1
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Zhao Y, Zhao X, Feng X. Alpha-lipoic acid upregulates the PPARγ/NRF2/GPX4 signal pathway to inhibit ferroptosis in the pathogenesis of unexplained recurrent pregnancy loss. Open Med (Wars) 2024; 19:20240963. [PMID: 38859880 PMCID: PMC11163161 DOI: 10.1515/med-2024-0963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/16/2024] [Accepted: 04/07/2024] [Indexed: 06/12/2024] Open
Abstract
Aim With unknown etiology and limited treatment options, unexplained recurrent pregnancy loss (URPL) remains a thorny problem. Ferroptosis, a newly identified type of cell death, has been shown to be crucial in the development in reproductive disorders. This study aims to explore the specific mechanism of ferroptosis in URPL and to uncover whether alpha-lipoic acid (ALA) can inhibit ferroptosis, and then exert a protective effect in URPL. Method The decidua tissues of URPL and control patients who actively terminated pregnancy were collected. The CBA/J × DBA/2 murine models of URPL were established, and were randomly treated with peroxisome proliferator activated receptor γ (PPARγ) agonists (Rosiglitazone) and ALA. The CBA/J × BALB/c murine models of normal pregnancy were intraperitoneally injected with PPARγ inhibitors (T0070907). Here, we used reactive oxygen species (ROS), malondialdehyde (MDA), glutathione (GSH)/GSSG, and FeRhoNox-1 analysis to detect the level of ferroptosis. We used quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) analysis to evaluate the mRNA level of PPARγ. Besides, western blot and immunofluorescence were utilized to test the expression profile of PPARγ/nuclear factor erythroid 2-related factor 2 (NRF2)/glutathione peroxidase 4 (GPX4). Results In this study, we found that iron deposition was increased in the decidual tissue of patients with URPL. Additionally, the changes in cell morphology, the level of ROS, MDA, GSH, and the expression of ferroptosis marker proteins NRF2/GPX4 confirmed activated ferroptosis in URPL. Besides, bioinformatics analysis combined with experiments confirmed that PPARγ was critical in triggering NRF2/GPX4 pathway in URPL. Furthermore, URPL mouse models were established, and the results showed that PPARγ/NRF2/GPX4-mediated ferroptosis was also significantly increased, which could be mitigated by ALA treatment. Conclusion Overall, these findings suggest that ferroptosis may play an important role in URPL, and ALA might be a promising therapeutic drug for improving pregnancy outcomes in URPL via targeting the PPARγ/NRF2/GPX4 pathway.
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Affiliation(s)
- Yan Zhao
- Department of Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Xiaoxuan Zhao
- Department of Traditional Chinese Medicine (TCM) Gynecology, Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310007, China
| | - Xiaoling Feng
- Department of Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China
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2
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Chilaka KN, Namoju R. Maternal supplementation of alpha-lipoic acid ameliorates prenatal cytarabine-induced mutilation in reproductive development and function in F1 male adult rats. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:4035-4053. [PMID: 38010397 DOI: 10.1007/s00210-023-02852-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Abstract
AIMS Cytarabine (CYT), a prevalent anticancer drug for blood cancers, detrimentally affects male reproductive development and function. Alpha-lipoic acid (ALA), a universal antioxidant, offers defense against chemical-induced reproductive dysfunction. Our study sought to explore ALA's protective role against prenatal CYT-induced reproductive impairment in F1 male adult rats. MAIN METHODS Pregnant rats were divided into 5 groups and administered normal saline, ALA 200 mg/kg, CYT 12.5 mg/kg, CYT 25 mg/kg, and CYT 25 mg/kg + ALA 200 mg/ kg from gestational day 8 to 21. On postnatal day 73, F1 male rats were sacrificed, and general, oxidative, steroidogenic, spermatogenic, histological, and morphometrical parameters were evaluated. KEY FINDINGS Prenatal CYT caused dose-dependent reductions in body weight, testis, and accessory gland weights; elevated oxidative stress; delayed puberty onset; sperm anomalies (decreased count, motility, viability, seminal fructose; increased morphological anomalies); impeded steroidogenesis (lower testosterone, follicle-stimulating hormone, luteinizing hormone, 3β-Hydroxysteroid dehydrogenase(HSD), 17β-HSD, and elevated cholesterol); and testicular histopathological and morphometric disturbances. Maternal supplementation of ALA was found to alleviate all the CYT-induced reproductive disruptions. SIGNIFICANCE The present work accentuates the beneficial actions of ALA against CYT-induced impairment in reproductive development and functions by combating disruptions in oxidative balance, steroidogenesis, spermatogenesis, and testicular histological aberrations. However, future experimental and clinical studies are warranted to explore the molecular mechanisms involved in the ALA's protection against prenatal CYT-induced testicular injury.
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Affiliation(s)
- Kavitha N Chilaka
- GITAM Institute of Pharmacy, GITAM Deemed to Be University, Rushikonda, Visakhapatnam, Andhra Pradesh, 530045, India
| | - Ramanachary Namoju
- GITAM Institute of Pharmacy, GITAM Deemed to Be University, Rushikonda, Visakhapatnam, Andhra Pradesh, 530045, India.
- Department of Pharmacology, Bhaskar Pharmacy College, Jawaharlal Nehru Technical University, Hyderabad, Telangana, 500075, India.
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3
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Hodeeb YM, El-Rewiny EM, Gaafar AM, Zayed AN, Hasan MS, Elsaie ML. The effect of alpha lipoic acid supplementation on sperm functions in idiopathic asthenozoospermic patients: a case-controlled study. HUM FERTIL 2023; 26:949-957. [PMID: 35023797 DOI: 10.1080/14647273.2021.2025271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 10/31/2021] [Indexed: 11/04/2022]
Abstract
Alpha-lipoic acid (ALA) is a natural short chain fatty acid containing sulfhydryl groups generated from octanoic acid and cysteine in the mitochondria, and is found in both the aqueous and lipid phases. The present study aimed to assess the efficacy of ALA supplementation in primary infertile males complaining of idiopathic asthenozoospermia. Eighty patients were randomly allocated to treatment group A (n = 40) and control group B (n = 40) groups, receiving daily doses of 600 mg (divided into two daily doses of 300 mg each) of alpha lipoic acid (ALA) or an identical placebo for 90 days. Semen analysis, anthropometric and total antioxidant capacity were analysed and compared before and after treatment. Daily supplementation with ALA improved total motility and progressive motility of the spermatozoa. In the ALA-treated group, sperm motility and progressive motility increased significantly, similarly, the mean percentage of sperm vitality demonstrated a significant increase among the ALA treated group (p < 0.001). Analysis revealed a statistically significant increase in semen volume and sperm concentration in the ALA supplemented group, while abnormal morphology decreased significantly (p < 0.001). ALA supplementation significantly improved sperm parameters and functional tests in group A patients. ALA supplementation in patients with idiopathic asthenozoospermic thus enhanced sperm quality and viability, which could therefore be considered as an adjunct therapy pending further verification of its association and mechanisms involved.
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Affiliation(s)
- Yahya M Hodeeb
- Department of Dermatology, Venereology and Andrology, Al Azhar University, Cairo, Egypt
| | - Emad M El-Rewiny
- Department of Dermatology, Venereology and Andrology, Al Azhar University, Cairo, Egypt
| | | | - Ahmed N Zayed
- Department of Dermatology, Venereology and Andrology, Al Azhar University, Cairo, Egypt
| | - Mohamed S Hasan
- Department of Dermatology, Venereology and Andrology, Al Azhar University, Cairo, Egypt
| | - Mohamed L Elsaie
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
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4
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Kaltsas A. Oxidative Stress and Male Infertility: The Protective Role of Antioxidants. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1769. [PMID: 37893487 PMCID: PMC10608597 DOI: 10.3390/medicina59101769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/24/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023]
Abstract
Oxidative stress is a significant factor in male infertility, compromising sperm function and overall reproductive health. As male infertility garners increasing attention, effective therapeutic interventions become paramount. This review investigates the therapeutic role of antioxidants in addressing male infertility. A detailed examination was conducted on antioxidants such as vitamin C, E, B12, D, coenzyme Q10, zinc, folic acid, selenium, l-carnitine, l-arginine, inositols, and alpha-lipoic acid. This analysis examines the methodologies, outcomes, and constraints of current clinical studies. Antioxidants show notable potential in counteracting the negative effects of oxidative stress on sperm. Based on the evidence, these antioxidants, individually or synergistically, can enhance sperm health and reproductive outcomes. However, certain limitations in the studies call for careful interpretation. Antioxidants are integral in tackling male infertility attributed to oxidative stress. The current findings underscore their therapeutic value, yet there's a pressing need for deeper, comprehensive research. Future studies should focus on refining dosage guidelines, identifying potential side effects, and discerning the most efficacious antioxidant combinations for male infertility solutions.
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Affiliation(s)
- Aris Kaltsas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
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5
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Naderi N, Nejad ZD, Tavalaee M, Nasr-Esfahani MH. The effect of alpha-lipoic acid on sperm functions in rodent models for male infertility: A systematic review. Life Sci 2023; 323:121383. [PMID: 36640903 DOI: 10.1016/j.lfs.2023.121383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/04/2023] [Accepted: 01/07/2023] [Indexed: 01/13/2023]
Abstract
In this systematic review, we assessed different studies to evaluate the protective effect of alpha-lipoic acid (ALA), as a multifaceted antioxidant, on sperm functions in rodent models. Four databases were searched to find papers reporting the effect of ALA treatment on animal models of male infertility. Up to December 2022, 11,787 articles were identified to explain the ALA protective effects. The included studies were evaluated for eligibility and risk of bias (CRD42022341370). Finally, we identified 23 studies that explain the effect of ALA on sperm functions in rodents. Among them, 15 studies indicated that ALA could restore sperm parameters. Six studies showed a significant reduction in sperm DNA damage by ALA treatment. Seventeen papers displayed the ALA antioxidant ability, and four studies indicated the ALA anti-inflammatory effect. Besides, thirteen studies displayed that ALA could modulate androgenesis. Also, eighteen studies revealed that ALA restored the testicular architecture to normal, and was also effective in restoring reproductive performance in two included studies. This systematic review provided cogent evidence for the protective effect of ALA in rodent models for male infertility by re-establishing spermatogenesis and steroidogenesis and maintaining redox and immune systems homeostasis.
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Affiliation(s)
- Nushin Naderi
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Zahra Darmishon Nejad
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Marziyeh Tavalaee
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran; Isfahan Fertility and Infertility Center, Isfahan, Iran.
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Tripathi AK, Ray AK, Mishra SK, Bishen SM, Mishra H, Khurana A. Molecular and Therapeutic Insights of Alpha-Lipoic Acid as a Potential Molecule for Disease Prevention. REVISTA BRASILEIRA DE FARMACOGNOSIA : ORGAO OFICIAL DA SOCIEDADE BRASILEIRA DE FARMACOGNOSIA 2023; 33:272-287. [PMID: 36778891 PMCID: PMC9904877 DOI: 10.1007/s43450-023-00370-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
Alpha-lipoic acid is an organic, sulfate-based compound produced by plants, humans, and animals. As a potent antioxidant and a natural dithiol compound, it performs a crucial role in mitochondrial bioenergetic reactions. A healthy human body, on the other hand, can synthesize enough α-lipoic acid to scavenge reactive oxygen species and increase endogenous antioxidants; however, the amount of α-lipoic acid inside the body decreases significantly with age, resulting in endothelial dysfunction. Molecular orbital energy and spin density analysis indicate that the sulfhydryl (-SH) group of molecules has the greatest electron donating activity, which would be responsible for the antioxidant potential and free radical scavenging activity. α-Lipoic acid acts as a chelating agent for metal ions, a quenching agent for reactive oxygen species, and a reducing agent for the oxidized form of glutathione and vitamins C and E. α-Lipoic acid enantiomers and its reduced form have antioxidant, cognitive, cardiovascular, detoxifying, anti-aging, dietary supplement, anti-cancer, neuroprotective, antimicrobial, and anti-inflammatory properties. α-Lipoic acid has cytotoxic and antiproliferative effects on several cancers, including polycystic ovarian syndrome. It also has usefulness in the context of female and male infertility. Although α-lipoic acid has numerous clinical applications, the majority of them stem from its antioxidant properties; however, its bioavailability in its pure form is low (approximately 30%). However, nanoformulations have shown promise in this regard. The proton affinity and electron donating activity, as a redox-active agent, would be responsible for the antioxidant potential and free radical scavenging activity of the molecule. This review discusses the most recent clinical data on α-lipoic acid in the prevention, management, and treatment of a variety of diseases, including coronavirus disease 2019. Based on current evidence, the preclinical and clinical potential of this molecule is discussed. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s43450-023-00370-1.
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Affiliation(s)
- Amit Kumar Tripathi
- School of Basic and Applied Science, Galgotias University, Gautam Buddha Nagar, UP Noida, India
- Molecular Biology Unit, Institute of Medical Science, Banaras Hindu University, Varanasi, 221005 India
| | - Anup Kumar Ray
- Department of Natural Products, National Institute of Pharmaceutical Education and Research, Sahibzada Ajit Singh Nagar, Punjab, India
| | - Sunil Kumar Mishra
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology, Banaras Hindu University, Varanasi, 221005 India
| | - Siddharth Mall Bishen
- Department of Physics, Banaras Hindu University, Mahila Maha Vidyalaya, Varanasi, India
| | - Hirdyesh Mishra
- Department of Physics, Banaras Hindu University, Mahila Maha Vidyalaya, Varanasi, India
| | - Aman Khurana
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology, Banaras Hindu University, Varanasi, 221005 India
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Hassan MAE, Khalil WA, Abdelnour SA, Aman RM. Supplementation of Alpha-lipoic acid-loaded nanoliposomes in semen extender improves freezability of buffalo spermatozoa. Sci Rep 2022; 12:22464. [PMID: 36577772 PMCID: PMC9797474 DOI: 10.1038/s41598-022-26960-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
This research was designed to explore the protective effect of alpha-lipoic acid-loaded nanoliposomes (ALAN) during cryopreservation of buffalo sperm. Buffalo semen was cryopreserved in a tris-citrate egg yolk extender without any supplement (ALAN0, control group) or with ALAN at levels of 25, 50, 75 or 150 µg (ALAN25, ALAN50, ALAN75 and ALAN150, respectively). The ALAN had a size of 171.80 nm and a negative zeta potential (- 43.40 mV). The progressive motility, vitality and membrane integrity significantly improved in all ALAN groups (except ALAN25 for membrane integrity). ALAN150 group exhibited the best values of progressive sperm motility, vitality and membrane integrity after thawing at 37 °C for 30 s or incubated for 2 h at 37 °C and 5% CO2 compared with those in other groups. Both ALAN75 and ALAN150 groups significantly improved the TAC, GR and catalase, while lipid peroxidation and early apoptotic spermatozoa significantly decreased in ALAN150 group followed by ALAN75 group. Collectively, the adding ALAN to buffalo semen freezing extender plays a substantial shielding function against cryodamage by preserving the sperm functional parameters.
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Affiliation(s)
- Mahmoud A. E. Hassan
- grid.418376.f0000 0004 1800 7673Animal Production Research Institute, Agriculture Research Centre, Ministry of Agriculture, Dokki, Giza, 12619 Egypt
| | - Wael A. Khalil
- grid.10251.370000000103426662Department of Animal Production, Faculty of Agriculture, Mansoura University, Mansoura, 35516 Egypt
| | - Sameh A. Abdelnour
- grid.31451.320000 0001 2158 2757Department of Animal Production, Faculty of Agriculture, Zagazig University, Zagazig, 44511 Egypt
| | - Reham Mokhtar Aman
- grid.10251.370000000103426662Department of Pharmaceutics, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia, 35516 Egypt
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Zhang QF, Wang S, Zhang H, Liu QL, Wei Y, Deng W, Wang C, Yang B. Effects of alpha-lipoic acid on sperm quality in patients with varicocele-related male infertility: study protocol for a randomized controlled clinical trial. Trials 2022; 23:1002. [PMID: 36510262 PMCID: PMC9746131 DOI: 10.1186/s13063-022-06951-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Varicocele is a high incidence and is considered to be the most common and correctable cause of male infertility. Oxidative stress (OS) plays a central role in the pathogenesis of varicocele-related male infertility. In addition to varicocelectomy, antioxidant supplementation seems to be an effective scheme for the treatment of varicocele-related male infertility, but it is still controversial. The purpose of this study is to determine the effects of alpha-lipoic acid (ALA) supplementation on sperm quality in patients with varicocele-related male infertility. METHODS In this randomized controlled clinical trial, we will randomize 80 patients with varicocele-related male infertility from Guilin People's Hospital. The non-surgical observation group (n = 20) will receive ALA, the non-surgical control group (n = 20) will receive vitamin E, the surgical observation group (n = 20) will receive ALA after the operation, and the surgical control group (n = 20) will receive vitamin E after the operation. The course of treatment will be 3 months. The results will compare the changes in semen parameters, sex hormones, testicular volume, sperm DNA fragment index (DFI), seminal plasma malondialdehyde (MDA), and total antioxidant capacity (TAC) between the groups at baseline and after 3 months of antioxidant supplementation. DISCUSSION Whether it is necessary to use antioxidants in varicocele-related male infertility, how potent antioxidants should be used, postoperative application or non-surgical independent application still needs to be explored. This study attempts to compare the effects of two antioxidants (ALA and vitamin E) on sperm quality in patients with varicocele-related male infertility (surgical or non-surgical) and attempted to answer the above questions. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR) ChiCTR2100054958. Registered on 29 December 2021.
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Affiliation(s)
- Qi-Feng Zhang
- Department of Andrology, Guilin People’s Hospital, Guilin, 541002 China
| | - Sheng Wang
- Department of Urology, Guilin People’s Hospital, Guilin, 541002 China
| | - Han Zhang
- Department of Urology, Guilin People’s Hospital, Guilin, 541002 China
| | - Qi-Li Liu
- grid.443385.d0000 0004 1798 9548Department of Vascular Surgery, Affiliated Hospital of Guilin Medical University, Guilin, 541002 China
| | - Yu Wei
- Department of Urology, Guilin People’s Hospital, Guilin, 541002 China
| | - Wei Deng
- Department of Urology, Guilin People’s Hospital, Guilin, 541002 China
| | - Chuang Wang
- Department of Urology, Guilin People’s Hospital, Guilin, 541002 China
| | - Bo Yang
- Department of Urology, Guilin People’s Hospital, Guilin, 541002 China
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Dong L, Yang F, Li J, Li Y, Yu X, Zhang X. Effect of oral alpha-lipoic acid (ALA) on sperm parameters: a systematic review and meta-analysis. Basic Clin Androl 2022; 32:23. [PMID: 36476425 PMCID: PMC9730623 DOI: 10.1186/s12610-022-00173-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/02/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Male fertility has gradually become a worldwide problem with limitations in the treatment. Alpha-lipoic acid, has been applied to improve the quality of sperm in clinical practice. However, there was currently no high quality of systematic review to evaluate the effects of alpha-lipoic acid on sperm parameters. MATERIAL AND METHODS The Cochrane Library, MEDLINE, EMBASE, Web of Science, Clinicaltrials.org, China National Knowledge Infrastructure Database, China Biology Medicine Database, etc., were retrieved. Related randomized controlled trials had be collected and selected up to March 10, 2022. English literature and Chinese literature were searched using terms including "male infertility", "semen", "sperm", "alpha-lipoid acid", "α-lipoid acid", "alpha lipoid acid", "thioctic acid". All statistical analyses were conducted by RevMan 5.3. RESULTS A total of 133 participants in three studies included. Compared with sham therapy, treated with alpha-lipoic acid has significant improvement in the following sperm parameters, including abnormal sperm forms (mean difference[MD] = -1.06, 95% confidence interval [CI] = -1.29-0.84, p < 0.00001), sperm concentration (MD = 3.98, 95%CI = 2.28-5.67, p < 0.00001), sperm total motility (grade a+b+c) (MD = 6.68, 95%CI = 4.88-8.48, p < 0.00001) and progressive motility(grade a+b) (MD = 6.90, 95%CI = 5.62-8.17, p < 0.00001) and semen volume(MD = -0.17, 95%CI = -0.31-0.02, p = 0.03). CONCLUSIONS In this meta-analysis of three randomized controlled trials, compared with other treatments, alpha-lipoic acid could improve normal sperm forms, sperm concentration, sperm total motility and progressive motility, but more stringent randomized controlled trials must be conducted.
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Affiliation(s)
- Liang Dong
- grid.415440.0TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China ,grid.411304.30000 0001 0376 205XDepartment of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Fang Yang
- grid.415440.0TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China ,grid.411304.30000 0001 0376 205XDepartment of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Junjun Li
- grid.411304.30000 0001 0376 205XDepartment of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yulin Li
- grid.411304.30000 0001 0376 205XChengdu University of Traditional Chinese Medicine, No.1166, Liutai Avenue, Wenjiang District, Chengdu, 611137 Sichuan People’s Republic of China
| | - Xujun Yu
- grid.415440.0TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China ,grid.411304.30000 0001 0376 205XChengdu University of Traditional Chinese Medicine, No.1166, Liutai Avenue, Wenjiang District, Chengdu, 611137 Sichuan People’s Republic of China
| | - Xiaojin Zhang
- grid.411304.30000 0001 0376 205XChengdu University of Traditional Chinese Medicine, No.1166, Liutai Avenue, Wenjiang District, Chengdu, 611137 Sichuan People’s Republic of China
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10
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Muffone ARMC, de Oliveira Lübke PDP, Rabito EI. Mediterranean diet and infertility: a systematic review with meta-analysis of cohort studies. Nutr Rev 2022:6811792. [DOI: 10.1093/nutrit/nuac087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Abstract
Context
The Mediterranean diet (MD) is a dietary pattern with evidence of positive health impact, and some nutrients in this diet have already been researched for their effectiveness in fertility. However, there are still questions about whether high adherence to the MD could be a factor that contributes to positive fertility outcomes in infertile men and women.
Objective
A systematic review and meta-analysis were conducted to determine whether a greater adherence to the MD can improve fertility markers and outcomes in infertile men and women.
Data sources
The MEDLINE, BVS, SciELO, CENTRAL, and Embase databases and gray literature were searched from their inception to May 2022.
Study selection
Data were included from cohort studies that addressed MD and outcomes.
Data extraction
Data searches, article selection, data extraction, and risk-of-bias assessments were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results
A total of 11 studies met the inclusion criteria (n = 13 157 women and 1338 men). Greater adherence to the MD was associated with live births (I2 = 83.16%; odds ratio [OR], 0.652; 95%CI, 0.408–3.194), pregnancy rate (I2 = 93.83%; OR, 1.192; 95%CI, 0.349–4.325), sperm concentration >15 × 106/mL (I2 = 32.97%; OR 2.862; 95%CI, 1.583–5.174), and sperm count > 39 × 106/mL (I2 = 48.1%; OR, 2.543; 95%CI, 1.319–4.904); however, in an inconsistent scenario regarding the meta-analysis.
Conclusion
Current evidence of high adherence to MD and fertility markers is insufficient to support their clinical application, even though it indicates sperm improvement and a possibility of better pregnancy outcomes.
Systematic Review Registration
PROSPERO registration no. 169396.
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Affiliation(s)
| | | | - Estela I Rabito
- Department of Nutrition, Federal University of Paraná , Curitiba, Paraná, Brazil
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11
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Assidi M. Infertility in Men: Advances towards a Comprehensive and Integrative Strategy for Precision Theranostics. Cells 2022; 11:cells11101711. [PMID: 35626747 PMCID: PMC9139678 DOI: 10.3390/cells11101711] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 02/05/2023] Open
Abstract
Male infertility is an increasing and serious medical concern, though the mechanism remains poorly understood. Impaired male reproductive function affects approximately half of infertile couples worldwide. Multiple factors related to the environment, genetics, age, and comorbidities have been associated with impaired sperm function. Present-day clinicians rely primarily on standard semen analysis to diagnose male reproductive potential and develop treatment strategies. To address sperm quality assessment bias and enhance analysis accuracy, the World Health Organization (WHO) has recommended standardized sperm testing; however, conventional diagnostic and therapeutic options for male infertility, including physical examination and semen standard analysis, remain ineffective in relieving the associated social burden. Instead, assisted reproductive techniques are becoming the primary therapeutic approach. In the post-genomic era, multiomics technologies that deeply interrogate the genome, transcriptome, proteome, and/or the epigenome, even at single-cell level, besides the breakthroughs in robotic surgery, stem cell therapy, and big data, offer promises towards solving semen quality deterioration and male factor infertility. This review highlights the complex etiology of male infertility, especially the roles of lifestyle and environmental factors, and discusses advanced technologies/methodologies used in characterizing its pathophysiology. A comprehensive combination of these innovative approaches in a global and multi-centric setting and fulfilling the suitable ethical consent could ensure optimal reproductive and developmental outcomes. These combinatorial approaches should allow for the development of diagnostic markers, molecular stratification classes, and personalized treatment strategies. Since lifestyle choices and environmental factors influence male fertility, their integration in any comprehensive approach is required for safe, proactive, cost-effective, and noninvasive precision male infertility theranostics that are affordable, accessible, and facilitate couples realizing their procreation dream.
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Affiliation(s)
- Mourad Assidi
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia; ; Tel.: +966-(012)-6402000 (ext. 69267)
- Medical Laboratory Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia
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Symeonidis EN, Evgeni E, Palapelas V, Koumasi D, Pyrgidis N, Sokolakis I, Hatzichristodoulou G, Tsiampali C, Mykoniatis I, Zachariou A, Sofikitis N, Kaltsas A, Dimitriadis F. Redox Balance in Male Infertility: Excellence through Moderation-"Μέτρον ἄριστον". Antioxidants (Basel) 2021; 10:antiox10101534. [PMID: 34679669 PMCID: PMC8533291 DOI: 10.3390/antiox10101534] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 12/02/2022] Open
Abstract
Male infertility, a relatively common and multifactorial medical condition, affects approximately 15% of couples globally. Based on WHO estimates, a staggering 190 million people struggle with this health condition, and male factor is the sole or contributing factor in roughly 20–50% of these cases. Nowadays, urologists are confronted with a wide spectrum of conditions ranging from the typical infertile male to more complex cases of either unexplained or idiopathic male infertility, requiring a specific patient-tailored diagnostic approach and management. Strikingly enough, no identifiable cause in routine workup can be found in 30% to 50% of infertile males. The medical term male oxidative stress infertility (MOSI) was recently coined to describe infertile men with abnormal sperm parameters and oxidative stress (OS), including those previously classified as having idiopathic infertility. OS is a critical component of male infertility, entailing an imbalance between reactive oxygen species (ROS) and antioxidants. ROS abundance has been implicated in sperm abnormalities, while the exact impact on fertilization and pregnancy has long been a subject of considerable debate. In an attempt to counteract the deleterious effects of OS, urologists resorted to antioxidant supplementation. Mounting evidence indicates that indiscriminate consumption of antioxidants has led in some cases to sperm cell damage through a reductive-stress-induced state. The “antioxidant paradox”, one of the biggest andrological challenges, remains a lurking danger that needs to be carefully avoided and thoroughly investigated. For that reason, oxidation-reduction potential (ORP) emerged as a viable ancillary tool to basic semen analysis, measuring the overall balance between oxidants and antioxidants (reductants). A novel biomarker, the Male infertility Oxidative System (MiOXSYS®), is a paradigm shift towards that goal, offering a quantification of OS via a quick, reliable, and reproducible measurement of the ORP. Moderation or “Μέτρον” according to the ancient Greeks is the key to successfully safeguarding redox balance, with MiOXSYS® earnestly claiming its position as a guarantor of homeostasis in the intracellular redox milieu. In the present paper, we aim to offer a narrative summary of evidence relevant to redox regulation in male reproduction, analyze the impact of OS and reductive stress on sperm function, and shed light on the “antioxidant paradox” phenomenon. Finally, we examine the most up-to-date scientific literature regarding ORP and its measurement by the recently developed MiOXSYS® assay.
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Affiliation(s)
- Evangelos N. Symeonidis
- Department of Urology, “G. Gennimatas” General Hospital, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece; (E.N.S.); (I.M.)
| | - Evangelini Evgeni
- Cryogonia Cryopreservation Bank, 11526 Athens, Greece; (E.E.); (D.K.)
| | - Vasileios Palapelas
- 3rd Department of Obstetrics and Gynecology, Hippokration General Hospital, School of Medicine, Aristotle University, 54642 Thessaloniki, Greece;
| | - Dimitra Koumasi
- Cryogonia Cryopreservation Bank, 11526 Athens, Greece; (E.E.); (D.K.)
| | - Nikolaos Pyrgidis
- Department of Urology, ‘Martha-Maria’ Hospital Nuremberg, 90491 Nuremberg, Germany; (N.P.); (I.S.); (G.H.)
| | - Ioannis Sokolakis
- Department of Urology, ‘Martha-Maria’ Hospital Nuremberg, 90491 Nuremberg, Germany; (N.P.); (I.S.); (G.H.)
| | | | | | - Ioannis Mykoniatis
- Department of Urology, “G. Gennimatas” General Hospital, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece; (E.N.S.); (I.M.)
| | - Athanasios Zachariou
- Department of Urology, School of Medicine, Ioannina University, 45500 Ioannina, Greece; (A.Z.); (N.S.); (A.K.)
| | - Nikolaos Sofikitis
- Department of Urology, School of Medicine, Ioannina University, 45500 Ioannina, Greece; (A.Z.); (N.S.); (A.K.)
| | - Ares Kaltsas
- Department of Urology, School of Medicine, Ioannina University, 45500 Ioannina, Greece; (A.Z.); (N.S.); (A.K.)
| | - Fotios Dimitriadis
- Department of Urology, “G. Gennimatas” General Hospital, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece; (E.N.S.); (I.M.)
- Correspondence: ; Tel.: +30-23-1041-1121
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Torres-Arce E, Vizmanos B, Babio N, Márquez-Sandoval F, Salas-Huetos A. Dietary Antioxidants in the Treatment of Male Infertility: Counteracting Oxidative Stress. BIOLOGY 2021; 10:241. [PMID: 33804600 PMCID: PMC8003818 DOI: 10.3390/biology10030241] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 02/07/2023]
Abstract
Infertility affects about 15% of the population and male factors only are responsible for ~25-30% of cases of infertility. Currently, the etiology of suboptimal semen quality is poorly understood, and many environmental and genetic factors, including oxidative stress, have been implicated. Oxidative stress is an imbalance between the production of free radicals, or reactive oxygen species (ROS), and the capacity of the body to counteract their harmful effects through neutralization by antioxidants. The purpose of this review, by employing the joint expertise of international researchers specialized in nutrition and male fertility areas, is to update the knowledge about the reproductive consequences of excessive ROS concentrations and oxidative stress on the semen quality and Assisted Reproduction Techniques (ART) clinical outcomes, to discuss the role of antioxidants in fertility outcomes, and finally to discuss why foods and dietary patterns are more innocuous long term solution for ameliorating oxidative stress and therefore semen quality results and ART fertility outcomes. Since this is a narrative review and not a systematic/meta-analysis, the summarized information in the present study should be considered cautiously.
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Affiliation(s)
- Elizabeth Torres-Arce
- Center of Health Sciences, Institute of Translational Nutrigenetics and Nutrigenomics, Universidad de Guadalajara, 44340 Guadalajara, Mexico; (E.T.-A.); (B.V.)
- Andrology and IVF Laboratory, Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT 84108, USA
| | - Barbara Vizmanos
- Center of Health Sciences, Institute of Translational Nutrigenetics and Nutrigenomics, Universidad de Guadalajara, 44340 Guadalajara, Mexico; (E.T.-A.); (B.V.)
| | - Nancy Babio
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Universitat Rovira i Virgili, 43201 Reus, Spain;
- Institut d’Investigació Sanitària Pere i Virgili, 43204 Reus, Spain
- Consorcio CIBER, M.P., Fisiopatología de la Obesidad y Nutrición (ciBeRobn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Fabiola Márquez-Sandoval
- Center of Health Sciences, Institute of Translational Nutrigenetics and Nutrigenomics, Universidad de Guadalajara, 44340 Guadalajara, Mexico; (E.T.-A.); (B.V.)
| | - Albert Salas-Huetos
- Andrology and IVF Laboratory, Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT 84108, USA
- Consorcio CIBER, M.P., Fisiopatología de la Obesidad y Nutrición (ciBeRobn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
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