Physiopathological basis of a new neuro-ophthalmological disease linked to “chemsex”.

Chemsex refers to the recreational use of psychoactive substances to enhance sexual experiences and is associated with increased sexual risk-taking and mental health issues, including substance dependence. One of the most commonly used substances in this context is isopropyl nitrite, owing to its low cost, wide availability, and ease of inhalation. In recent years, growing concern has emerged regarding its effects on the central nervous system (CNS), particularly following reports of retinal dysfunction linked to neurodegenerative processes.
While visual disturbances after isopropyl nitrite exposure are often transient, multiple cases of irreversible retinal damage have been documented. These adverse effects appear to occur more frequently in individuals who concurrently use ritonavir, a protease inhibitor widely prescribed for viral infections such as HIV, and sildenafil citrate, a phosphodiesterase type 5 inhibitor frequently used in chemsex settings. However, stigma surrounding chemsex has led to substantial underdiagnosis, limiting current knowledge of long-term neurological consequences beyond the retina.
This project hypothesizes that combined exposure to a nitric oxide donor, a PDE5 inhibitor, and a protease inhibitor disrupts redox homeostasis in neurovascular units by increasing nitric oxide bioavailability. The resulting oxidative and nitrosative stress damages the neurovascular endothelium, induces rapid neurovascular uncoupling, and may trigger neurodegeneration.

Faculty Supervisor:

Sergio Crespo Garcia

Student:

Partner:

University of Alcalá

Discipline:

Life Sciences

Sector:

Education

University:

Université de Montréal

Program: