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Venditti M, Romano MZ, Boccella S, Haddadi A, Biasi A, Maione S, Minucci S. Type 1 diabetes impairs the activity of rat testicular somatic and germ cells through NRF2/NLRP3 pathway-mediated oxidative stress. Front Endocrinol (Lausanne) 2024; 15:1399256. [PMID: 38818504 PMCID: PMC11137174 DOI: 10.3389/fendo.2024.1399256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/26/2024] [Indexed: 06/01/2024] Open
Abstract
Background It is well known that metabolic disorders, including type 1 diabetes (T1D), are often associated with reduced male fertility, mainly increasing oxidative stress and impairing the hypothalamus-pituitary-testis (HPT) axis, with consequently altered spermatogenesis and reduced sperm parameters. Herein, using a rat model of T1D obtained by treatment with streptozotocin (STZ), we analyzed several parameters of testicular activity. Methods A total of 10 adult male Wistar rats were divided into two groups of five: control and T1D, obtained with a single intraperitoneal injection of STZ. After 3 months, the rats were anesthetized and sacrificed; one testis was stored at -80°C for biochemical analysis, and the other was fixed for histological and immunofluorescence analysis. Results The data confirmed that T1D induced oxidative stress and, consequently, alterations in both testicular somatic and germ cells. This aspect was highlighted by enhanced apoptosis, altered steroidogenesis and Leydig cell maturity, and impaired spermatogenesis. In addition, the blood-testis barrier integrity was compromised, as shown by the reduced levels of structural proteins (N-cadherin, ZO-1, occludin, connexin 43, and VANGL2) and the phosphorylation status of regulative kinases (Src and FAK). Mechanistically, the dysregulation of the SIRT1/NRF2/MAPKs signaling pathways was proven, particularly the reduced nuclear translocation of NRF2, affecting its ability to induce the transcription of genes encoding for antioxidant enzymes. Finally, the stimulation of testicular inflammation and pyroptosis was also confirmed, as highlighted by the increased levels of some markers, such as NF-κB and NLRP3. Conclusion The combined data allowed us to confirm that T1D has detrimental effects on rat testicular activity. Moreover, a better comprehension of the molecular mechanisms underlying the association between metabolic disorders and male fertility could help to identify novel targets to prevent and treat fertility disorders related to T1D.
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Affiliation(s)
- Massimo Venditti
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Maria Zelinda Romano
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Serena Boccella
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Asma Haddadi
- Laboratoire LR11ES41 Génétique Biodiversité et Valorisation des Bio-Ressourcés Institut Supérieur de Biotechnologie de Monastir, Université de Monastir, Monastir, Tunisia
| | - Alessandra Biasi
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Sabatino Maione
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Sergio Minucci
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
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Falcone M, Bocu K, Keskin H, Solorzano Vazquez JF, Banthia R, Mahendran T, Deger MD, Kv V, Mirko P, Harraz AM, Saleh R, Shah R, Agarwal A. Anti-sperm Antibody Positivity in Men with Varicocele: A Systematic Review and Meta-Analysis. World J Mens Health 2024; 42:42.e43. [PMID: 38606868 DOI: 10.5534/wjmh.240003] [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: 01/02/2024] [Revised: 01/22/2024] [Accepted: 02/02/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele. MATERIALS AND METHODS This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs). RESULTS Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09-17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81-15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39-25.89]; p<0.01). CONCLUSIONS This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.
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Affiliation(s)
- Marco Falcone
- Department of Urology, Molinette Hospital, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Torino, Italy
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Kadir Bocu
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Silopi State Hospital, Sirnak, Turkey
| | - Hakan Keskin
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, School of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Ravi Banthia
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Western General Hospital, Edinburgh, UK
| | - Tara Mahendran
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology Center, Coimbatore, India
| | - Muslim Dogan Deger
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Edirne Sultan 1st Murat State Hospital, Edirne, Turkey
| | - Vinod Kv
- Global Andrology Forum, Moreland Hills, OH, USA
- Centre for Urological Research and Evaluation, Thiruvananthapuram, India
| | - Preto Mirko
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Molinette Hospital A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Ahmed M Harraz
- Global Andrology Forum, Moreland Hills, OH, USA
- Sabah Al Ahmad Urology Center, Kuwait City, Kuwait
- General Surgery Department, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Ramadan Saleh
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
- Ajyal IVF Center, Ajyal Hospital, Sohag, Egypt
| | - Rupin Shah
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Ashok Agarwal
- Global Andrology Forum, Moreland Hills, OH, USA
- Cleveland Clinic Foundation, Cleveland, OH, USA.
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3
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Sanyal D, Arya D, Nishi K, Balasinor N, Singh D. Clinical Utility of Sperm Function Tests in Predicting Male Fertility: A Systematic Review. Reprod Sci 2024; 31:863-882. [PMID: 38012524 DOI: 10.1007/s43032-023-01405-7] [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: 09/11/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
Routine semen analysis provides considerable information regarding sperm parameters; however, it is not solely adequate to predict male fertility potential. In the past two decades, several advance sperm function tests have been developed. The present systematic review intends to assess the clinical utility of available advance sperm function tests in predicting the male fertility potential. A systematic literature search was conducted as per PRISMA guidelines using PubMed, MEDLINE, Google Scholar, and Cochrane Library. Different keywords either singly or in combination were used to retrieve the relevant articles related to sperm function tests, male fertility, and pregnancy outcomes. A total of 5169 articles were obtained, out of which 110 meeting the selection criteria were included in this review. The majorly investigated sperm function tests are hypo-osmotic swelling test, acrosome reaction test, sperm capacitation test, hemizona binding assay, sperm DNA fragmentation test, seminal reactive oxygen species test, mitochondrial dysfunction tests, antisperm antibody test, nuclear chromatin de-condensation (NCD) test, etc. The different advance sperm function tests analyse different aspects of sperm function. Hence, any one test may not be helpful to appropriately predict the male fertility potential. Currently, the unavailability of high-quality clinical data, robust thresholds, complex protocols, high cost, etc., are the limiting factors and prohibiting current sperm function tests to reach the clinics. Further multi-centric research efforts are required to fulfil the existing lacunas and pave the way for these tests to be introduced into the clinics.
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Affiliation(s)
- Debarati Sanyal
- Department of Neuroendocrinology, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai, 400012, India
| | - Deepshikha Arya
- Department of Neuroendocrinology, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai, 400012, India
| | - Kumari Nishi
- Department of Neuroendocrinology, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai, 400012, India
| | - Nafisa Balasinor
- Department of Neuroendocrinology, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai, 400012, India.
| | - Dipty Singh
- Department of Neuroendocrinology, ICMR-National Institute for Research in Reproductive and Child Health, Parel, Mumbai, 400012, India.
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Signorini C, Saso L, Ghareghomi S, Telkoparan-Akillilar P, Collodel G, Moretti E. Redox Homeostasis and Nrf2-Regulated Mechanisms Are Relevant to Male Infertility. Antioxidants (Basel) 2024; 13:193. [PMID: 38397791 PMCID: PMC10886271 DOI: 10.3390/antiox13020193] [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: 12/29/2023] [Revised: 01/20/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Infertility represents a significant global health challenge, affecting more than 12% of couples worldwide, and most cases of infertility are caused by male factors. Several pathological pathways are implicated in male infertility. The main mechanisms involved are driven by the loss of reduction-oxidation (redox) homeostasis and the resulting oxidative damage as well as the chronic inflammatory process. Increased or severe oxidative stress leads to sperm plasma membrane and DNA oxidative damage, dysregulated RNA processing, and telomere destruction. The signaling pathways of these molecular events are also regulated by Nuclear factor-E2-related factor 2 (Nrf2). The causes of male infertility, the role of oxidative stress in male infertility and the Keap1-Nrf2 antioxidant pathway are reviewed. This review highlights the regulatory role of Nrf2 in the balance between oxidants and antioxidants as relevant mechanisms to male fertility. Nrf2 is involved in the regulation of spermatogenesis and sperm quality. Establishing a link between Nrf2 signaling pathways and the regulation of male fertility provides the basis for molecular modulation of inflammatory processes, reactive oxygen species generation, and the antioxidant molecular network, including the Nrf2-regulated antioxidant response, to improve male reproductive outcomes.
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Affiliation(s)
- Cinzia Signorini
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (C.S.); (G.C.); (E.M.)
| | - Luciano Saso
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, 00185 Rome, Italy
| | - Somayyeh Ghareghomi
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran 1417466191, Iran;
| | | | - Giulia Collodel
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (C.S.); (G.C.); (E.M.)
| | - Elena Moretti
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy; (C.S.); (G.C.); (E.M.)
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Andretta RR, de Castro LS, de Carvalho RC, Moura JACD, Fraietta R, Okada FK, Bertolla RP. Understanding the impact of varicocele on sperm capacitation. F&S SCIENCE 2023; 4:229-238. [PMID: 37169221 DOI: 10.1016/j.xfss.2023.05.001] [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: 02/17/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To study the relationship between the seminal sample quality of men with varicocele and sperm capacitation. DESIGN Cross-sectional observational study. SETTING Academic hospital. PATIENT(S) Seventy-six men (19 control and 57 with varicocele) were analyzed. INTERVENTION(S) Semen samples were submitted to a discontinuous density gradient for sperm selection. Sperm capacitation was induced using a human tubal fluid medium supplemented with bovine serum albumin. MAIN OUTCOME MEASURE(S) After capacitation induction, the sperm were assessed by capacitation state, computer-assisted sperm motility, mitochondrial activity, membrane integrity, acrosome reaction, and intracellular oxidative stress. RESULT(S) The capacitation period increased sperm motility, showing an increase in the average path velocity and a decrease in the straightness compared with sperm before capacitation (paired analysis). After capacitation, the rate of capacitated sperm, motility, and mitochondrial activity showed differences between groups (control and varicocele). The varicocele group showed lower mitochondrial activity and capacitation than the control group. On the other hand, no significant differences were observed in the other variables evaluated. CONCLUSION(S) Varicocele men showed less viable sperm and mitochondrial activity than control men after capacitation sperm. The induction of capacitation altered motility by increasing path velocity and decreasing straightness in all of the studied groups, evidencing the occurrence of hyperactivation.
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Affiliation(s)
- Rhayza Roberta Andretta
- Human Reproduction Section, Division of Urology, Department of Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Letícia Signori de Castro
- Laboratory of Spermatozoa Biology, Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Sao Paulo, Brazil
| | - Renata Cristina de Carvalho
- Human Reproduction Section, Division of Urology, Department of Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | - Renato Fraietta
- Human Reproduction Section, Division of Urology, Department of Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Fatima Kazue Okada
- Human Reproduction Section, Division of Urology, Department of Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil; Laboratory of Developmental Biology, Department of Morphology and Genetics, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | - Ricardo Pimenta Bertolla
- Human Reproduction Section, Division of Urology, Department of Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil
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Mahdi M, Majzoub A, Elbardisi H, Arafa M, Khalafalla K, Al Said S, El Ansari W. Impact of body mass index on semen parameters and reproductive hormones among men undergoing microsurgical subinguinal varicocelectomy. Arab J Urol 2023; 21:190-197. [PMID: 37521450 PMCID: PMC10373608 DOI: 10.1080/2090598x.2023.2206336] [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: 02/01/2023] [Accepted: 04/19/2023] [Indexed: 08/01/2023] Open
Abstract
Background Few studies assessed the relationships between BMI and post varicocelectomy semen quality and fertility potential and they reported inconsistent findings. Objective To assess the association of BMI with semen parameters and reproductive hormones before and after microsurgical varicocelectomy. Materials and Methods Retrospective chart review in a tertiary infertility center. Of 1170 patients with clinical varicocele during the study period (8 years), 813 patients were eligible and included. Patients were grouped into: Group A (kg/m2, n = 251 patients), B (BMI 25-29.9 kg/m2, n = 289), C (BMI 30-34.9 kg/m2, n = 183) and D (kg/m2, n = 90). Clinical data, semen parameters, sperm DNA fragmentation and hormonal profile were collected before and 3 months after microsurgical varicocelectomy. Results Patients' mean age was 35.87 ± 8.17 years. Higher-grade varicocele was significantly more prevalent in the lower BMI groups. BMI was significantly negatively correlated with preoperative sperm concentration, total motility progressive motility and total motile sperm count. Pre-operatively, sperm concentration, total motility, progressive motility and total motile sperm count showed significant differences between BMI groups, where higher BMI (Groups C and D) exhibited the poorest semen parameters. Postoperatively, all groups showed significant improvement in sperm concentration compared with pre-operative values. However, total and progressive motility were significantly improved in Groups A, B and C, while in Group D (highest BMI), total motility improved clinically but not statistically, progressive motility did not display improvement, and total motile sperm count was significantly improved only in Groups B and C. Postoperatively, mean improvements in semen parameters across the BMI groups were not significantly different, except for morphology, which improved significantly more in the less obese patients. Conclusion For infertile patients with clinical varicocele undergoing micro-surgical varicocelectomy, BMI appears not to impact the improvements across most of the semen parameters and hormones. The procedure might improve the fertility potential.
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Affiliation(s)
- Mohammed Mahdi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medicine-Qatar, Doha, Qatar
- Department of Urology, Qatar University, Doha, Qatar
| | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medicine-Qatar, Doha, Qatar
- Department of Andrology, Cairo University, Cairo, Egypt
| | - Kareim Khalafalla
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Urology Department, University of Texas McGovern Medical School Houston, Texas, USA
- Urology Department, MD Anderson Cancer Center, Houston, TX, USA
| | - Sami Al Said
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Walid El Ansari
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- Department of Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
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7
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Feng J, He H, Wang Y, Zhang X, Zhang X, Zhang T, Zhu M, Wu X, Zhang Y. The efficacy and mechanism of acupuncture in the treatment of male infertility: A literature review. Front Endocrinol (Lausanne) 2022; 13:1009537. [PMID: 36329891 PMCID: PMC9624472 DOI: 10.3389/fendo.2022.1009537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
Fertility, a social, cultural, and medical issue, has aroused public attention because of its potential to predict future health. In recent years, the incidence of male infertility has increased significantly, and various risk factors, such as congenital factors, acquired factors, and idiopathic factors, have led to this situation. Male infertility causes substantial psychological and social distress in patients. With the implementation of the two-child policy, male infertility has brought enormous psychological and social pressure and huge economic burden to patients and the healthcare system. This has attracted the attention of not only men of childbearing age but also many male experts. The conventional therapeutic approaches for treating male infertility, including drugs, varicocele surgery, intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection, can restore fertility to a certain extent, but their efficacy is far from satisfactory, not to mention some adverse events. Therefore, acupuncture has been chosen by many men to treat their infertility and produced significant effects. In the present paper, the efficacy and mechanism of acupuncture in the treatment of male infertility were analyzed from different perspectives such as regulating hormone secretion, reducing inflammation, and improving semen parameters. The existing literature shows that acupuncture can effectively treat male infertility.
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Affiliation(s)
- Jiaxing Feng
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hui He
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yu Wang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xu Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiuying Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tiantian Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Mengyi Zhu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiaoke Wu
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China
| | - Yuehui Zhang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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