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Tavakoli A, Aliakbari F, Soleimani Mehranjani M. Kisspeptin decreases the adverse effects of human ovarian vitrification by regulating ROS-related apoptotic occurrences. ZYGOTE 2023; 31:537-543. [PMID: 37655529 DOI: 10.1017/s0967199423000412] [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] [Indexed: 09/02/2023]
Abstract
Kisspeptin is characterized as a neuropeptide with a pivotal function in female and male infertility, and its antioxidant properties have been demonstrated. In this study, the effects of kisspeptin on the improvement of the vitrification and thawing results of human ovarian tissues were investigated. In this work, 12 ovaries from patients who underwent hysterectomy were collected laparoscopically, and then 32 samples from each of their tissues were taken. Haematoxylin and eosin (H&E) staining was performed to check the normality of the ovarian tissue and, subsequently, the samples were allocated randomly into four groups, including: (1) fresh (control), (2) vitrification, (3) vitrified + 1 μM kisspeptin, and (4) vitrified + 10 μM kisspeptin groups. After vitrification, thawing, and tissue culture processes, H&E staining for tissue quality assessment, terminal deoxynucleotidyl transferase dUTP nick end labelling assay for apoptosis evaluation, and malondialdehyde (MDA), superoxide dismutase (SOD), and ferric reducing ability of plasma tests for oxidative stress appraisal were carried out. Our histological results showed incoherency of ovarian tissue morphology in the vitrification group compared with other groups. Other findings implicated increased apoptosis rate and MDA concentration and reduced SOD activity and total antioxidant capacity (TAC) in the vitrification group compared with the control group (P < 0.05). Moreover, decreased apoptosis rate and MDA concentration, and increased TAC and SOD function were observed in the vitrification with kisspeptin groups (1 μM and 10 μM) compared with the vitrified group (P < 0.05). Our reports express that kisspeptin is an effective agent to overcome the negative effects of vitrification by regulating reactive oxygen species-related apoptotic processes.
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Affiliation(s)
- Anahita Tavakoli
- Department of Biology, Faculty of Science, Arak University, Arak, Iran
| | - Fereshteh Aliakbari
- Fereshteh Aliakbari, Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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2
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Sarman E, Gulle K, Ilhan I. Histochemical, Immunohistochemical, and Biochemical Investigation of the Effect of Resveratrol on Testicular Damage Caused by Methotrexate (MTX). Reprod Sci 2023; 30:3315-3324. [PMID: 37268870 DOI: 10.1007/s43032-023-01269-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/09/2023] [Indexed: 06/04/2023]
Abstract
Cancer is one of the world's major causes of death. The aim of this study is to examine the acute effects of resveratrol on testicular toxicity, oxidative stress, and apoptosis caused by MTX, which is widely used in the treatment of many diseases, especially cancer, histochemically, immunohistochemically, and biochemical methods using different parameters. A total of 32 Wistar albino male rats were randomly divided into 4 groups: control, resveratrol (RES), MTX, and MTX + RES, with 8 animals in each group. At the end of the experiment, tissue and blood samples were taken, and histochemical, immunohistochemical, and biochemical parameters were examined. In this study, where parameters were compared for the first time, total thiol (TT) and native thiol (NT) are the highest in the RES group, disulfide (DS), and ischemia-modified albumin (IMA) are the highest in the MTX group. Total oxidant status (TOS) and oxidative stress index (OSI) are the highest in the MTX group, and total antioxidant status (TAS) is the highest in the RES group. Separation and deterioration in the tunica albuginea, congestion and edema in the interstitial region, vacuolization in the seminiferous epithelium, and spermatogenic serial cells spilling into the lumen without completing their maturation were observed. When examined in terms of histochemical, immunohistochemical, and biochemical examinations, our study revealed that resveratrol has positive effects on methotrexate-induced acute testicular damage, oxidative stress, and apoptosis.
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Affiliation(s)
- Emine Sarman
- Department of Histology and Embryology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Campus, 03030, Afyonkarahisar, Turkey.
| | - Kanat Gulle
- Department of Histology and Embryology, Faculty of Medicine, Suleyman Demirel University, Campus, 32260, Isparta, Turkey
| | - Ilter Ilhan
- Department of Biochemistry, Faculty of Medicine, Suleyman Demirel University, Campus, 32260, Isparta, Turkey
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3
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Kermani T, Hosseini SF, Talaei-Khozani T, Aliabadi E. Effect of Pre-Incubation of Cryopreserved Sperm with either Kisspeptin or Glutathione to Mitigate Freeze-Thaw Damage. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:198-208. [PMID: 36895454 PMCID: PMC9989238 DOI: 10.30476/ijms.2022.92300.2354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/11/2022] [Accepted: 01/31/2022] [Indexed: 03/11/2023]
Abstract
Background Sperm cryopreservation reduces sperm quality. Kisspeptin (KP) has beneficial effects on sperm functions. This study compares the effect of KP and Glutathione (GSH) on mitigating the detrimental effects of the freeze-thaw cycle on sperm. Methods An experimental study was conducted in Birjand (Iran) during 2018-2020. Thirty normal swim-up semen samples were treated with Ham's F10 medium (negative control), 1 mM GSH (positive control), or KP (10 µM) for 30 min before freezing. The motility, acrosome reaction, capacitation, and DNA quality of the frozen-thawed sperms were assessed according to the WHO guidelines. Statistical analysis was performed using paired t test, one-way analysis of variance, and least significant difference. Results Pre-incubation with KP significantly increased the percentage of sperm motility (34.00±6.7, P=0.003) compared to the control (20.44±7.4) and GSH-treated (31.25±12.2) aliquots. The frequency of non-capacitated spermatozoa was significantly higher in the KP-treated group (98.73%) than in the control (96.46%) and GSH-treated (96.49%) aliquots (P<0.001). The percentage of acrosome-intact spermatozoa in the KP-treated group (77.44%) was significantly higher than the control (74.3%) and GSH-treated (74.54%) groups (P<0.001). The sperm frequency with normal histone in the KP-treated group (51.86%) and with normal protamine (65.39%) was significantly higher than the controls (P=0.001 and P=0.002, respectively). The percentage of TUNEL-positive sperm was significantly lower in the KP-treated group (9.09±2.71) than both GSH-treated (11.22±2.73) and control (11.31±2.2) groups (both P=0.002). Conclusion Pre-incubation with KP protects sperm motility and DNA integrity from the detrimental effect of the freeze-thaw cycle. KP is suitable as a pre-treatment to control sperm quality during freezing-thawing.
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Affiliation(s)
- Tayebeh Kermani
- Department of Anatomy, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Syedeh-Fatemeh Hosseini
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Talaei-Khozani
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Histomorphometry and Stereology Research center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Aliabadi
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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4
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El-Agawy MSED, Badawy AMM, Rabei MR, Elshaer MMA, El Nashar EM, Alghamdi MA, Alshehri MA, Elsayed HRH. Methotrexate-Induced Alteration of Renal Aquaporins 1 and 2, Oxidative Stress and Tubular Apoptosis Can Be Attenuated by Omega-3 Fatty Acids Supplementation. Int J Mol Sci 2022; 23:12794. [PMID: 36361584 PMCID: PMC9653681 DOI: 10.3390/ijms232112794] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/08/2022] [Accepted: 10/19/2022] [Indexed: 09/10/2023] Open
Abstract
Methotrexate (MTX) is a potent anti-cancer drug, commonly associated with nephrotoxicity via the induction of oxidative stress and apoptosis with alteration of renal water channel proteins, namely aquaporins (AQPs). Omega-3 long-chain polyunsaturated fatty acids (LC-PUFA) have shown cytoprotective effects through their anti-oxidant and antiapoptotic activities. The present study aims for the first time to explore the role of LC-PUFA against MTX-induced nephrotoxicity. Rats were divided into the following groups: saline control, LC-PUFA control, MTX, MTX + LC-PUFA (150 mg/kg), or MTX + LC-PUFA (300 mg/kg). Then, H&E staining and immunohistochemical staining for the anti-apoptosis marker B-cell lymphoma 2 (BCL-2), the apoptosis marker BCL2-Associated X Protein (BAX), the proinflammatory marker Nuclear factor kappa B (NF-kB), AQPs 1 and 2 were performed in kidney sections with an assessment of renal oxidative stress. The MTX caused a renal histopathological alteration, upregulated renal BAX and NF-kB, downregulated Bcl-2 and AQP1, altered the distribution of AQP2, and caused oxidative stress. The LC-PUFA attenuated the pathological changes and decreased renal BAX and NF-kB, increased BCL-2 and AQP1, restored the normal distribution of AQP2, and decreased the oxidative stress. Therefore, LC-PUFA is a good adjuvant to MTX to prevent its adverse effects on kidneys through its antiapoptotic, antioxidant, and anti-inflammatory effect and its role in the restoration of the expression of AQPs 1 and 2.
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Affiliation(s)
- Mosaab Salah El-din El-Agawy
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
- Department of Anatomy, Faculty of Medicine, New Mansoura University, New Mansoura 35712, Egypt
| | | | - Mohammed R. Rabei
- Department of Medical Physiology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
- Department of Physiology, Faculty of Medicine, King Salman International University, South Sinai 46511, Egypt
| | - Mohamed Mahmoud Abdelraheem Elshaer
- Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
- Department of Clinical Pharmacology, Faculty of Medicine, King Salman International University, South Sinai 46511, Egypt
| | - Eman Mohamad El Nashar
- Department of Anatomy, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
- Department of Histology and Cell Biology, Faculty of Medicine, Benha University, Benha 13511, Egypt
| | - Mansour A. Alghamdi
- Department of Anatomy, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
- Genomics and Personalized Medicine Unit, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Mohammed A. Alshehri
- Nephrology Section, Internal Medicine Department, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Hassan Reda Hassan Elsayed
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
- Department of Anatomy, Faculty of Medicine, New Mansoura University, New Mansoura 35712, Egypt
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Fayyaz MH, Andrabi SMH, Haider MS, Khalique MA, Shah SAH. Kisspeptin‐10 in cryodiluent improves the post‐thaw quality of
Nili‐Ravi
buffalo (
Bubalus bubalis
) bull spermatozoa. Andrologia 2022; 54:e14564. [DOI: 10.1111/and.14564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/30/2022] [Accepted: 08/04/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Muhammad Hammad Fayyaz
- Animal Reproduction and Genetics Program Animal Sciences Institute, National Agricultural Research Centre, PARC Islamabad Pakistan
| | - Syed Murtaza Hassan Andrabi
- Animal Reproduction and Genetics Program Animal Sciences Institute, National Agricultural Research Centre, PARC Islamabad Pakistan
| | - Muhammad Shafiq Haider
- Animal Reproduction and Genetics Program Animal Sciences Institute, National Agricultural Research Centre, PARC Islamabad Pakistan
| | - Mubashir Ali Khalique
- Animal Reproduction and Genetics Program Animal Sciences Institute, National Agricultural Research Centre, PARC Islamabad Pakistan
- Faculty of Veterinary and Animal Sciences University of Poonch Rawalakot AJK Pakistan
| | - Syed Aftab Hussain Shah
- Pakistan Scientific & Technological Information Centre Quaid‐i‐Azam University Campus Islamabad Pakistan
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Fatima I, Qureshi IZ. Intraperitoneal kisspeptin-10 administration ameliorates sodium arsenite-induced reproductive toxicity in adult male mice. Andrologia 2021; 54:e14347. [PMID: 34897760 DOI: 10.1111/and.14347] [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: 09/17/2021] [Revised: 11/15/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022] Open
Abstract
The current study investigated the protective ameliorative effect of intraperitoneally administered kisspeptin-10 (50 nmol/day) against reproductive toxicity in adult male mice challenged with 35 days of exposure to sodium arsenite in drinking water. Mice were divided into tap water control, sodium arsenite-alone (4 ppm and 10 ppm), kisspeptin-alone (intermittent and continuous) and combined (sodium arsenite +kisspeptin-10 intermittent and continuous) treatment groups. Results revealed protective effect of both intermittent and continuous kisspeptin doses on reproductive organs against sodium arsenite-induced toxicity. This was indicated by an increase (p < 0.001) in the activity of antioxidant enzymes and a decrease (p < 0.001) in the levels of oxidative stress biomarkers. Concomitant significant increase was noticeable in the relative organ weight (p < 0.01), and serum testosterone and seminal fructose (p < 0.001), and a significant improvement in sperm parameters was also observed. A significant downregulation of lactate dehydrogenase concentration demonstrated further the protective effect of kisspeptin against tissue damage. Histologically, both treatment regimens of kisspeptin combined with sodium arsenite exposure prevented massive germ cell loss and tissue damage, a condition prominent in sodium arsenite-alone-treated mice. The study demonstrates for the first time kisspeptin's potential to mitigate the biochemical and histotoxic effects of arsenic on male reproductive system.
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Affiliation(s)
- Iffat Fatima
- Department of Zoology (Animal Sciences), Quaid-i-Azam University, Islamabad, Pakistan
| | - Irfan Zia Qureshi
- Department of Zoology (Animal Sciences), Quaid-i-Azam University, Islamabad, Pakistan
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7
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Gloria A, Contri A, Mele E, Fasano S, Pierantoni R, Meccariello R. Kisspeptin Receptor on the Sperm Surface Reflects Epididymal Maturation in the Dog. Int J Mol Sci 2021; 22:ijms221810120. [PMID: 34576283 PMCID: PMC8466692 DOI: 10.3390/ijms221810120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022] Open
Abstract
Alongside the well-known central modulatory role, the Kisspeptin system, comprising Kiss1, its cleavage products (Kisspeptins), and Kisspeptin receptor (Kiss1R), was found to regulate gonadal functions in vertebrates; however, its functional role in the male gamete and its localization during maturation have been poorly understood. The present study analyzed Kisspeptin system in dog testis and spermatozoa recovered from different segments of the epididymis, with focus on Kiss1R on sperm surface alongside the maturation during epididymal transit, demonstrated by modification in sperm kinetic, morphology, and protamination. The proteins Kiss1 and Kiss1R were detected in dog testis. The receptor Kiss1R only was detected in total protein extracts from epididymis spermatozoa, whereas dot blot revealed Kiss1 immunoreactivity in the epidydimal fluid. An increase of the Kiss1R protein on sperm surface along the length of the epididymis, with spermatozoa in the tail showing plasma membrane integrity and Kiss1R protein (p < 0.05 vs. epididymis head and body) was observed by flow cytometry and further confirmed by epifluorescence microscopy and Western blot carried on sperm membrane preparations. In parallel, during the transit in the epididymis spermatozoa significantly modified their ability to move and the pattern of motility; a progressive increase in protaminization also occurred. In conclusion, Kisspeptin system was detected in dog testis and spermatozoa. Kiss1R trafficking toward plasma membrane along the length of the epididymis and Kiss1 in epididymal fluid suggested a new functional role of the Kisspeptin system in sperm maturation and storage.
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Affiliation(s)
- Alessia Gloria
- Faculty of Veterinary Medicine, University of Teramo, Loc. Piano d’Accio, 64100 Teramo, Italy;
| | - Alberto Contri
- Faculty of Biosciences and Technologies for Agriculture Food and Environment, University of Teramo, Via Balzarini 1, 64100 Teramo, Italy
- Correspondence: (A.C.); (R.M.)
| | - Elena Mele
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, 80133 Naples, Italy;
| | - Silvia Fasano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.F.); (R.P.)
| | - Riccardo Pierantoni
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.F.); (R.P.)
| | - Rosaria Meccariello
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, 80133 Naples, Italy;
- Correspondence: (A.C.); (R.M.)
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8
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Jensen NB, Justesen SD, Larsen A, Ernst E, Pedersen LH. A systematic overview of the spermatotoxic and genotoxic effects of methotrexate, ganciclovir and mycophenolate mofetil. Acta Obstet Gynecol Scand 2021; 100:1557-1580. [PMID: 33755191 DOI: 10.1111/aogs.14151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/23/2021] [Accepted: 03/14/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Immunosuppressant drugs are increasingly being used in the reproductive years. Theoretically, such medications could affect fetal health either through changes in the sperm DNA or through fetal exposure caused by a presence in the seminal fluid. This systematic overview summarizes existing literature on the spermatotoxic and genotoxic potentials of methotrexate (MTX), a drug widely used to treat rheumatic and dermatologic diseases, and mycophenolate mofetil (MMF), which alone or supplemented with ganciclovir (GCV) may be crucial for the survival of organ transplants. MATERIAL AND METHODS The systematic overview was performed in accordance with the PRISMA guidelines: A systematic literature search of the MEDLINE and Embase databases was done using a combination of relevant terms to search for studies on spermatotoxic or genotoxic changes related to treatment with MTX, GCV or MMF. The search was restricted to English language literature, and to in vivo animal studies (mammalian species) and clinical human studies. RESULTS A total of 102 studies were identified, hereof 25 human and 77 animal studies. For MTX, human studies of immunosuppressive dosages show transient effect on sperm quality parameters, which return to reference values within 3 months. No human studies have investigated the sperm DNA damaging effect of MTX, but in other organs the genotoxic effects of immunosuppressive doses of MTX are fluctuating. In animals, immunosuppressive and cytotoxic doses of MTX adversely affect sperm quality parameters and show widespread genotoxic damages in various organs. Cytotoxic doses transiently change the DNA material in all cell stages of spermatogenesis in rodents. For GCV and MMF, data are limited and the results are indeterminate, for which reason spermatotoxic and genotoxic potentials cannot be excluded. CONCLUSIONS Data from human and animal studies indicate transient spermatotoxic and genotoxic potentials of immunosuppressive and cytotoxic doses of MTX. There are a limited number of studies investigating GCV and MMF.
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Affiliation(s)
| | | | - Agnete Larsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Erik Ernst
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Laboratory for Reproduction, Institute of Anatomy, Aarhus University, Aarhus, Denmark
| | - Lars H Pedersen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
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9
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Meccariello R, Fasano S, Pierantoni R. Kisspeptins, new local modulators of male reproduction: A comparative overview. Gen Comp Endocrinol 2020; 299:113618. [PMID: 32950583 DOI: 10.1016/j.ygcen.2020.113618] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/04/2020] [Accepted: 09/13/2020] [Indexed: 11/29/2022]
Abstract
Spermatogenesis is a complex process that leads to the production of male gametes within the testis through the coordination of mitotic, meiotic and differentiation events, under a deep control of endocrine, paracrine and autocrine modulators along the Hypothalamus-pituitary-gonad (HPG) axis. The kisspeptin system plays a fundamental role along the HPG axis as it is the main positive modulator upstream of the hypothalamic neurons that secrete the Gonadotropin Releasing Hormone (GnRH), the decapeptide that supports pituitary gonadotropins and the production of gonadal sex steroid. Currently, kisspeptins and their receptor, KISS1R, have a recognized activity in the central control of puberty onset, sex maturation, reproduction and sex-steroid feedback mechanisms in both animal models and human. However, kisspeptin signaling has been widely reported in peripheral tissues, particularly in the testis of mammalian and non-mammalian vertebrates, with functions related to Leydig cells physiology and steroid biosynthesis, spermatogenesis progression and spermatozoa functions, but its mandatory role within the testis is still a matter of discussion. This review provides a summary of the main intratesticular effects of kisspeptin in vertebrates, via a comparative approach. Particular emphasis was devoted to data from the anuran amphibian Pelophylax esculentus, the first animal model in which the direct intratesticular activity of kisspeptin was reported.
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Affiliation(s)
- Rosaria Meccariello
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, Napoli, Italy.
| | - Silvia Fasano
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania "L. Vanvitelli", Napoli, Italy
| | - Riccardo Pierantoni
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania "L. Vanvitelli", Napoli, Italy
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10
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Kavram Sarihan K, Yardimoğlu Yilmaz M, Eraldemir FC, Yazir Y, Acar E. Protective effects of apocynin on damaged testes of rats exposed to methotrexate. Turk J Med Sci 2020; 50:1409-1420. [PMID: 32394677 PMCID: PMC7491294 DOI: 10.3906/sag-1909-52] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 05/05/2020] [Indexed: 01/14/2023] Open
Abstract
Background/aim Methotrexate (MTX), widely used as a drug in cancer, has many adverse effects on tissues. Apocynin (APO) is a NADPH oxidase inhibitor and is known with many antioxidant properties. In this study, we aimed to evaluate the adverse effects of MTX on testicular tissue and the protective effects of APO at two different doses (20 mg/kg and 50 mg/kg) on MTX-induced testicular damage. Materials and methods Fifty adult male Wistar albino rats (8 weeks old and weighing 200–250 g) were divided into five groups of 10 rats each: 1. saline control, 2. dimethyl sulfoxide (DMSO) control, 3. MTX, 4. APO-20 + MTX, and 5. APO-50 + MTX. All injections were performed intraperitoneally. At the end of day 28, all rats were sacrificed under anesthesia. The testes were evaluated histologically and the blood samples were analyzed biochemically. Results According to histological and biochemical analyses, there was no significant difference between the DMSO and control groups. In terms of the histological findings, MTX group was significantly the worst affected group compared to the others, and in this group, apoptotic cell number (P = 0.011) was significantly increased in comparison with the control group. Except MTX, there was no significant difference in apoptotic cell number of the other groups compared to the control group. In the MTX group, malondialdehyde (MDA, P = 0.017) and myeloperoxidase (MPO, P < 0.001) levels were significantly increased in tissue and in blood (MDA P < 0.001, MPO P < 0.001), while tissue glutathione (GSH, P < 0.05) and serum testosterone levels (P < 0.01) were decreased compared with the control group. APO + MTX treatment groups exhibited better testis morphology, and apoptotic cells were also significantly decreased compared to MTX group (P < 0.001). Conclusion Our results suggest that MTX induced defects on testis via oxidative stress and APO reversed the effects of MTX with its antioxidant properties.
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Affiliation(s)
- Kübra Kavram Sarihan
- Department of Histology and Embryology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Melda Yardimoğlu Yilmaz
- Department of Histology and Embryology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Fatma Ceyla Eraldemir
- Department of Medical Biochemistry, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Yusufhan Yazir
- Department of Histology and Embryology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey,Stem Cell and Gene Therapies Research and Application Center, Kocaeli University, Kocaeli, Turkey
| | - Esra Acar
- Department of Medical Biochemistry, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
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11
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Türk E, Güvenç M, Cellat M, Uyar A, Kuzu M, Ağgül AG, Kırbaş A. Zingerone protects liver and kidney tissues by preventing oxidative stress, inflammation, and apoptosis in methotrexate-treated rats. Drug Chem Toxicol 2020; 45:1054-1065. [PMID: 32781857 DOI: 10.1080/01480545.2020.1804397] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The clinical use of drugs used in the treatment of diseases is limited due to the toxic side effects, and many studies have been conducted to benefit from herbal adjuvant therapies recently to eliminate these effects. In this study, the protective effect of zingerone against liver and kidney damage generated in rats through methotrexate (MTX). Histopathological investigations were performed to determine tissue damage caused by MTX and the healing effect of zingone and liver function markers such as serum alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and renal function markers such as urea, creatine, and aquaporin-1 (AQP-1) were measured. The effects of MTX and protective properties of zingerone on oxidative stress were investigated through the measurement of malondialdehyde and reduced glutathione (GSH) levels, catalase (CAT), and glutathione peroxidase (GPx) enzyme activities. The anti-inflammatory effect of zingerone was determined by measuring the cytokine levels causing inflammation such as nuclear factor-kappa B (NF-κB), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β), and its effects on apoptosis were determined by immunohistochemical analysis of caspase-3 and B-cell lymphoma-2 (Bcl-2) expression levels. According to the results obtained within the scope of the study, it was determined that zingerone treatment prevented the increase in MTX-induced liver and kidney function markers, showed healing effects on antioxidant parameters degraded in both tissues, and decreased the inflammation parameters. It was determined that it also prevented apoptosis and possessed a protective effect on disrupted tissue architecture by decreasing the increased caspase-3 expression and increasing the decreased Bcl-2 level.
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Affiliation(s)
- Erdinç Türk
- Department of Pharmacology and Toxicology, Mustafa Kemal University, Hatay, Turkey
| | - Mehmet Güvenç
- Department of Physiology, Mustafa Kemal University, Hatay, Turkey
| | - Mustafa Cellat
- Department of Physiology, Mustafa Kemal University, Hatay, Turkey
| | - Ahmet Uyar
- Department of Pathology, Mustafa Kemal University, Hatay, Turkey
| | - Müslüm Kuzu
- Department of Nutrition and Dietetics, Karabuk University, Karabuk, Turkey
| | | | - Akın Kırbaş
- Department of Internal Medicine, Bozok University, Yozgat, Turkey
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Abdelzaher WY, Khalaf HM, El-Hussieny M, Bayoumi A, Shehata S, Refaie M. Role of nitric oxide donor in methotrexate-induced testicular injury via modulation of pro-inflammatory mediators, eNOS and P-glycoprotein. Hum Exp Toxicol 2020; 39:1700-1709. [PMID: 32666843 DOI: 10.1177/0960327120940361] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Methotrexate (MTX) is a widely used chemotherapeutic agent but its clinical use is challenged with different forms of toxicities including testicular injury. The aim of the current study was to evaluate the potential protective effect of potassium channel opener, nicorandil (NIC) (3 and 10 mg/kg/day) on MTX-induced testicular injury in a rat model. Rats were randomly divided into four groups (nine rats each) and treated for 2 weeks as follows: (I) normal control (CON group) received vehicle, (II) model group (MTX group) given MTX (20 mg/kg) single intraperitoneal (i.p.) injection dose on 11th day, (III) MTX + NLD group treated with NIC (3 mg/kg/day) orally for 2 weeks and MTX (20 mg/kg) single i.p. dose on 11th day, and (IV) MTX + NHD group treated with NIC (10 mg/kg/day) orally for 2 weeks and MTX (20 mg/kg) single i.p. injection on the 11th day. The testicular injury was assessed biochemically via serum testosterone, total antioxidant capacity, testicular oxidative stress parameters, P-glycoprotein, tumor necrosis factor-alpha, and interleukin-1β. Furthermore, histopathological evaluation, endothelial nitric oxide synthase (eNOS) immunoexpression, and detection of p53 expression level using Western blotting were performed. Results showed that MTX induced testicular injury which was proved by both biochemical and histopathological evaluations. Our results concluded that NIC pretreatment attenuated MTX-induced testicular injury via significantly increased eNOS immunoexpression, antiapoptotic, anti-inflammatory, and antioxidant properties. Interestingly, NIC high dose is more protective than low dose.
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Affiliation(s)
- W Y Abdelzaher
- Department of Pharmacology, Faculty of Medicine, 68877Minia University, Minia, Egypt
| | - H M Khalaf
- Department of Pharmacology, Faculty of Medicine, 68877Minia University, Minia, Egypt
| | - M El-Hussieny
- Department of Pathology, Faculty of Medicine, 68877Minia University, Minia, Egypt
| | - Ama Bayoumi
- Department of Biochemistry, Faculty of Pharmacy, 68877Minia University, Minia, Egypt
| | - S Shehata
- Department of Cardiology, Faculty of Medicine, 68877Minia University, Minia, Egypt
| | - Mmm Refaie
- Department of Pharmacology, Faculty of Medicine, 68877Minia University, Minia, Egypt
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13
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Sukhorum W, Umka Welbat J, Krutsri S, Iamsaard Comma S. Protective effect of melatonin against methotrexate-induced testicular damage in the rat model: An experimental study. Int J Reprod Biomed 2020; 18:327-338. [PMID: 32637861 PMCID: PMC7306061 DOI: 10.18502/ijrm.v13i5.7153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/22/2019] [Accepted: 11/19/2019] [Indexed: 11/24/2022] Open
Abstract
Background Methotrexate (MTX) has been shown to affect the testes adversely, especially the seminiferous epithelium. As melatonin, an endocrine hormone, has been shown to normalize testicular function, its ability to prevent MTX-induced testicular damage should be considered. Objective Based on the antioxidant, anti-inflammatory, and antiapoptotic activities of melatonin, this study aimed to investigate its protective effect against testicular damage induced by MTX. Materials and Methods Forty adult male rats (200-230 g) were divided into five groups (n = 8/each). The rats in group I were injected with vehicle as a control. In group II, the rats were received intraperitoneal injections of melatonin (8 mg/kg) for 15 consecutive days. The rats in group III were intravenously injected with MTX (75 mg/kg) for 15 consecutive days. The remaining two groups received melatonin (8 mg/kgBW) for 15 (group IV) and 30 (group V) consecutive days, intraperitoneally, and then intravenously received MTX (75 mg/kgBW) on days 8 and 15 of the experimental period. Reproductive parameters, including epididymal sperm concentration, testicular tyrosine-phosphorylated protein expression, steroidogenic acute regulatory (StAR) protein expression, and caspase-3 and malondialdehyde levels, were examined. Results The sperm concentrations ( × 10 6 /ml) of groups IV (58.75 ± 1.28) and V (55.93 ± 2.57) were improved significantly (p = 0.032) compared with that of group II (32.92 ± 2.14). The seminiferous epithelium in groups IV and V also increased, while caspase-3 expression decreased. In the melatonin-treated groups, the expression of tyrosine-phosphorylated proteins at 32 kDa was decreased and that of proteins at 47 kDa was increased compared with the MTX group. StAR protein expression was not altered in any of the groups. Conclusion Our results indicate that melatonin improves the epididymal sperm concentration by decreasing the expression of caspase-3 and increasing that of tyrosine-phosphorylated proteins in MTX-treated testes.
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Affiliation(s)
- Wannisa Sukhorum
- School of Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Jariya Umka Welbat
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Suchada Krutsri
- Research Institute for Human High Performance and Health Promotion (HHP & HP), Khon Kaen, Thailand
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14
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Han Y, Zhao Y, Si W, Jiang X, Wu J, Na R, Han Y, Li K, Yang L, E G, Zeng Y, Zhao Y, Huang Y. Temporal expression of the KISS1/GPR54 system in goats' testes and epididymides and its spatial expression in pubertal goats. Theriogenology 2020; 152:114-121. [PMID: 32388039 DOI: 10.1016/j.theriogenology.2020.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 12/17/2022]
Abstract
Kisspeptin, encoded by the KISS1 gene, and its receptor GPR54 are essential in puberty onset and male fertility due to their central regulatory roles. However, the roles of KISS1/GPR54 in peripheral tissues remain unclear. This study aimed to investigate the temporal expression patterns of KISS1/GPR54 in goat testes and epididymides and its spatial expression patterns in pubertal goats. Immunohistochemical analysis revealed that kisspeptin/GPR54 were localized in Leydig, Sertoli, and germ cells of pubertal goats' testis, as well as in principal and basal cells of the epididymis. RT-PCR revealed a marked variation in the KISS1/GPR54 expressions in the testes and epididymides from the age of first week to adulthood. KISS1 and GPR54 mRNA levels in testes decreased from the age of first week to two months and then increased from two months to puberty and adulthood. The KISS1 and GPR54 mRNA levels in Leydig cells decreased from the age of one week to two months and increased from two months to puberty, and then decreased from puberty to adulthood. Only GPR54 mRNA levels in the epididymides increased from the age of one week to two months and puberty, and then decreased from puberty to adulthood. RT-PCR analysis showed the different spatial expression patterns of KISS1/GPR54 in pubertal goat tissues. The KISS1 mRNA level was high in the hypothalamus, moderate in pancreas, liver, epididymis and testis; and low in the other tissues. The GPR54 expression was high in the pancreas and testis; moderate in pituitary, hypothalamus and mesenteric lymph node; and low in the other tissues. In conclusion, the KISS1/GPR54 system possessed distinct temporal expression profiles in goats' testes and epididymides, as well as different spatial expression patterns in pubertal goat tissues, which implied the possible local role of this system in goats' testes, epididymides, and other peripheral tissues.
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Affiliation(s)
- Yanguo Han
- College of Animal Science and Technology, Southwest University, Chongqing Key Laboratory of Forage & Herbivore, Chongqing Engineering Research Centre for Herbivores Resource Protection and Utilization, Chongqing, 400715, China
| | - Yuhetian Zhao
- Institute of Animal Science of Chinese Academy of Agricultural Science, Beijing, 100193, China
| | - Weijiang Si
- College of Animal Science and Technology, Southwest University, Chongqing Key Laboratory of Forage & Herbivore, Chongqing Engineering Research Centre for Herbivores Resource Protection and Utilization, Chongqing, 400715, China
| | - Xunping Jiang
- College of Animal Science and Technology, Huazhong Agricultural University, Key Lab of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, Wuhan, 430070, China
| | - Jiayuan Wu
- College of Animal Science and Technology, Southwest University, Chongqing Key Laboratory of Forage & Herbivore, Chongqing Engineering Research Centre for Herbivores Resource Protection and Utilization, Chongqing, 400715, China
| | - Risu Na
- College of Animal Science and Technology, Southwest University, Chongqing Key Laboratory of Forage & Herbivore, Chongqing Engineering Research Centre for Herbivores Resource Protection and Utilization, Chongqing, 400715, China
| | - Yuqing Han
- College of Animal Science and Technology, Southwest University, Chongqing Key Laboratory of Forage & Herbivore, Chongqing Engineering Research Centre for Herbivores Resource Protection and Utilization, Chongqing, 400715, China
| | - Kai Li
- Institute of Animal Science of Chinese Academy of Agricultural Science, Beijing, 100193, China
| | - Liguo Yang
- College of Animal Science and Technology, Huazhong Agricultural University, Key Lab of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, Wuhan, 430070, China
| | - Guangxin E
- College of Animal Science and Technology, Southwest University, Chongqing Key Laboratory of Forage & Herbivore, Chongqing Engineering Research Centre for Herbivores Resource Protection and Utilization, Chongqing, 400715, China
| | - Yan Zeng
- College of Animal Science and Technology, Southwest University, Chongqing Key Laboratory of Forage & Herbivore, Chongqing Engineering Research Centre for Herbivores Resource Protection and Utilization, Chongqing, 400715, China
| | - Yongju Zhao
- College of Animal Science and Technology, Southwest University, Chongqing Key Laboratory of Forage & Herbivore, Chongqing Engineering Research Centre for Herbivores Resource Protection and Utilization, Chongqing, 400715, China
| | - Yongfu Huang
- College of Animal Science and Technology, Southwest University, Chongqing Key Laboratory of Forage & Herbivore, Chongqing Engineering Research Centre for Herbivores Resource Protection and Utilization, Chongqing, 400715, China.
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Gulcu Bulmus F, Canpolat S, Sahin Z, Bulmus O, Serhatlioglu I, Kelestimur H. Kisspeptin and RF9 prevent paroxetine-induced changes in some parameters of seminal vesicle fluid in the male rats. Andrologia 2020; 52:e13538. [PMID: 32052480 DOI: 10.1111/and.13538] [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: 12/06/2019] [Revised: 12/30/2019] [Accepted: 01/11/2020] [Indexed: 11/28/2022] Open
Abstract
The aim of the study was to examine possible impacts of paroxetine and agomelatine on the levels of some components that constitute the seminal vesicle fluid. As a second purpose, it was also aimed to examine how possible negative effects induced by paroxetine on seminal vesicle fluid components were affected by kisspeptin and RF9 (an RFamide-related peptide antagonist, RFRP). Forty-two male rats, aged 21 days, divided into six groups; control, sham, paroxetine, agomelatine, paroxetine + kisspeptin and paroxetine + RF9. Paroxetine (3.6 mg/kg) and agomelatine (10 mg/kg) were administrated by oral gavage. Kisspeptin (1 nmol) and RF9 (20 nmol) were administered intracerebroventricular (i.c.v). The experiments were ended on post-natal 120 days; fructose, vitamin E, sodium, potassium and magnesium levels were measured in seminal vesicle fluid. Fructose, vitamin E, magnesium and potassium levels were significantly decreased in seminal vesicle fluid from the rats treated with paroxetine but did not show significant differences following agomelatine administration. The co-administration of kisspeptin or RF9 with paroxetine prevented the paroxetine-induced negative effects on seminal vesicle fluid components. These results suggest that reduction in sperm fertilising ability caused by changes in seminal vesicle fluid can be seen in long-term antidepressant use. RF-9 and kisspeptin might have positive effects on long-term antidepressant use-induced infertility.
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Affiliation(s)
| | - Sinan Canpolat
- Department of Physiology, Medicine Faculty, Firat University, Elazig, Turkey
| | - Zafer Sahin
- Department of Physiology, Medicine Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Ozgur Bulmus
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Firat University, Elazig, Turkey
| | - Ihsan Serhatlioglu
- Department of Biophysics, Medicine Faculty, Firat University, Elazig, Turkey
| | - Haluk Kelestimur
- Department of Physiology, Medicine Faculty, Firat University, Elazig, Turkey
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16
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Aslankoc R, Ozmen O, Ellidag HY. Ameliorating effects of agomelatine on testicular and epididymal damage induced by methotrexate in rats. J Biochem Mol Toxicol 2020; 34:e22445. [PMID: 31975554 DOI: 10.1002/jbt.22445] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 11/07/2019] [Accepted: 01/08/2020] [Indexed: 12/12/2022]
Abstract
The aim of this study was to investigate the possible prophylactic effects of agomelatine (AGO) against testicular and epididymal damage induced by methotrexate (MTX) in rats. Twenty-four male Wistar albino rats were divided into three groups: Group I (control group), Group II (MTX group: 20 mg/kg MTX, i.p, single dose), and Group III (MTX+AGO group: 20 mg/kg MTX, i.p, single dose+40 mg/kg AGO; gavage, 7 days). The rats were killed under anesthesia 24 hours after the last AGO application. Testicular and epididymal tissues were bilaterally removed for morphometric, biochemical, pathological, and immunohistochemical analyses. Body, testicular, and epididymal weights were measured. Malondialdehyde (MDA), superoxide dismutase, catalase, and glutathione peroxidase levels were measured in testes. Sperm count, hyperemia, edema, inflammatory reaction, degenerated and necrotic cells were evaluated by histopathological analysis. In addition, inducible nitric oxide synthase (iNOS), granulocyte colony-stimulating factor (G-CSF), osteopontin (OPN), and heat shock protein-70 (HSP70) immune reactions were analyzed in testes and epididymides. Decreased epididymal weights, increased MDA levels, decreased sperm count, hyperemia, edema, inflammatory reaction, and degenerated and necrotic cells were observed in the MTX group. In addition, iNOS, HSP70, G-CSF, and OPN immune reactions were increased. AGO improved morphometric, biochemical, histopathological, and immunohistochemical findings. The present study confirms that MTX induces testicular and epididymal damage both biochemically and immunohistochemically. However, AGO demonstrated ameliorative effects on both biochemical and pathological findings of the current study.
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Affiliation(s)
- Rahime Aslankoc
- Faculty of Medicine, Department of Physiology, Suleyman Demirel University, Isparta, Turkey
| | - Ozlem Ozmen
- Faculty of Veterinary Medicine, Department of Pathology, Mehmet Akif Ersoy University, Burdur, Turkey
| | - Hamit Yasar Ellidag
- Department of Clinical Biochemistry, Antalya Education and Research Hospital, Antalya, Turkey
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17
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Abou Khalil NS, Mahmoud GB. Reproductive, antioxidant and metabolic responses of Ossimi rams to kisspeptin. Theriogenology 2019; 142:414-420. [PMID: 31711707 DOI: 10.1016/j.theriogenology.2019.10.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/21/2019] [Accepted: 10/31/2019] [Indexed: 02/06/2023]
Abstract
The aim of this study was to evaluate the potential reproductive, antioxidant and metabolic effects of kisspeptin-10 (KP-10) on Ossimi rams. Twelve Ossimi rams (1.5-2 years old) were divided randomly into two groups (six per group). The first one served as a control group, while the second one served as a treated group. Rams of the treated group were injected once weekly with KP-10 (5 μg/kg body weight) for one month. There were no significant differences in all measured parameters between rams of control group at pre-treatment period and those at post-treatment period. However, most examined parameters in the same rams in the treated group were affected by injection of KP-10 when comparing pre-treatment values in treated group with its post-treatment values. At the pre-treatment period, there were no significant differences between the treated and control groups regarding semen pH, mass motility, sperm concentration/mL, live and dead spermatozoa, total sperm abnormality, testosterone and oxidative stress and metabolic parameters. However, all semen characteristics were significantly improved in the treated group compared with the control group at the post-treatment period and in the treated group at the post-treatment period compared with that at the pre-treatment period. In addition, scrotal circumference, ejaculate volume and total sperm concentration/ejaculate showed higher significant improvements when comparing the treated group with the control one at the post-treatment period than when comparing the two groups at the pre-treatment period and also when comparing the treated group at the post-treatment period with that at the pre-treatment period. Serum testosterone, total antioxidant capacity, lipid peroxides, nitric oxide, total protein, albumin, glucose and high density lipoprotein-cholesterol levels significantly increased when comparing the treated group with the control one at the post-treatment period and also when comparing the treated group at the post-treatment period with that at the pre-treatment period. In conclusion, KP-10 led to potential improvement in the reproductive efficacy and metabolic capacity of Ossimi ram.
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Affiliation(s)
- Nasser S Abou Khalil
- Department of Medical Physiology, Faculty of Medicine, Assiut University, Assiut, 71526, Egypt.
| | - Gamal B Mahmoud
- Department of Animal Production, Faculty of Agriculture, Assiut University, Assiut, 71526, Egypt.
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Reactive oxygen species, not Ca
2+
, mediates methotrexate‐induced autophagy and apoptosis in spermatocyte cell line. Basic Clin Pharmacol Toxicol 2019; 126:144-152. [DOI: 10.1111/bcpt.13306] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/06/2019] [Indexed: 02/06/2023]
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