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Katami H, Suzuki S, Fujii T, Ueno M, Tanaka A, Ohta KI, Miki T, Shimono R. Genetic and histopathological analysis of spermatogenesis after short-term testicular torsion in rats. Pediatr Res 2023; 94:1650-1658. [PMID: 37225778 DOI: 10.1038/s41390-023-02638-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/23/2023] [Accepted: 04/20/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Patients with testicular torsion (TT) may exhibit impaired spermatogenesis from reperfusion injury after detorsion surgery. Alteration in the expressions of spermatogenesis-related genes induced by TT have not been fully elucidated. METHODS Eight-week-old Sprague-Dawley rats were grouped as follows: group 1 (sham-operated), group 2 (TT without reperfusion) and group 3 (TT with reperfusion). TT was induced by rotating the left testis 720° for 1 h. Testicular reperfusion proceeded for 24 h. Histopathological examination, oxidative stress biomarker measurements, RNA sequencing and RT-PCR were performed. RESULTS Testicular ischemia/reperfusion injury induced marked histopathological changes. Germ cell apoptosis was significantly increased in group 3 compared with group 1 and 2 (mean apoptotic index: 26.22 vs. 0.64 and 0.56; p = 0.024, and p = 0.024, respectively). Johnsen score in group 3 was smaller than that in group 1 and 2 (mean: 8.81 vs 9.45 and 9.47 points/tubule; p = 0.001, p < 0.001, respectively). Testicular ischemia/reperfusion injury significantly upregulated the expression of genes associated with apoptosis and antioxidant enzymes and significantly downregulated the expression of genes associated with spermatogenesis. CONCLUSION One hour of TT followed by reperfusion injury caused histopathological testicular damage. The relatively high Johnsen score indicated spermatogenesis was maintained. Genes associated with spermatogenesis were downregulated in the TT rat model. IMPACT How ischemia/reperfusion injury in testicular torsion (TT) affects the expressions of genes associated with spermatogenesis has not been fully elucidated. This is the first study to report comprehensive gene expression profiles using next generation sequencing for an animal model of TT. Our results revealed that ischemia/reperfusion injury downregulated the expression of genes associated with spermatogenesis and sperm function in addition to histopathological damage, even though the duration of ischemia was short.
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Affiliation(s)
- Hiroto Katami
- Department of Pediatric Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa Prefecture, Japan
| | - Shingo Suzuki
- Department of Anatomy and Neurobiology, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa Prefecture, Japan
| | - Takayuki Fujii
- Department of Pediatric Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa Prefecture, Japan
| | - Masaki Ueno
- Department of Pathology and Host Defense, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa Prefecture, Japan
| | - Aya Tanaka
- Department of Pediatric Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa Prefecture, Japan
| | - Ken-Ichi Ohta
- Department of Anatomy and Neurobiology, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa Prefecture, Japan
| | - Takanori Miki
- Department of Anatomy and Neurobiology, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa Prefecture, Japan
| | - Ryuichi Shimono
- Department of Pediatric Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa Prefecture, Japan.
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Long-term protective effects of the combination of intermittent reperfusion and hypothermia on reperfusion injury in an experimental testicular torsion model. J Pediatr Surg 2021; 56:2037-2044. [PMID: 33279218 DOI: 10.1016/j.jpedsurg.2020.11.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/21/2020] [Accepted: 11/21/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION There are many significantfactors in testicular injury which determine the prognosis in testicular torsion. Reperfusion injury following detorsion also has a significant effect on testicular injury.This study was planned considering that with the implementation of intermittent reperfusion and hypothermia, reperfusion injury can be reduced, and such an application might have a positive effect on testicular tissue in the long term. MATERIALS AND METHODS Forty adult male rats were divided into five groups as follows: Sham(Sh)(n = 8), Torsion(T)(n = 8), Intermittent reperfusion(IR)(n = 8), Hypothermia(H)(n = 8), and Intermittent reperfusion+hypothermia(IR+H)(n = 8). Except forGroup Sh, the left testicle was taken out of the scrotum in all groups, rotated three times counterclockwise, fixed back in the scrotum, and left for four hours.After four hours, and just before reperfusion, the testicle's detorsion was performed while holding the vascular structures in the proximal part of the torsed segment with an atraumatic vessel clamp, and thus, not allowing reperfusion in Groups T, IR, H, and IR+H. In Group T, the clamp was released immediately. In Group H, an ice-bag cooling was performed around the testis, and the clamp was released when the tissue temperature was reached and kept constant at 4 °C. In Group IR, the clamp was released, allowing reperfusion of five seconds, followed by reclamping, providing an ischemic status for ten seconds; this procedure was repeated ten times. In Group H+IR,an ice-bag cooling was performed around the testis, and the clamp was released when the tissue temperature was reached and kept constant at 4 °C. Then, reperfusion was applied for 5 s, followed by 10 s ischemia with reclamping. This procedure was repeated ten times.Tissue blood flow was provided for60 days of reperfusion in all groups. After 60 days, both testicles were excised under anesthesia in all living rats, and samples ofthe left testicle werereserved for biochemical and pathological examinations. At the end of the procedure, all animals were sacrificed by a high dose of anesthesia. RESULTS It was biochemically and histopathologically determined that the tissues were preserved in the experimental groups compared to Group T, which was statistically significant (p < 0.05).However, no experimental group's superiority over each other was determined both biochemically and histopathologically (p > 0.05). CONCLUSION Our long-term experimental study revealed that all methods were protective in testicular torsion. The authors believe that these methods can be applied in clinical practice because of their ease of application and no additional cost. On the other hand, the results of our study should further be supported by other experimental studies.
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Thaker H, Nelson CP. Adjuvant pharmacological and surgical therapy for testicular torsion: Current state of the art. J Pediatr Urol 2020; 16:807-814. [PMID: 32861587 PMCID: PMC8048197 DOI: 10.1016/j.jpurol.2020.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Although the consequences of testicular torsion (TT) have been recognized for centuries, little progress has been made to improve outcomes beyond those seen with timely scrotal exploration. Even with testicular salvage, ischemia/reperfusion injury cause significant atrophy and functional impairment. Recent efforts have sought to identify adjuvant pharmacological or surgical interventions that may attenuate these consequences. In this review, we assess the evidence supporting clinical use of these nascent interventions. METHODS We conducted a review of the literature published from 2000 to 2020, using the search terms "torsion", "testicular", "reperfusion", "ischemia", and "injury". Clinical and laboratory research focused on adjuvant pharmacological and surgical techniques mitigating torsion-associated injury in animal models and humans were identified. We recorded intervention timing/dose/route, and outcome timing/category through biomarkers of reperfusion injury, histology, and hormonal/reproductive function. RESULTS Fifty-four FDA-approved agents, plus 52 herbal/investigational drugs, were reported in animal TT models. In every study, the investigated agents showed beneficial effects on measured endpoints compared to controls. Despite these universally promising animal findings, no pharmacological trials in humans were reported. Surgical techniques studied in animal models included decompression (tunica albuginea incision, TAI), "ischemic conditioning", and hypothermia. Only three human studies on surgical adjuvant maneuvers have been reported, all involving TAI; these showed potential benefit, but the level of evidence is low. CONCLUSION There is preliminary evidence that adjuvant treatments may mitigate the effects of ischemia/reperfusion injury. However, the pool of investigated pharmacological agents is wide, yet remarkably shallow; most compounds have been reported in a single animal study. To advance this field, a mechanism-based approach should be used to select promising agents that can be tested systematically. This will determine treatment parameters that maximize safety, efficacy, and tolerability. Only then is it possible to move toward human trials. Adjuvant surgical methods such as TAI show promise in humans but require more robust clinical evaluation.
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Affiliation(s)
- Hatim Thaker
- Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Caleb P Nelson
- Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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Seker U, Nergiz Y, Aktas A, Akkus M, Ozmen MF, Uyar E, Soker S. Trolox is more successful than allopurinol to reduce degenerative effects of testicular ischemia/reperfusion injury in rats. J Pediatr Urol 2020; 16:465.e1-465.e8. [PMID: 32595071 DOI: 10.1016/j.jpurol.2020.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/20/2020] [Accepted: 05/10/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Reperfusion surgery following testicular ischemia is a reproductive health threatening status and may result with organ dysfunction in men. The high level of reactive oxygen species (ROS) and cease of blood flow to the testis are the most important reasons of this testicular injury. Until today, numerous experimental studies reported that antioxidants might be efficient to alleviate oxidative stress induced organ dysfunction. For this purpose, in this study, we have investigated the protective effects of xanthine oxidase (XO) inhibitor, allopurinol, and ROS scavenger, trolox, in a comparative perspective in testicular ischemia reperfusion injury subjected rats. MATERIALS AND METHODS Twenty-eight adult male Sprague Dawley rats were divided into four groups of seven animals in each; control, ischemia/reperfusion (I/R), allopurinol and trolox. The rats in control group did not receive any application. Animals in I/R, allopurinol and trolox groups were subjected to 2 h testicular reperfusion injury following 5 h ischemia. Intraperitoneally (i.p.) 1 ml isotonic, 200 mg/kg allopurinol and 50 mg/kg trolox were administered to the animals in these groups 30 min prior reperfusion. At the end of experiment, all animals were sacrificed and blood serum malondialdehyde (MDA) levels were measured. Histological sections were obtained from the testis and stained with hematoxylin and eosin (H&E), proliferating cell nuclear antigen (PCNA) and cleaved caspase-3. Apoptotic index was evaluated with TUNEL Assay. RESULTS Severe morphological degenerations, increased serum MDA, cleaved caspase-3 and TUNEL Assay positivity rate, but reduced PCNA positivity rate was observed in ischemia and reperfusion group. Morphological degenerations, MDA level, apoptotic index and PCNA positive cell rate were slightly alleviated in allopurinol administered animals compared with ischemia and reperfusion group. Protection with trolox was more successful and the results of the analysis were similar to the control group. DISCUSSION Ischemia that leading to testicular torsion is a reproductive health affecting problem and current surgical treatment methods might be insufficient to recover testis. Various types of ROS generating mechanisms in cell are limiting protective potency of allopurinol, and cocktail administration of different ROS inhibitors might be more effective. However, our results indicate that free radical scavenger trolox might be a candidate drug to alleviate degenerative effects of testicular ischemia reperfusion injury. CONCLUSIONS This is the first study that demonstrates antioxidant trolox was more successful than XO inhibitor allopurinol to protect testis against ischemia and reperfusion injury in rats.
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Affiliation(s)
- Ugur Seker
- Department of Histology and Embryology, Faculty of Medicine, Dicle University, Turkey.
| | - Yusuf Nergiz
- Department of Histology and Embryology, Faculty of Medicine, Dicle University, Turkey
| | - Ayfer Aktas
- Department of Histology and Embryology, Faculty of Medicine, Dicle University, Turkey
| | - Murat Akkus
- Department of Histology and Embryology, Faculty of Medicine, Dicle University, Turkey
| | - Mehmet Ferit Ozmen
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Medicine, Dicle University, Turkey
| | - Emre Uyar
- Department of Pharmacology, Faculty of Medicine, Dicle University, Turkey
| | - Sevda Soker
- Department of Histology and Embryology, Faculty of Medicine, Dicle University, Turkey
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Moradi-Ozarlou M, Javanmardi S, Tayefi-Nasrabadi H. Antioxidant property of Plantago major leaf extracts reduces testicular torsion/detorsion-induced ischemia/reperfusion injury in rats. VETERINARY RESEARCH FORUM : AN INTERNATIONAL QUARTERLY JOURNAL 2020; 11:27-33. [PMID: 32537104 PMCID: PMC7282225 DOI: 10.30466/vrf.2019.102182.2432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 05/07/2019] [Indexed: 11/01/2022]
Abstract
The present study was aimed to determine the protective effects of Plantago major L (PM) leaf extracts on the testicular torsion/detorsion (T/D)-induced ischemia/reperfusion (I/R) injury in rats. Twenty-four mature male Sprague-Dawley rats, weighing 200-220 g, were selected. They were randomly divided into four groups of six animals each: Sham (sham-operated rats; all the surgical steps were performed but T/D was not induced), TDC (Control group; T/D was induced and the right testicular torsion of 720° lasting two hours was followed by detorsion), TDP50 (T/D-operated rats received 50.00 mg kg-1 of PM extract daily for seven days intraperitoneally after detorsion) and TDP100 (T/D-operated rats received 100 mg kg-1 of PM extract daily for seven days intraperitoneally after detorsion). After seven days of treatment, the right testicles were collected. Histopathological and biochemical analyses including levels of malondialdehyde (MDA) and catalase (CAT) and peroxidase activities were determined in testicular tissues of the rats. Tissue sections were taken from testis, Hematoxylin-Eosin staining was done, and the slides were examined by a light microscope. The level of MDA was significantly increased in the testes of the TDC group. The CAT activity levels were decreased significantly after I/R. The post-torsion treatment with PM, particularly at 100 mg kg-1, prevented the increase in lipid peroxidation and reduced the CAT activity levels. The PM also prevented I/R-induced cellular damage and histological changes in the testicular tissues. According to the results of the current study, PM leaf extracts had significant positive effects on the testicular T/D-induced I/R injury. The possible mechanism of reduction in biochemical and histological injuries by PM extracts could be due to antioxidant property.
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Affiliation(s)
- Masoumeh Moradi-Ozarlou
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran;
| | - Sara Javanmardi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran;
| | - Hossein Tayefi-Nasrabadi
- Department of Basic Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran.
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Erdem AO, Coşkun ÖD, Başer AT, Şirinyıldız F, Ek R, Çulhacı N, Yazici M, Ozkisacik S. Comparison of the effects of intermittent reperfusion and hypothermia in preventing testicular ischemia-reperfusion injury in the testicular torsion model in rats. J Pediatr Urol 2019; 15:617-623. [PMID: 31630934 DOI: 10.1016/j.jpurol.2019.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/13/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Reperfusion injury after detorsion in testicular torsion is a clinical problem. This study was planned to investigate the protective effect of intermittent reperfusion in hypothermia-applied testicles. MATERIALS AND METHODS A total of 40 adult male rats were used, and 5 groups were created: sham (Sh; n = 8), torsion (T; torsion-detorsion) (n = 8), intermittent reperfusion (IR; n = 8), hypothermia (H; n = 8), and intermittent reperfusion+hypothermia (H+IR; n = 8). The left testicle was removed in all groups except in the Sh group, and it was rotated 3 times counterclockwise, fixed in the scrotum, and left for 4 h. After 4 h, the testicle was detorsioned in the groups T, IR, H, and H+IR. During detorsion, an atraumatic vessel clamp was applied in the proximal part of the vascular structures to prevent any reperfusion of the testicle. The clamp was opened immediately in the group T. In the group IR, the clamp was opened, a reperfusion of 5 s was applied; then, the clamp was closed again, and ischemia was created for 10 s; this procedure was repeated 10 times. In the group H, an ice bag cooling was performed around the testis. The tissue temperature was kept constant at 4 °C using a digital thermometer control. The testicle was cooled using an ice bag in the group H+IR; the same procedure was applied to the IR group. In all groups, reperfusion was performed for 1 h at the end of these procedures. The left testicle was removed from all rats; a portion of each testicle was separated for biochemistry testing, and some was separated for histopathological evaluation. At the end of the procedure, intracardiac blood was taken to examine oxidative stress parameters. At the end of the procedure, all animals were sacrificed after administration of a high dose of anesthesia. RESULTS The authors observed that the tissue was preserved in the experimental groups and this was statistically significant (p<0.05). It was detected that the tissues were also histopathologically and significantly preserved in the groups IR, H, and H+IR. However, both biochemically and histopathologically, there was no superiority of hypothermia, intermittent reperfusion, or combined application (p>0.05). DISCUSSION Both hypothermia and intermittent reperfusion alone protect tissue from IR damage. But no studies have been found in which these applications were used together. And as a result of this work, the combination of both methods did not show superiority over the effect they showed when they were used separately. The authors think that these methods can be applied clinically because of their ease of application and no additional costs; however, it should be supported by other studies.
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Affiliation(s)
- Ali Onur Erdem
- Adnan Menderes University Medical School, Department of Pediatric Surgery, Turkey.
| | - Özge Durmaz Coşkun
- Gaziantep Şehit Kamil Public Hospital, Department of Pediatric Surgery, Turkey
| | - Ayça Töre Başer
- Adnan Menderes University Medical School, Department of Pediatric Surgery, Turkey
| | - Ferhat Şirinyıldız
- Adnan Menderes University Medical School, Department of Physiology, Turkey
| | - Rauf Ek
- Adnan Menderes University Medical School, Department of Physiology, Turkey
| | - Nil Çulhacı
- Adnan Menderes University Medical School, Department of Pathology, Turkey
| | - Mesut Yazici
- Adnan Menderes University Medical School, Department of Pediatric Surgery, Turkey
| | - Sezen Ozkisacik
- Adnan Menderes University Medical School, Department of Pediatric Surgery, Turkey
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Ganjiani V, Ahmadi N, Raayat Jahromi A. Protective effects of
Stevia rebaudiana
aqueous extract on experimental unilateral testicular ischaemia/reperfusion injury in rats. Andrologia 2019; 52:e13469. [DOI: 10.1111/and.13469] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/19/2019] [Accepted: 09/28/2019] [Indexed: 12/19/2022] Open
Affiliation(s)
- Vahid Ganjiani
- School of Veterinary Medicine Shiraz University Shiraz Iran
| | - Nasrollah Ahmadi
- Veterinary Pathology School of Veterinary Medicine Shiraz University Shiraz Iran
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Ghasemnejad-Berenji M, Ghazi-Khansari M, Yazdani I, Nobakht M, Abdollahi A, Ghasemnejad-Berenji H, Mohajer Ansari J, Pashapour S, Dehpour AR. Effect of metformin on germ cell-specific apoptosis, oxidative stress and epididymal sperm quality after testicular torsion/detorsion in rats. Andrologia 2017; 50. [DOI: 10.1111/and.12846] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 12/22/2022] Open
Affiliation(s)
- M. Ghasemnejad-Berenji
- Department of Pharmacology; School of Medicine; Tehran University of Medical Sciences; Tehran Iran
- Experimental Medicine Research Center; Tehran University of Medical Sciences; Tehran Iran
- Department of Pharmacology; Faculty of Pharmacy; Urmia University of Medical Sciences; Urmia Iran
| | - M. Ghazi-Khansari
- Department of Pharmacology; School of Medicine; Tehran University of Medical Sciences; Tehran Iran
| | - I. Yazdani
- Department of Pharmacology; School of Medicine; Tehran University of Medical Sciences; Tehran Iran
- Experimental Medicine Research Center; Tehran University of Medical Sciences; Tehran Iran
| | - M. Nobakht
- Department of Anatomy; School of Medicine; Iran University of Medical Sciences; Tehran Iran
| | - A. Abdollahi
- Department of Pathology; Cancer Institute; Tehran University of Medical Sciences; Tehran Iran
| | - H. Ghasemnejad-Berenji
- Department of Anatomy and Reproductive Biology; School of Medicine; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - J. Mohajer Ansari
- Department of Anatomy; School of Medicine; Iran University of Medical Sciences; Tehran Iran
| | - S. Pashapour
- Department of Pathology; Urmia University of Medical Science; Urmia Iran
| | - A. R. Dehpour
- Department of Pharmacology; School of Medicine; Tehran University of Medical Sciences; Tehran Iran
- Experimental Medicine Research Center; Tehran University of Medical Sciences; Tehran Iran
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Dias Filho AC, Oliveira Rodrigues R, Riccetto CL, Oliveira PG. Improving Organ Salvage in Testicular Torsion: Comparative Study of Patients Undergoing vs Not Undergoing Preoperative Manual Detorsion. J Urol 2017; 197:811-817. [DOI: 10.1016/j.juro.2016.09.087] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Cassio L.Z. Riccetto
- Department of Surgery, Division of Urology, Hospital das Clínicas da Universidade Estadual de Campinas, Campinas, Brazil
| | - Paulo Gonçalves Oliveira
- Department of Surgery, Faculdade de Ciências Médicas da Universidade de Brasília, Brasilia, Brazil
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Shimizu S, Tsounapi P, Dimitriadis F, Higashi Y, Shimizu T, Saito M. Testicular torsion-detorsion and potential therapeutic treatments: A possible role for ischemic postconditioning. Int J Urol 2016; 23:454-63. [DOI: 10.1111/iju.13110] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/29/2016] [Indexed: 01/30/2023]
Affiliation(s)
- Shogo Shimizu
- Department of Pharmacology; Kochi Medical School; Kochi University; Nankoku Kochi Japan
| | - Panagiota Tsounapi
- Division of Urology; Tottori University School of Medicine; Yonago Tottori Japan
| | - Fotios Dimitriadis
- Department of Urology; School of Medicine; Ioannina University; Ioannina Greece
| | - Youichirou Higashi
- Department of Pharmacology; Kochi Medical School; Kochi University; Nankoku Kochi Japan
| | - Takahiro Shimizu
- Department of Pharmacology; Kochi Medical School; Kochi University; Nankoku Kochi Japan
| | - Motoaki Saito
- Department of Pharmacology; Kochi Medical School; Kochi University; Nankoku Kochi Japan
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11
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Mertoğlu C, Senel U, Cayli S, Tas U, Küskü Kiraz Z, Özyurt H. Protective role of methylprednisolone and heparin in ischaemic-reperfusion injury of the rat testicle. Andrologia 2015; 48:737-44. [PMID: 26626546 DOI: 10.1111/and.12503] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2015] [Indexed: 12/15/2022] Open
Abstract
This study evaluated the therapeutic efficacy of heparin and methylprednisolone in the treatment of ischaemic reperfusion (IR) injury of the testis. Twenty-four male Sprague-Dawley rats were allocated equally into three groups of eight animals each. The left testes were rotated 720° for 2 h in the rats in the torsion-detorsion group. Rats in the treatment groups underwent the same surgical procedure as the torsion-detorsion group but were also given methylprednisolone (group II) or heparin (group III) by an intraperitoneal route 30 min prior to detorsion. Left orchiectomy was performed in all rats from each experimental animal at 2 h after detorsion, and the tissue was harvested for the measurement of malondialdehyde (MDA), protein carbonyl (PC) and nitric oxide (NO) and the endogenous antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase. Additional tissue was evaluated using histopathological and immunohistochemical changes. PC and MDA levels were significantly reduced in the treated groups compared to the control group. There was no statistically significant difference in NO level or SOD, GSH-Px and catalase activity among the treatment groups. Histopathological and immunohistochemical findings supported biochemical changes. It is concluded that pre-treatment with methylprednisolone or heparin protects the testis in ischaemic reperfusion injury caused by testicular torsion-detorsion.
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Affiliation(s)
- C Mertoğlu
- Medical Biochemistry, Faculty of Medicine, Erzincan University, Erzincan, Turkey
| | - U Senel
- Pediatric Surgery, Faculty of Medicine, Ufuk Şenel: Gaziosmanpasa University, Tokat, Turkey
| | - S Cayli
- Histology and Embryology, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - U Tas
- Anatomy, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | | | - H Özyurt
- Medical Biochemistry, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
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12
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Effects of gradual low-flow reperfusion postconditioning on ischemia–reperfusion injury involving incomplete testicular torsion in rabbits. J Med Ultrason (2001) 2014; 42:207-14. [DOI: 10.1007/s10396-014-0591-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
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13
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Ozkisacik S, Yazici M, Gursoy H, Culhaci N. Does gradual detorsion protect the ovary against ischemia-reperfusion injury in rats? Pediatr Surg Int 2014; 30:437-40. [PMID: 24519483 DOI: 10.1007/s00383-014-3480-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2010] [Indexed: 11/26/2022]
Abstract
AIM Adnexal torsion is an infrequent and serious gynecologic surgical emergency. Adnexal torsion may result from pre-existing tubal or ovarian pathology or hyperstimulation of the ovary during ovulation. Early diagnosis and emergency surgical treatment (detorsion) are important to preserve fertility and to prevent peritonitis or loss of the adnexa. However, during reperfusion, tissue damage is more severe than during ischemia because of oxygen-derived radicals. The present study aimed to investigate the protective effect of gradual detorsion on adnexal torsion. MATERIALS AND METHODS Twenty-one adult female rats were divided into three groups as sham-operated (Sh group, n = 7); torsion + detorsion (TD group, n = 7); and torsion + gradual detorsion (TGD group, n = 7). A midline laparotomy was performed under anesthesia. In the TD and TGD groups, the left adnexa along with tubal and ovarian vessels were twisted three times in a clockwise direction and fixed to the abdominal wall. After 30 h, detorsion was performed on the mesenteries of both TD and TGD groups. In the TGD group, however, detorsion was performed gradually: the ovarian mesentery was detorsioned 360°, followed by a 5-min pause, then a repeat of the cycle until full detorsion was achieved. Rats were killed 1 week later. Left ovaries were removed and evaluated histopathologically. RESULTS The histopathological mean grade was significantly higher in the TD than in the TGD group (p < 0.05). CONCLUSION Gradual detorsion can reduce reperfusion injury in a rat model of ovarian torsion. This method is easily applicable and may be a useful method for human patients with ovarian torsion.
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Affiliation(s)
- Sezen Ozkisacik
- Department of Pediatric Surgery, Adnan Menderes University Faculty of Medicine, Aydin, Turkey,
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14
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Beneficial effects of taurine and carnosine in experimental ischemia/reperfusion injury in testis. Pediatr Surg Int 2012; 28:1125-31. [PMID: 22961384 DOI: 10.1007/s00383-012-3168-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 12/15/2022]
Abstract
PURPOSE Testicular torsion can be thought of as an ischemia/reperfusion (I/R) injury to the testis. This study aimed to investigate the effects of taurine (TAU) and carnosine (CAR), which are strong antioxidants, on experimental testicular I/R injury model. METHODS Male Wistar albino rats were divided into four groups with eight animals in each. A sham operation was performed in group 1. To create testicular I/R, the left testis was torsioned 720° for 2 h followed by 2 h of detorsion. Groups 2 (I/R), 3 (I/R + TAU) and 4 (I/R + CAR) received intraperitoneal saline, TAU (250 mg/kg) and CAR (250 mg/kg), respectively, 1 h before detorsion. Thiobarbituric acid reactive substances (TBARS), diene conjugate (DC), protein carbonyls (PC), nonprotein sulfhydryl (NPSH), and vitamin C levels were measured in testis tissues as well as superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities. Histopathological evaluation was also performed. RESULTS TBARS, DC, and PC levels were significantly increased in I/R group. TAU and CAR did not alter TBARS levels, but decreased the elevated DC and PC levels. There were no changes in testicular NPSH levels, SOD, and GPx activities in all groups; however, vitamin C significantly decreased in I/R group. CAR treatment was found to increase vitamin C levels as compared to I/R group. Histopathologically, both I/R + TAU and I/R + CAR groups showed significant increase in testicular spermatogenesis in comparison to I/R group. CONCLUSION Our results indicate that TAU and CAR reduces oxidative stress and may have a protective role in testicular I/R injury.
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The hypoxic testicle: physiology and pathophysiology. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2012; 2012:929285. [PMID: 23056665 PMCID: PMC3465913 DOI: 10.1155/2012/929285] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Revised: 08/07/2012] [Accepted: 08/09/2012] [Indexed: 12/15/2022]
Abstract
Mammalian spermatogenesis is a complex biological process occurring in the seminiferous tubules in the testis. This process represents a delicate balance between cell proliferation, differentiation, and apoptosis. In most mammals, the testicles are kept in the scrotum 2 to 7°C below body core temperature, and the spermatogenic process proceeds with a blood and oxygen supply that is fairly independent of changes in other vascular beds in the body. Despite this apparently well-controlled local environment, pathologies such as varicocele or testicular torsion and environmental exposure to low oxygen (hypoxia) can result in changes in blood flow, nutrients, and oxygen supply along with an increased local temperature that may induce adverse effects on Leydig cell function and spermatogenesis. These conditions may lead to male subfertility or infertility. Our literature analyses and our own results suggest that conditions such as germ cell apoptosis and DNA damage are common features in hypoxia and varicocele and testicular torsion. Furthermore, oxidative damage seems to be present in these conditions during the initiation stages of germ cell damage and apoptosis. Other mechanisms like membrane-bound metalloproteinases and phospholipase A2 activation could also be part of the pathophysiological consequences of testicular hypoxia.
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Ozkisacik S, Erdem AO, Durmaz O, Culhaci N, Gursoy H, Yazici M. The long-term protective effects of short-interval postconditioning in testicular ischemia-reperfusion injury in rats. J Pediatr Surg 2012; 47:743-6. [PMID: 22498390 DOI: 10.1016/j.jpedsurg.2011.10.070] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 09/29/2011] [Accepted: 10/23/2011] [Indexed: 11/27/2022]
Abstract
AIM Even with prompt diagnosis and treatment, testicular torsion may lead to infertility and atrophy after testicular salvage. The aims of this study were to investigate the long-term protective effects of short-interval postconditioning on testicular atrophy and to optimize the reperfusion period. MATERIALS AND METHODS Forty adult male rats were divided into 5 subgroups: sham operated; torsion + detorsion; torsion + postconditioning, 5 seconds (PC5); torsion + postconditioning, 10 seconds; and torsion + postconditioning, 20 seconds. Torsion was created by rotating the left testis 1080° counterclockwise and then fixing the testis to the scrotum with 3 sutures. Torsion was maintained for 4 hours. The testicular artery was visualized, and an atraumatic vascular clamp was applied to prevent reperfusion in all study groups. Detorsion of the testis was then performed. In the torsion + detorsion group, the clamp was released just after detorsion. In all the other intervention groups, the subsequent procedures were repeated 10 times. In the PC5 group, the clamp was released for 5 seconds and applied for 10 seconds; in the torsion + postconditioning, 10 seconds group, the clamp was released for 10 seconds and applied for 10 seconds; and in the torsion + postconditioning, 20 seconds group, the clamp was released for 20 seconds and applied for 10 seconds. Then, reperfusion was allowed. After 60 days, rats in all study groups were killed, both testes were removed, and the histopathology was evaluated. The χ(2) test was used for statistical analysis. RESULTS Compared with the other groups, the extent of tissue injury determined by histopathologic grades according to Cosentino et al (J Androl. 1986;7:23-31) was significantly less in group PC5 (P < .05). CONCLUSION We conclude that short-interval postconditioning can protect against long-term testicular reperfusion injury. Furthermore, the optimal time for reperfusion during postconditioning was 5 seconds in our rat model of testicular torsion. This technique seems easily applicable, and evidence suggests that similar techniques may be useful during testicular surgery.
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Affiliation(s)
- Sezen Ozkisacik
- Department of Pediatric Surgery, Adnan Menderes University Faculty of Medicine, Aydin, Turkey.
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Ozkisacik S, Yazici M, Gursoy H, Serter M, Culhaci N. The effects of short-interval postconditioning in preventing testicular ischemia-reperfusion injury in rats. J Pediatr Surg 2011; 46:546-50. [PMID: 21376207 DOI: 10.1016/j.jpedsurg.2010.08.056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 08/12/2010] [Accepted: 08/12/2010] [Indexed: 11/17/2022]
Abstract
AIM Testicular torsion can lead to testicular damage. During reperfusion, tissue damage is more severe. The aim of this study was to investigate the protective effect of short-interval postconditioning and determine the optimal time of reperfusion for postconditioning. MATERIALS AND METHODS Thirty-five adult male rats were divided into 5 subgroups: Sh (sham operated), TD (torsion + detorsion), PC5 (torsion + postconditioning 5 seconds), PC10 (torsion + postconditioning-10 seconds), PC20 (torsion + postconditioning 20 seconds). Torsion was created by rotating the left testis counterclockwise 1080° and the testis fixed to the scrotum with 3 sutures. Torsion was maintained for 4 hours. The testicular artery was visualized, and before detorsion of the testis, an atraumatic vessel clamp was applied to prevent reperfusion in all study groups. Then, detorsion of the testis was performed. In the TD group, the clamp was released just after detorsion; in the PC5 group, the clamp was released for 5 seconds and closed for 10 seconds (10 times); in the PC10 group, the clamp was released for 10 seconds and closed for 10 seconds (10 times); and in the PC20 group, the clamp was released for 20 seconds and closed for 10 seconds (10 times). Then, all testes were reperfused for a 1-hour period in all study groups. After this period, the rats were sacrificed, and the left testes were removed and evaluated histopathologically and biochemically. The Mann-Whitney U test was used for statistical analyses. RESULTS Tissue malondialdehyde levels were 79.3 ± 10.6, 231.7 ± 102.3, 71.3 ± 12.6, 73.8 ± 13.7, and 124.3 ± 48.0 nmol/g tissue in the Sh, TD, PC5, PC10, and PC20 groups, respectively. Tissue malondialdehyde levels were significantly lower in the PC5 and PC10 groups (P < .05) compared to the other groups. However, mean histopathologic grade was lower in all postconditioning groups compared to the control group, but the difference was significant only in the PC5 group (P < .05). CONCLUSION We conclude that short-interval postconditioning can reduce reperfusion injury in ischemic tissue and the optimal mode of short-interval postconditioning is 5 seconds × 10 times. This technique seems easily applicable, and a similar technique may be used during testicular surgery.
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Affiliation(s)
- Sezen Ozkisacik
- Department of Pediatric Surgery, Adnan Menderes University Faculty of Medicine, Aydin, Turkey.
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Atahan E, Ergün Y, Kurutaş EB, Alici T. Protective effect of zinc aspartate on long-term ischemia-reperfusion injury in rat skeletal muscle. Biol Trace Elem Res 2010; 137:206-15. [PMID: 19937281 DOI: 10.1007/s12011-009-8568-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2009] [Accepted: 11/03/2009] [Indexed: 10/20/2022]
Abstract
The present study investigated the protective effect of zinc aspartate, in connection with reactive oxygen species and nitric oxide, on long-term ischemia-reperfusion injury (IRI) in rat skeletal muscle. Following ketamine anesthesia, 24 rats were randomly assigned to four groups: groups 1 and 2, each without tourniquet application, received no drug and zinc, respectively; groups 3 and 4, each subjected to tourniquet-induced IRI (3 + 24 h), received no drug and zinc, respectively. IRI was achieved by the application of an elastic rubber band in the left hind limb of the anesthetized rats. Gastrocnemius muscle samples were obtained for biochemical measurements. Malondialdehyde levels were lower in group 2 and higher in group 3 than those seen in group 1. However, zinc aspartate (group 4) totally reversed malondialdehyde levels to control levels. Superoxide dismutase activity was increased in group 2 compared with group 1; however, there was no difference between groups 1 and 3, and Zn injection (group 4) increased superoxide dismutase activity. While catalase values were similar in groups 1 and 2, significant increments were observed in 3 and 4. A similar enhancement in glutathione levels were observed in groups 2 and 4 compared with group 1. Nitric oxide levels were lower in group 2 than 1, and no difference between groups 1 and 3 was demonstrated. In conclusion, zinc seems to be an effective treatment option against IRI.
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Affiliation(s)
- Erhan Atahan
- Department of Cardiovascular Surgery, School of Medicine, Cumhuriyet University, Sivas, Turkey
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Shimizu S, Saito M, Dimitriadis F, Kinoshita Y, Shomori K, Satoh I, Satoh K. Protective effect of ischaemic post-conditioning on ipsilateral and contralateral testes after unilateral testicular ischaemia-reperfusion injury. ACTA ACUST UNITED AC 2010; 34:268-75. [DOI: 10.1111/j.1365-2605.2010.01077.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Long term testicular ischemia-reperfusion injury-induced apoptosis: involvement of survivin down-regulation. Biochem Biophys Res Commun 2010; 395:342-7. [PMID: 20380811 DOI: 10.1016/j.bbrc.2010.04.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 04/02/2010] [Indexed: 11/23/2022]
Abstract
Testicular torsion is associated with damage to the testicular tissue as a result of ischemia-reperfusion injury (IRI) and induction of apoptosis leading to progressive damage to spermatogenesis. Survivin is suggested to be an important regulator in the control of the mitochondrial apoptotic pathway, although its role in torsion-induced IRI is unknown. Therefore, we sought to evaluate testicular survivin expression after long term IRI induced by testicular torsion. Survivin expression was measured by real-time PCR in 6-12 month old New Zealand white rabbits divided into three groups (4 animals/group): group (A) sham control, group (B) ischemia alone for 60 min and group (C) ischemia for 60 min followed by reperfusion for 6 months. Germ cell apoptosis was evaluated by TUNEL assay, Bax/Bcl-2 ratio and DNA fragmentation. The Johnsen score was used to assess testicular morphological damage, while lipid peroxidation was used as an indicator for oxidative stress. Survivin expression was detected in all testicular tissue samples. The rate of survivin expression after IRI was significantly higher (p<0.05) compared with ischemic only and sham control testes. Its expression in IRI samples was inversely correlated with the significant increase (p<0.05) in apoptosis, oxidative levels and spermatogenic damage. In conclusion, down-regulation of testicular survivin expression after long term IRI to the testis and its association with apoptosis induction suggests its involvement in the regulation of this apoptotic pathway. These findings also identify survivin as a potential new target for the prevention of germ cell death during testicular torsion.
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