Ameliorative effects of Lycium chinensis on male sexual dysfunction and testicular oxidative damage in streptozotocin-induced diabetic rats

Mechanism of Traditional Chinese Medicine extract in the treatment of diabetic erectile dysfunction

ETHNOPHARMACOLOGICAL RELEVANCE

Diabetic erectile dysfunction (DED) is a prevalent but often overlooked microvascular complication of type 2 diabetes mellitus (T2DM), with strong associations to cardiovascular disease. The pathophysiology of erectile dysfunction (ED) in T2DM patients is more intricate than in non-diabetic individuals, likely involving multiple pathogenic mechanisms such as endothelial dysfunction, vascular alterations, neuropathy, and oxidative stress. Traditional Chinese Medicine (TCM) has long been utilized in the management of DED, drawing on an extensive body of clinical experience. In TCM, DED is typically attributed to imbalances such as renal yang deficiency or insufficiencies in qi and blood. Herbal therapies within the TCM framework offer a multifaceted approach to treatment, targeting not only the replenishment of kidney yang and the regulation of qi and blood but also incorporating strategies for glycemic control and renal protection. This holistic approach has demonstrated effectiveness in alleviating erectile dysfunction in diabetic patients, thereby improving quality of life. However, the complexity of Chinese herbal formulations, with their diverse bioactive constituents, complicates the identification of specific active compounds and the mechanistic understanding of their therapeutic actions. This complexity has contributed to ongoing skepticism regarding the clinical utility of TCM and herbal remedies in the treatment of DED.

AIM OF THE STUDY

This study aimed to investigate the pathological mechanisms underlying the therapeutic effects of TCM in the treatment of DED, with a specific focus on the associated signaling pathways. By elucidating these mechanisms, the study seeks to provide a scientific basis for novel therapeutic strategies and enhance the viability of TCM-based approaches for DED management. Future research should prioritize the development of efficacious Chinese patent medicines tailored for the treatment of DED.

METHODS

This study utilizes keywords such as "diabetic erectile dysfunction", "signaling pathways", "traditional Chinese Medicine", "bioactive compounds", "herbal", "herbal monomers", and "herbal extracts" to conduct a comprehensive literature search in databases including Embase, PubMed, Web of Science, CNKI, Wanfang, and VIP, spanning all relevant publications up to February 2024.

RESULTS

It has been demonstrated that TCM extract can treat the DED by influencing the signaling pathways involved.

CONCLUSION

A comprehensive literature review was conducted across multiple databases, followed by rigorous screening, exclusion, summarization, synthesis, and analysis of relevant studies. The results indicate that TCM for DED primarily targets key pathological features, including endothelial dysfunction, vascular and neural abnormalities, and oxidative stress. The underlying mechanisms involve the NO/cGMP, eNOS, and PI3K/Akt/mTOR signaling pathways, contributing to significant improvements in erectile function. These findings provide a scientific basis for the use of TCM in DED, offering viable therapeutic options and innovative strategies to advance TCM-based treatment approaches. Furthermore, TCM exhibits notable potential in mitigating the pathological progression of DED. The pharmacological mechanisms and molecular signaling pathways of TCM extracts have been extensively investigated, underscoring their high value for clinical research and therapeutic development.

Diabetes-induced male infertility: potential mechanisms and treatment options

Male infertility is a physiological phenomenon in which a man is unable to impregnate a fertile woman during a 12-month period of continuous, unprotected sexual intercourse. A growing body of clinical and epidemiological evidence indicates that the increasing incidence of male reproductive problems, especially infertility, shows a very similar trend to the incidence of diabetes within the same age range. In addition, a large number of previous in vivo and in vitro experiments have also suggested that the complex pathophysiological changes caused by diabetes may induce male infertility in multiple aspects, including hypothalamic-pituitary-gonadal axis dysfunction, spermatogenesis and maturation disorders, testicular interstitial cell damage erectile dysfunction. Based on the above related mechanisms, a large number of studies have focused on the potential therapeutic association between diabetes progression and infertility in patients with diabetes and infertility, providing important clues for the treatment of this population. In this paper, we summarized the research results of the effects of diabetes on male reproductive function in recent 5 years, elaborated the potential pathophysiological mechanisms of male infertility induced by diabetes, and reviewed and prospected the therapeutic measures.

Securidaca inappendiculata stem extract confers robust antioxidant and antidiabetic effects against high fructose/streptozotocin induced type 2 diabetes in rats. Exploration of bioactive compounds using UHPLC-ESI-QTOF-MS

Diabetes mellitus is the most deadly and most prevalent metabolic disease of contemporary times. This study evaluated the antidiabetic, antioxidant, and pancreato-protective effects of Securidaca inappendiculata extract (SIE) in high-fructose/streptozotocin-induced type 2 diabetes. SIE (50, 100, and 200 mg/kg) was administered to diabetic rats for 8 weeks, thereafter glycaemic parameters, pancreatic β cell function, lipid profile, hepatorenal function, and antioxidant parameters were evaluated in diabetic rats treated SIE. The results indicated that treatment with SIE markedly lowered blood glucose, lipid parameters, hepatorenal function parameters, and lipid peroxidation at the end of the intervention. Additionally, serum insulin levels were significantly increased as supported by restoration of pancreatic β-cell cells in the H&E staining. Moreover, SIE also upregulated serum antioxidant enzyme activities in the treated diabetic rats. The results revealed that SIE possesses potent antihyperglycemic and antihyperlipidemic and antioxidant effects with the considerable restoration of pancreatic β-cells function.

Antioxidant, antiapoptotic, and antifibrotic abilities of L-Arginine ameliorate the testicular dysfunction in diabetic rats

Testicular dysfunction and infertility are serious complications of diabetes mellitus (DM). L-Arginine (L-Arg) is a semi essential amino acid with various biological and metabolic functions. The molecular mechanisms of L-Arg on testicular dysfunction caused by DM remain elusive. This study aimed to assess the potential protective effect of L-Arg in diabetic testis and its possible mechanisms. 24 adult male Wistar albino rats were randomly divided into four groups: CON, L-Arg that received 1 g/kg body weight of L-Arg orally for 4 weeks, DM that fed a high fat diet followed by an injection of 30 mg/kg streptozotocin intraperitoneally, and L-Arg-treated DM that were diabetic and administered L-Arg. DM decreased relative testicular weight, reduced serum testosterone, and impaired semen parameters. Reduced total antioxidant capacity (TAC), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px), in addition to increased transforming growth factor B1 (TGF-β1) and nitric oxide (NO) levels, were found in the testicular tissue. This was associated with severe degenerative changes in the seminiferous tubules and interstitial cells of Leydig, reduction of Johnsen's score, significantly increased expression of both inducible nitric oxide synthase (iNOS) and caspase-3, and reduced zonula occludens (ZO)- 1 expression. Ultrastructurally, disrupted intercellular junctions and degeneration of interstitial cells of Leydig were observed. In contrast, treatment of diabetic animals with L-Arg increased TAC, SOD and GSH-Px, decreased TGF-β1 and NO levels, downregulated iNOS and caspase-3 expression, upregulated ZO-1 expression, and maintained the integrity of the Sertoli cell junctions. Hence, L-Arg restored the normal testicular structure and function via its antioxidant, antiapoptotic, and antifibrotic effects.

Ameliorative potentials of the ethanolic extract from Lycium chinense leaf extract against diabetic cardiomyopathy. Insight into oxido-inflammatory and apoptosis modulation

The prevalence of cardiovascular complications in diabetes has become one of the major cause of diabetes related morbidity/mortality. The onset and progression of diabetic cardiomyopathy (DCM) has been majorly linked to lipid alterations, oxidative stress, inflammation and apoptosis. This present study investigated the cardioprotective role of Lycium chinense leaf extract (LCME) in fructose/streptozotocin induced diabetic rats. Diabetic animals were orally gavaged with LCME (100 and 400 mg/kg) for five weeks. The results indicated that diabetic rats showed increased blood glucose concentration, serum cardiac function markers (troponin T, creatine kinase-MB, aspartate aminotransferase and lactate dehydrogenase) and lipid profile (triglycerides and cholesterol). In addition, the cardiac tissues of diabetic rats showed increased levels of nuclear factor-κB (NF-κB), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL 1β), interleukin 6 (IL-6), caspase-3 and malondialdehyde as well as significantly reduced activities of catalase, superoxide dismutase, reduced glutathione and glutathione peroxidase. LCME significantly ameliorated hyperglycemia and markedly decreased serum concentrations of troponin T, creatine kinase-MB, aspartate aminotransferase and lactate dehydrogenase, triglycerides and cholesterol. Furthermore, LCME notably suppressed cardiac oxido-inflammatory mediators and boosted cardiac antioxidant defense. Histopathologically, LCME restored cardiac structural alterations and also suppressed the immunohistochemical expression of collagen IV, smooth muscle alpha-actin (α-SMA) and p53, while Bcl2 expression was significantly increased. In conclusion, our result indicated that LCME protected against diabetic cardiomyopathy suppressing oxidative stress, inflammation, apoptosis and fibrosis.

Therapeutic Effects of Xianlu Oral Solution on Rats with Oligoasthenozoospermia through Alleviating Apoptosis and Oxidative Stress

Idiopathic oligoasthenozoospermia (iOAZS) is one of the major causes of male infertility, and the ideal therapies for iOAZS have not been established yet. Traditional Chinese medicine (TCM), including Xianlu oral solution (XL), has been widely used as an adjunct treatment for male infertility in the clinic. However, the underlying mechanisms of XL treatment on iOAZS are still not known. Here, we found that XL treatment has therapeutic effects on ornidazole (ORN)-induced OAZS model rats through the amelioration of testis tissues spermatogenesis and the improvement of sperm concentration and motility. Moreover, XL treatment ameliorated the serum hormone levels, mitochondrial membrane potential, apoptosis status, and oxidative stress status in the testis tissues of iOAZS model rats. These findings identify a potential mechanism underlying the therapeutic effects of Xianlu oral solution on iOAZS, and Xianlu oral solution may be used as a traditional Chinese medicine (TCM) therapy for male infertility caused by iOAZS in clinical practice.

Trifolium pratense extract increases testosterone and improves sperm characteristics and antioxidant status in diabetic rats

Male reproductive dysfunction is a common complication of diabetes mellitus. Trifolium pratense exhibits antioxidant and antidiabetic effects. We investigated the effects of an extract of T. pratense on serum antioxidant status, sperm characteristics, testicular tissue changes and testosterone level in diabetic rats. Male Wistar rats were divided into six groups: 1, untreated control; 2, diabetic; 3 and 4, 100 or 200 mg/kg T. pratense extract treated, respectively; 5 and 6, diabetic 100 or 200 mg/kg T. pratense extract treated, respectively. Diabetes was induced by intraperitoneal injection of streptozotocin. After 3 weeks, serum glucose, testosterone and nitric oxide (NO); sperm parameters; testicular histology and total antioxidant capacity (TAC) were evaluated. In diabetic rats treated with T. pratense extract, sperm motility, count and viability, as well as TAC and testosterone were increased significantly compared to untreated diabetic rats, while serum NO and bcl-2 and p53 expression was decreased significantly compared to untreated diabetic rats. T. pratense extract reduced testicular tissue destruction caused by diabetes.

Nobiletin protects against diabetes-induced testicular injury via hypophysis-gonadal axis upregulation and amelioration of oxidative stress

BACKGROUND

Testicular injury is one of the most serious problems associated with diabetes mellitus. The present study aimed to compare the effects of two different doses of nobiletin and analyze its mechanisms of action against diabetes-induced testicular impairment in rats.

METHODS AND RESULTS

Streptozotocin injection was used to induce diabetes. Diabetic rats received nobiletin orally at 10 or 25 mg/kg daily for 30 days. Diabetic rats displayed significant elevations in glucose, glycosylated hemoglobin (HbA1c), Homeostatic Model of Insulin Resistance (HOMA-IR), and pro-inflammatory cytokines, while the serum levels of insulin, testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were significantly reduced. Histological changes to positivity for caspase-3 and decreased androgen receptors (AR) immunoexpression were observed in diabetic rats. Both doses of nobiletin improved hyperglycemia, reduced pro-inflammatory cytokines, and augmented insulin, testosterone, LH, and FSH levels. LH and FSH receptors and cytochrome P450 17 α-hydroxylase (CYP17A1) were markedly downregulated in terms of both gene and protein expression in testicular tissues of the diabetic group, effects that were markedly ameliorated with both doses of nobiletin. In addition, both doses significantly reduced lipid peroxidation and caspase-3 immunoexpression and improved the activity of the antioxidant enzymes and AR in testicular tissues of the diabetic group.

CONCLUSION

Both nobiletin doses showed protective effects against diabetes-induced testicular injury by reducing oxidative stress, hyperglycemia, inflammation, and caspase-3 and upregulating the hypophysis-gonadal axis and AR. The high dose of nobiletin was more effective than the lower one.

Impacts of garlic extract on testicular oxidative stress and sperm characteristics in type 1 and 2 diabetic rats: An experimental study

BACKGROUND

Hyperglycemia damages various tissues such as the testes through oxidative stress and inflammation, which can eventually lead to infertility.

OBJECTIVE

Garlic extract effects on the testicular tissue of diabetic rats were investigated.

MATERIALS AND METHODS

In this experimental study, 36 male Wistar rats (8-wk old, weighing 230-300 gr) were randomly divided into 6 groups (n = 6/each) including; C: control rats, G: received 0.4 gr of garlic extract/100 gr body weight, D1: Streptozotocin-induced-diabetic rats or type 1, D1+G: D1 rats that were treated with garlic, D2: Streptozotocin + nicotinamide-induced-diabetic rats or type 2, D2+G: D2 rats treated with garlic. At the end of the study, serum testosterone was assayed by ELISA. Also, sperm quality and quantity were evaluated. For determination of oxidative stress status, total antioxidant capacity, total oxidative status, lipid peroxidation, and thiol groups were assayed in the testis tissues of the rats by colorimetric methods. Also, inducible nitric oxide synthase (iNOS) gene expression and the protein level of interleukin-1 β (IL-1 β ) were determined by quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay, respectively.

RESULTS

In diabetic rats, glucose, total oxidative status and lipid peroxidation, iNOS gene expression, and IL-1 β were higher than in non-diabetic rats, whereas testosterone, total antioxidant capacity and thiol groups, and sperm quality were significantly lower compared with control rats. These alterations were normalized by garlic intervention.

CONCLUSION

In diabetic rats, garlic was associated with reduced glucose, oxidative stress, IL-1 β , and iNOS gene expression and increased testosterone and sperm quality. So, the results suggest that garlic can reduce the severity of damage in testicular tissues of diabetic rats through its hypoglycemic, antioxidant, and anti-inflammatory properties.

Tiliacora triandra extract and its major constituent attenuates diabetic kidney and testicular impairment by modulating redox imbalance and pro-inflammatory responses in rats

BACKGROUND

Literature has demonstrated that diabetes is associated with renal complication and testicular dysfunctions. The current study explored the potential of Tiliacora triandra extract and its major component against diabetic kidney and testicular damages in rats.

METHODS

Diabetes was induced by high fat diet/streptozotocin (HFD/STZ) and treated orally with Tiliacora triandra extract (TTE, 100 and 400 mg kg^-1 body weight) and its major component, 5,7-dihydroxy-6-oxoheptadecanoic acid (DHA, 25 mg kg^-1 body weight) for 30 consecutive days. Testicular activities of testicular enzymes, serum levels of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), sperm parameters and urinalysis for protein and albumin levels were evaluated. Renal and testicular biomarkers of oxidative stress and pro-inflammation were analysed along with histology.

RESULTS

The experimental diabetes induced significant alterations in the levels and activities of indices evaluated compared to non-diabetic normal rats. The 28-day treatment of diabetic rats with TTE and DHA markedly improved activities of testicular enzymes, restored levels of testosterone, LH and FSH and sperm parameters compared to untreated diabetic rats. TTE and DHA abrogated proteinuria and reversed urine albumin level. Testicular and renal oxidative stress and pro-inflammation were attenuated in diabetic rats treated with TTE and DHA. The diabetes-mediated histopathological damage was alleviated in the kidney and testis.

CONCLUSION

The protective effect of TTE and DHA against diabetes induced kidney and testicular damages may be related to its antioxidant and anti-inflammatory activities. © 2020 Society of Chemical Industry.

Protective effects of ethyl acetate extract from Shorea roxburghii against diabetes induced testicular damage in rats

Diabetic mellitus is a chronic metabolic disorder that is associated with several complications including testicular dysfunction. This research investigated the protective action of the ethyl acetate extract from Shorea roxburghii (SRE) on diabetes induced testicular damage in rats. Diabetic rats were orally administered with SRE at doses of 100 and 400 mg/kg for 4 weeks. SRE improved the body weight gain, testes weight, testes index and increased serum concentration of testosterone. Furthermore, SRE increased the testicular antioxidant enzymes including superoxide dismutase, catalase and glutathione peroxidase. In addition, SRE ameliorated testicular inflammatory mediators such as myeloperoxidase, tumor necrosis factor alpha, interleukin 6, p38 MAPK and nuclear factor kappa B activation and decreased testicular cell apoptosis in the treated diabetic rats. SRE also raised sperm parameters after treatment of diabetic rats. Conclusively, our results suggested that SRE ameliorated diabetes induced testicular damage by inhibiting oxidative stress and inflammation.

Vitamins combined with traditional Chinese medicine for male infertility: A systematic review and meta-analysis

BACKGROUND

Male infertility is a tough problem in medicine. This article aims to provide the latest evidence for the efficacy and safety of traditional Chinese medicine (TCM) combined with vitamins in the treatment of male infertility.

METHOD

All randomized controlled trials (RCTs) that used TCM combined with vitamins for male infertility treatment were included in databases of China National Knowledge Infrastructure (CNKI), Wanfang, VIP Database, China Biology Medicine disc (CBM), MEDLINE, EMBASE, and Cochrane Library. The quality of the included articles was evaluated using the Cochrane Reviewer's Handbook 5.3, and meta-analysis was performed using Stata 15.

RESULTS

A total of 14 eligible studies with 1488 patients were included in this meta-analysis. The results suggested that, compared with vitamin E or vitamin E + C alone, combination of TCM with vitamins increased significantly sperm concentration, sperm motility, sperm viability, liquefaction time of semen, the activity of acrosome enzyme, and the pregnancy rate of patients with male infertility. Three kinds of TCM (Shengjing capsule, Huanshao capsule, and compound Xuanju capsule) showed significant improvement for male infertility in terms of pregnancy rate, sperm concentration, or sperm motility. In addition, the results of the publication bias test demonstrated that no significant bias occurred.

CONCLUSION

Traditional Chinese medicine combined with vitamins has significant efficacy in the treatment of male infertility with no increase in side effects. The specific implementing regulations still need more long-term, multicenter, randomized, and double-blind clinical trials.