Purpose: Tadalafil’s
exact analgesic mechanism is still
unclear. The current study aimed to elucidate this mechanism in an
inflammatory pain model. Methods: Computer-assisted simulation docking
experiments were carried out to assess the binding of tadalafil to
different ligands. The anti-inflammatory and analgesic effects of
tadalafil were evaluated using formalin-induced paw edema and a von
Frey filament test, respectively. The plantar paw of the mice was
then dissected to quantify iNOS, nNOS, COX-2, TNFα, IL1, and
IL10 gene expression levels using a real-time polymerase chain reaction.
iNOS, TNFα, and COX-2 inhibition was reassessed in vitro using
the ELISA technique. One-way analysis of variance followed by post
hoc Tukey test or t-test was used to compare the
means. Results: Docking analysis showed a superior binding score of
tadalafil to COX-2, iNOS, IL-1, and TNF-α compared to that of
indomethacin and morphine and a similar binding score to nNOS and
IL-10 relative to that of indomethacin. In the in vivo study, tadalafil,
after an hour of formalin administration, inhibited significantly
paw edema, similar to indomethacin. Furthermore, it significantly
increased the withdrawal force in the von Frey filament test as compared
to the negative control, which was similar to the effect observed
with indomethacin and morphine. The RT-PCR revealed that tadalafil
reduced significantly the iNOS, COX-2, and TNF-α gene expressions
but had no effect on nNOS, IL 1, and IL10. In vitro ELISA tests confirmed
the inhibition of iNOS, COX-2, and TNF-α. Conclusion: Tadalafil
probably exerts its analgesic effect through the simultaneous inhibition
of iNOS, COX-2, and TNF-α, which is not the case with other
nonsteroidal anti-inflammatory drugs. Nevertheless, further studies
are required to confirm its mechanism.