spectrum of biological activities. This review summarizes current advances in the development of organic imidazolium derivatives and metal–N-heterocyclic carbene (NHC) complexes, with particular emphasis on their structure–activity relationships (SARs), mechanisms of action, and therapeutic potential. Numerous IMSDs exhibit significant antiproliferative activity against a wide range of cancer cell lines through multiple mechanisms, including DNA damage, reactive oxygen species generation, mitochondrial dysfunction, thioredoxin reductase inhibition, cell-cycle arrest, and apoptosis induction. Among the reported compounds, Au(I)-, Pt(II)-, and Ag(I)-NHC complexes consistently demonstrate the highest cytotoxic potency, whereas hybrid derivatives incorporating pharmacologically active moieties, such as lithocholic acid, have been investigated as potential approaches to improving selectivity and multitarget activity. Current SAR analyses indicate that metal coordination, bulky aromatic substituents, molecular hybridization, and balanced lipophilicity are key determinants of enhanced biological activity. Despite these encouraging findings, most available evidence is limited to in vitro studies, while comprehensive in vivo evaluation, pharmacokinetic characterization, and systematic toxicological assessment remain insufficient. Consequently, the clinical relevance of these compounds has yet to be established. Future research should focus on rational structural optimization, standardized preclinical evaluation, combination therapies, and advanced drug delivery strategies, including nanomedicine, to facilitate the translation of IMSDs into clinically useful anticancer agents.

This article investigates the association between the use of statins, which are popular in clinical practice and the risk of depressive disorders and suicidal behaviour. It has been observed that low blood cholesterol levels may be associated with the occurrence of depression. However, the findings regarding the impact of statins as lipid profile modifying drugs remain inconclusive. Some studies and meta-analyses indicate that statin use has a protective effect, while others suggest an increased risk of depression or no effect. The studies included in this review do not confirm a significant effect of statin use on suicidal behaviour and the effect of statin use on depression cannot be conclusively established based on these studies. These considerations are based on the possibility that the use of statin drugs may affect central nervous system cholesterol metabolism and serotonergic function. The membrane cholesterol has a significant effect on the serotonergic receptors and the serotonin transporter. The authors emphasise the possibility of a synergistic effect between statins and antidepressants, such as selective serotonin reuptake inhibitors, which could potentially result in enhancements in the patient’s mental state. However, it is imperative to bear in mind the potential for adverse effects when combining these drug groups. Thus recommending heightened patient monitoring. The authors acknowledge the need for further clinical trials to further understand the issue under study.

The Central European Journal of Urology is an open access quarterly-issued journal, which provides a forum for the presentation of original clinical, experimental and other research studies...

Statins have been used in the treatment of hyperlipidemia, both as monotherapy and in combination therapy. Natural fermentation processes of fungi such as Monascus spp., Penicillium spp., Aspergillus terreus, and Pleurotus ostreatus have given rise to natural statins. Compactin (mevastatin), the original naturally occurring statin, is the primary biotransformation substrate in the manufacturing process of marketed drugs. Statins are classified into natural, semi-synthetic derivatives of natural statins, and synthetic ones. Synthetic statins differ from natural statins in their structural composition, with the only common feature being the HMG-CoA-like moiety responsible for suppressing HMG-CoA reductase. Statins do not differ significantly regarding their pleiotropic and adverse effects, but their characteristics depend on their pharmacokinetic parameters and chemical properties. This paper focuses on describing the processes of obtaining natural statins, detailing the pharmacokinetics of available statins, divided into natural and synthetic, and indicating their pleiotropic effects.