Gut/brain peptides in the genital tract: VIP and PACAP.

The two structurally related gut/brain peptides vasoactive intestinal polypeptide (VIP) and pituitary adenylate cyclase activating polypeptide (PACAP) are pleiotropic peptides with a wide-spread occurrence. Besides their presence and functions in the gut and the brain VIP and PACAP have distinct physiological roles in the genital tract. VIP seems to be involved in the nervous control of ovum transportation, sexual arousal in women and penile erection in men. Dysfunction of the VIP nerves can lead to erectile failure and VIP in combination with phentolamine can be successfully used as self-injection therapy of impotence. PACAP could be a co-transmitter with VIP in a number of functions involving nervous control of blood flow and motility, but in addition PACAP is a sensory neurotransmitter. The most fascinating role for PACAP is, however, its auto- or paracrine function in the peri- and postovulatory events involving acute progesterone production and subsequent luteinization in periovulatory granulosa/lutein cells.