Role of seminal prostaglandins in male fertility. II. Effects of prostaglandin synthesis inhibition on spermatogenesis in man

Effects of clinical medications on male fertility and prospects for stem cell therapy

An increasing number of men require long-term drug therapy for various diseases. However, the effects of long-term drug therapy on male fertility are often not well evaluated in clinical practice. Meanwhile, the development of stem cell therapy and exosomes treatment methods may provide a new sight on treating male infertility. This article reviews the influence and mechanism of small molecule medications on male fertility, as well as progress of stem cell and exosomes therapy for male infertility with the purpose on providing suggestions (recommendations) for evaluating the effect of drugs on male fertility (both positive and negative effect on male fertility) in clinical application and providing strategies for diagnosis and treatment of male infertility.

Arachidonic Acid Pathways and Male Fertility: A Systematic Review

Arachidonic acid (AA) is a polyunsaturated fatty acid that is involved in male fertility. Human seminal fluid contains different prostaglandins: PGE (PGE₁ and PGE₂), PGF_2α, and their specific 19-hydroxy derivatives, 18,19-dehydro derivatives of PGE₁ and PGE₂. The objective of this study is to synthesize the available literature of in vivo animal studies and human clinical trials on the association between the AA pathway and male fertility. PGE is significantly decreased in the semen of infertile men, suggesting the potential for exploitation of PGE agonists to improve male fertility. Indeed, ibuprofen can affect male fertility by promoting alterations in sperm function and standard semen parameters. The results showed that targeting the AA pathways could be an attractive strategy for the treatment of male fertility.

Circulating levels of adropin and diabetes: a systematic review and meta-analysis of observational studies

OBJECTIVE

Adropin, a newly identified regulatory protein has garnered attention given its potential role in metabolism regulation, especially glucose metabolism and insulin resistance. However, studies on the association between adropin and type 2 diabetes mellitus (T2DM) are equivocal. The aim of this study is to assess the association between serum adropin levels and T2DM using a systematic review and meta-analysis of observational studies.

METHODS

PubMed, Scopus, ISI Web of science, and Google Scholar were searched, up to August 2022, for studies that reported the association between serum levels of adropin in adults with T2DM compared to a control group without diabetes. A random-effect model was used to compute the pooled weighted mean difference (WMD) with 95% confidence intervals (CI).

RESULTS

Meta-analysis of 15 studies (n = 2813 participants) revealed that the serum adropin concentrations were significantly lower in patients with T2DM compared with the control group (WMD= -0.60 ng/mL, 95% CI: -0.70 to -0.49; I² = 99.5%). Subgroup analysis also found lower concentration of adropin in patients with T2DM who were otherwise healthy compared to a control group (n = 9; WMD=-0.04 ng/ml, 95% CI= -0.06 to -0.01, p = 0.002; I² = 96.4).

CONCLUSIONS

Our study showed adropin levels are lower in patients with diabetes compared to a control group without diabetes. However, the limitations of observational studies challenge the validity of the results, and further investigations are needed to confirm the veracity of these findings and additionally explore possible mechanisms.

Protective effect of indomethacin on vanadium-induced adrenocortical and testicular damages in rat

Vanadium toxicity is a globally recognized threat to the reproductive health of man and animal. However the mechanism of vanadium-induced damage to the testicular and adrenocortical tissues is not fully characterized. It was hypothesized that prostaglandins may partially mediate the inflammatory response to vanadate damage. In this study prostaglandin (PG) mediated effects of vanadate on testicular and adrenocortical functions was substantiated by using indomethacin to block prostaglandin synthesis. Significant inhibition of spermatogenesis, decreased serum level of testosterone and gonadotropins in the vanadium-exposed group of rats indicated the damaging effects of vanadium-induced reactive oxygen species. This was also reflected in the appreciable increase in testicular lipid peroxidation (LPO) level and decline in the activities of steroidogenic and antioxidant enzymes. Histopathological studies revealed regressive and degenerative changes in testis. However, inhibition of cyclooxygenase activity by indomethacin increased steroid hormone production, gonadotropin level, elevated the specific activities of enzymes and decreased LPO level in rat testis exposed to vanadium. Vanadium also caused prostaglandin mediated adrenocortical hyperactivity, as inhibition of PG synthesis abolished these adrenal responses to vanadium. The studies showed that vanadium toxicity is directly linked to stimulation of prostaglandin synthesis. Therefore, indomethacin can be a good prospect to alleviate vanadium induced male infertility.

Regulation of smooth muscle contraction by the epithelium: role of prostaglandins

As an analog to the endothelium situated next to the vascular smooth muscle, the epithelium is emerging as an important regulator of smooth muscle contraction in many vital organs/tissues by interacting with other cell types and releasing epithelium-derived factors, among which prostaglandins have been demonstrated to play a versatile role in governing smooth muscle contraction essential to the physiological and pathophysiological processes in a wide range of organ systems.

Evaluation of vaginal misoprostol effect on pregnancy rate after intrauterine insemination

The goal of this study was to evaluate the effect ofmisoprostol on pregnancy rate after intrauterine insemination. This randomized double blind clinical trial study was performed on 66 (33 cases and 33 controls) infertile women who referred to infertility center of Imam Khomeini Hospital Sari, Iran for intrauterine insemination during 2006-2007. The two groups were matched for age, infertility causes and BMI. After intrauterine insemination, 200 mcg misoprostol was placed in posterior fornix of case group and a similar placebo tablet in control group. Chemical and clinical pregnancies and complications were recorded. Results were analyzed by means of SPSS 11 software, paired t-test and student t-test. The p-values of less than 0.05 were considered to be statistically significant. Chemical pregnancy (positive BHCG) occurred in 6 patients (18.2%) in each group. Clinical pregnancy occurred in 5 patients (15.15%) in case and 6 patients (18.2%) in controls. There were no significant statistical differences in complications between the two groups. Vaginal misoprostol after intrauterine insemination does not improve pregnancy rate.

Human testicular mast cells contain tryptase: increased mast cell number and altered distribution in the testes of infertile men

OBJECTIVE

To determine whether human testicular mast cells contain the potent fibroblast growth factor tryptase and to examine changes in mast cell morphology and intratesticular distribution in testes with normal spermatogenesis versus abnormal spermatogenesis.

DESIGN

Retrospective evaluation of testicular biopsies with the use of immunohistochemistry, morphometry, and electron microscopy.

SETTING

University research and clinical institutes.

PATIENT(S)

Infertile men (total of 24) with severe hypospermatogenesis, germ cell arrest syndrome, or Sertoli cell only syndrome, and men without pathologies.

INTERVENTION(S)

Diagnostic testicular biopsy.

MAIN OUTCOME MEASURE(S)

Location, number, and distribution of testicular mast cells.

RESULT(S)

All groups showed tryptase-positive mast cells. In specimens with normal spermatogenesis, mast cells were round and located mainly in the interstitial spaces close to Leydig cells. In germ cell arrest syndrome, a 2-fold increase was evident, and in Sertoli cell only syndrome, a >3-fold increase of tryptase-immunoreactive mast cells became evident. Moreover, there was a statistically significant shift of the cells from the interstitium to the tubular walls in Sertoli cell only syndrome and germ cell arrest syndrome. Mast cells in specimens of Sertoli cell only syndrome and germ cell arrest syndrome were heterogeneous, with rounded or elongated shapes and signs of degranulation. The thickness of the tubular walls was doubled in specimens of germ cell arrest syndrome and Sertoli cell only syndrome in comparison with normal specimens, and this increase was positively correlated with the number of mast cells in these patients.

CONCLUSION(S)

Our results suggest that mast cell products, including the potent fibroblast growth factor tryptase, are involved in the thickening of the tubular wall and other changes in infertile testes.

Aspirin inhibits androgen response to chorionic gonadotropin in humans

Eicosanoids play an important role in the regulation of the hypothalamic-pituitary axis; less clear is their role in testicular steroidogenesis. To evaluate the involvement of cyclooxygenase metabolites, such as prostaglandins, in the regulation of human testicular steroidogenesis, we examined the effects of a prostaglandin-blocker, aspirin, on plasma testosterone, pregnenolone, progesterone, 17OH-progesterone, androstenedione, dehydroepiandrosterone, and 17beta-estradiol response to human chorionic gonadotropin (hCG) in normal male volunteers in a placebo-controlled, single-blinded study. To test the efficacy of aspirin, seminal prostaglandin E(2) levels were also determined. hCG stimulation increased peripheral levels of testosterone, 17OH-progesterone, androstenedione, dehydroepiandrosterone, and 17beta-estradiol, without affecting circulating pregnenolone and progesterone values. Aspirin significantly lowered seminal prostaglandin E(2) levels, whereas it did not modify steroid concentrations not exposed to exogenous hCG. Moreover, the drug significantly reduced the response of testosterone, 17OH-progesterone, androstenedione, and dehydroepiandrosterone to hCG, as assessed by the mean integrated area under the curve, whereas it did not influence 17beta-estradiol response. In conclusion, aspirin treatment inhibits androgen response to chorionic gonadotropin stimulation in normal humans. The action of aspirin is probably mediated via an effective arachidonate cyclooxygenase block.

Advances in the evaluation and treatment of the infertile man

Numerous advances in technology have been made in the last several years in the diagnosis and treatment of the infertile man. Using case presentations, this article highlights these important new developments and reviews the basics of a comprehensive male infertility evaluation. The use of ultrasound as a critical, indispensable, yet noninvasive tool in the evaluation of possible male reproductive tract obstruction is discussed. Since assisted reproductive techniques (ARTs) have become increasingly important in the management of the otherwise untreatable infertile man, specialized testing of sperm function, e.g., the sperm penetration assay (SPA), and strict morphology assessment are often useful prior to the initiation of some of these assisted reproductive procedures such as intrauterine insemination (IUI) or in vitro fertilization (IVF). Testicular touch preparation cytology and image analysis are also important additions to routine testicular biopsy for quantifying the extent of spermatogenesis. Finally, the revolutionary micromanipulation procedure of intracytoplasmic sperm injection (ICSI) has forever changed the practice of andrology by enabling men previously thought to be irreversibly infertile the chance to initiate their own biologic pregnancy.

Transgenic model for the discovery of novel human secretory non-pancreatic phospholipase A2 inhibitors

Transgenic mice were created which overexpress human secretory non-pancreatic phospholipase A2 (sPLA2) pansomatically as a potential disease and drug-testing model. The mice were produced using a DNA construct in which the inducible mouse metallothionein gene promoter drives expression of a human sPLA2 minigene. High levels of sPLA2 were detected in several tissues by immunofluorescence localization. Expression in the testes caused hypospermia and male infertility. Circulating catalytically active sPLA2 could be induced to levels observed in patients undergoing a systemic inflammatory response but had no detectable effect on the mice. Therefore, these results suggest that sPLA2 hyperphospholipasemia alone may have only limited pathophysiological consequences. We further show that 3-[3-acetamide-1-benzyl-2-ethylindolyl-5-oxy]propane phosphonic acid LY311727), a potent new inhibitor of phospholipase A2 catalysis developed by our group, dramatically suppresses the circulating enzyme activity in these animals whereas 3-[3-acetamide-1-benzyl-2-propylindolyl-5-oxy]propane phosphonic acid (LY314024), a substantially less potent LY311727 analog, is without effect. These later results thus motivate the further development of this compound as a potential new therapeutic agent and valuable research tool.