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Zheng Z, Wang H, Chen Z, Gao H, Gao P, Gao J, Jiang H, Zhang X. Impact of chronic sleep deprivation on male reproductive health: Insights from testicular and epididymal responses in mice. Andrology 2024. [PMID: 39092868 DOI: 10.1111/andr.13718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/09/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Sleep deprivation (SD) can cause damage to the male reproductive system. However, the duration required for such damage and the specific sequence and severity of damage to the testis and epididymis remain unclear. OBJECTIVE To investigate the effects of different durations of SD on different parts of the testis and epididymis caput, corpus, and cauda. METHODS Adult ICR mice were randomly assigned to five groups: the SD group (SD for 18 h/day for 1, 2, 3, or 4 weeks), the SD + Vit E group (supplemented with Vit E 50 mg/kg/d during 4 weeks of SD, the SD+NS group (saline supplementation during 4 weeks of SD), the SD + RS group (5 weeks of recovery sleep after 4 weeks of SD), and a normal sleep control (Ctrl) group. Following the interventions, sperm parameters, testicular and epididymal histopathology, inflammatory response, and oxidative stress markers were compared between the groups. RESULTS Compared to the Ctrl group, the SD group showed a decrease in sperm motility and concentration from SD 2 W and SD 3 W, respectively. Decreases in sperm concentration and motility were more pronounced in the cauda compared to the caput and corpus. Pathological damage was less severe in the epididymis caput than in the corpus and cauda. After 4 weeks of SD, inflammation and oxidative stress increased in both testes and epididymis. Both sleep recovery and vitamin E supplementation showed significant improvements, though they did not fully reach the level of the Ctrl group. CONCLUSION Chronic SD for more than 2 weeks causes varying degrees of damage to the testis, epididymis caput, corpus, and cauda in male mice. This damage is not fully reversible after 5 weeks of sleep recovery and antioxidant stress treatment. These findings help us to identify and prevent SD damage to the male reproduction at an early stage.
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Affiliation(s)
- Zhenming Zheng
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Hui Wang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Zhimin Chen
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Hui Gao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Pan Gao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Jingjing Gao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Hui Jiang
- Andrology Center, Peking University First Hospital, Beijing, China
| | - Xiansheng Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
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Yang W, Hua R, Cao Y, He X. A metabolomic perspective on the mechanisms by which environmental pollutants and lifestyle lead to male infertility. Andrology 2024; 12:719-739. [PMID: 37815095 DOI: 10.1111/andr.13530] [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: 05/10/2023] [Revised: 08/17/2023] [Accepted: 09/03/2023] [Indexed: 10/11/2023]
Abstract
The incidence of male infertility (MI) is rising annually. According to epidemiological studies, environmental pollution (e.g., organic, inorganic, and air pollutants), occupational exposure (e.g., high temperature, organic solvents, and pesticides), and poor lifestyle (e.g., diet, sleep, smoking, alcohol consumption, and exercise) are important non-genetic causative factors of MI. Due to multiple and complex causative factors, the dose-effect relationship, and the uncertainty of pathogenicity, the pathogenesis of MI is far from fully clarified. Recent data show that the pathogenesis of MI can be monitored by the metabolites in serum, seminal plasma, urine, testicular tissue, sperm, and other biological samples. It is considered that these metabolites are closely related to MI phenotypes and can directly reflect the individual pathological and physiological conditions. Therefore, qualitative and quantitative analysis of the metabolome, the related metabolic pathways, and the identification of biomarkers will help to explore the MI-related metabolic problems and provide valuable insights into its pathogenic mechanisms. Here, we summarized new findings in MI metabolomics biomarkers research and their abnormal metabolic pathways triggered by the presented non-genetic risk factors, providing a metabolic landscape of semen and seminal plasma in general MI patients. Then, we compared the similarities and differences in semen and seminal plasma biomarkers between MI patients exposed to environmental and poor lifestyle factors and MI patients in general, and summarized some common biomarkers. We provide a better understanding of the biological underpinnings of MI pathogenesis, which might offer novel diagnostic, prognostic, and precise treatment approaches to MI.
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Affiliation(s)
- Wen Yang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Rong Hua
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Yunxia Cao
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Xiaojin He
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
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de Aguiar GC, Souza ACF, de Souza DV, Neto MM, Le Sueur-Maluf L, de Moraes Malinverni AC, Antunes HKM, Ribeiro DA. Degenerative changes induced by paradoxical sleep deprivation in rat sublingual glands. Eur Arch Otorhinolaryngol 2023; 280:4261-4269. [PMID: 37256344 DOI: 10.1007/s00405-023-08041-6] [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: 04/04/2023] [Accepted: 05/22/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE The aim of this study was to evaluate whether sleep deprivation can induce degenerative changes in rat sublingual glands. METHODS For this purpose, a total of 24 males were distributed into three groups: control (n = 8), in which the animals were not subjected to any procedure; sleep deprivation (n = 8) in which the animals were submitted to sleep deprivation for 96 h; recovery (n = 8), in which the animals were subjected to paradoxical sleep deprivation for 96 consecutive hours followed by 96 h without intervention. Morphological changes in sublingual glands as well as the immunoexpressions of some proteins, such as Ki-67, p16, cleaved caspase-3 and BCL-2 were investigated in this setting. RESULTS The results showed that paradoxical sleep deprivation induced tissue degeneration as a result of the presence of pyknosis, vacuoles and areas of salivary retention, in the experimental groups. Expression of cleaved caspase 3 and BCL-2 were increased in both sleep deprivation and recovery groups. The analysis of Ki-67 showed an increase in expression only in the recovery group, associated with a decrease in p16 levels. CONCLUSION Sleep deprivation can induce a degenerative process in the parenchyma of sublingual gland by means of dysregulation of apoptosis associated with proliferative activity.
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Affiliation(s)
- Gabriel Carvalhal de Aguiar
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | - Ana Carolina Flygare Souza
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | - Daniel Vitor de Souza
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | - Marcos Monico Neto
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | - Luciana Le Sueur-Maluf
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | | | - Hanna Karen Moreira Antunes
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | - Daniel Araki Ribeiro
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil.
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Karimi F, Noorafshan A, Karbalay-Doust S, Naseh M. Sleep deprivation induces structural changes in the adult rat testis: The protective effects of olive oil. Clin Exp Reprod Med 2023; 50:19-25. [PMID: 36935408 PMCID: PMC10030206 DOI: 10.5653/cerm.2022.05624] [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: 08/21/2022] [Accepted: 11/29/2022] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE Sleep deprivation (SD) is a common problem in today's stressful lifestyle and have physiological consequences, including reproductive dysfunction and infertility. As an antioxidant, olive oil may be effective in reducing testicular and spermatological damage by decreasing the production of free radicals. METHODS This study investigated the effects of olive oil on sperm quality and testicular structure using stereological methods to assess rats with SD. RESULTS When comparing SD group to grid floor+distilled water (GR) group, we found that the sperm count and motility, as well as the percentage of slow progressive sperm was significantly lower in SD group (p<0.05), but the percentage of immotile sperm was higher (p<0.01). However, no improvement was observed in sperm count or motility after concomitant treatment of SD group with olive oil. Stereological examinations revealed no significant change in the total volumes of the seminiferous tubules, interstitial tissue, and germinal epithelium in the study groups. Conversely, the total number of testicular cell types was significantly lower in SD group than in GR group. Although the total number of Sertoli and Leydig cells was significantly higher in the SD+olive oil group than in the untreated SD group, no significant difference in the total number of other testicular cell types was observed between the two groups. CONCLUSION SD potentially induced structural changes in testis that affected sperm count and motility. However, olive oil only improved the total number of Sertoli and Leydig cells in the animals with SD and did not improve sperm count and motility.
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Affiliation(s)
- Fatemeh Karimi
- Histomorphometry and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Noorafshan
- Histomorphometry and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saied Karbalay-Doust
- Histomorphometry and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Naseh
- Histomorphometry and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Machine Learning Predictive Models for Evaluating Risk Factors Affecting Sperm Count: Predictions Based on Health Screening Indicators. J Clin Med 2023; 12:jcm12031220. [PMID: 36769868 PMCID: PMC9917545 DOI: 10.3390/jcm12031220] [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: 12/20/2022] [Revised: 01/13/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
In many countries, especially developed nations, the fertility rate and birth rate have continually declined. Taiwan's fertility rate has paralleled this trend and reached its nadir in 2022. Therefore, the government uses many strategies to encourage more married couples to have children. However, couples marrying at an older age may have declining physical status, as well as hypertension and other metabolic syndrome symptoms, in addition to possibly being overweight, which have been the focus of the studies for their influences on male and female gamete quality. Many previous studies based on infertile people are not truly representative of the general population. This study proposed a framework using five machine learning (ML) predictive algorithms-random forest, stochastic gradient boosting, least absolute shrinkage and selection operator regression, ridge regression, and extreme gradient boosting-to identify the major risk factors affecting male sperm count based on a major health screening database in Taiwan. Unlike traditional multiple linear regression, ML algorithms do not need statistical assumptions and can capture non-linear relationships or complex interactions between dependent and independent variables to generate promising performance. We analyzed annual health screening data of 1375 males from 2010 to 2017, including data on health screening indicators, sourced from the MJ Group, a major health screening center in Taiwan. The symmetric mean absolute percentage error, relative absolute error, root relative squared error, and root mean squared error were used as performance evaluation metrics. Our results show that sleep time (ST), alpha-fetoprotein (AFP), body fat (BF), systolic blood pressure (SBP), and blood urea nitrogen (BUN) are the top five risk factors associated with sperm count. ST is a known risk factor influencing reproductive hormone balance, which can affect spermatogenesis and final sperm count. BF and SBP are risk factors associated with metabolic syndrome, another known risk factor of altered male reproductive hormone systems. However, AFP has not been the focus of previous studies on male fertility or semen quality. BUN, the index for kidney function, is also identified as a risk factor by our established ML model. Our results support previous findings that metabolic syndrome has negative impacts on sperm count and semen quality. Sleep duration also has an impact on sperm generation in the testes. AFP and BUN are two novel risk factors linked to sperm counts. These findings could help healthcare personnel and law makers create strategies for creating environments to increase the country's fertility rate. This study should also be of value to follow-up research.
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Zhang W, Shi X, Zhang Y, Liu G, Wu X, Huang H, Jiang H, Zhang X. Attenuation Effect of Recovery Sleep for Impaired Reproductive Function in Male Rats by Sleep Deprivation. World J Mens Health 2023:41.e8. [PMID: 36593710 DOI: 10.5534/wjmh.220130] [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: 07/01/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 01/03/2023] Open
Abstract
PURPOSE The aim of the present study was to test the hypothesis that recovery sleep could counteract the detrimental effects of sleep deprivation (SD) on male rats' fertility. MATERIALS AND METHODS Twenty-two rats were housed in groups of six per cage with unrestricted access to food and water in a room. The modified multiple platform method was used to induce SD in rats over a 96-hour period. We examined the effect of SD on semen quality, reproductive hormones, and testicular histology in adult male rats. Then, we investigated the effect of 7 days recovery sleep on impaired reproductive function induced by SD. RESULTS After the acclimation period, 22 rats were randomly separated into three experimental groups (SD, recovery sleep, and the control groups). Ninety-six hours of SD resulted in a significant decrease in sperm motility (24.33±10.93 vs. 48.20±8.55, p<0.001) and the number of morphologically normal sperm (9.68±2.77 vs. 26.21±14.60, p<0.01) in rats, accompanied by a decrease in testosterone levels (1.53±0.55 vs. 4.44±0.56, p<0.001) and destruction of testicular tissue structure compared with control group. After 7 days of recovery sleep, semen quality, especially sperm motility, was improved and testosterone levels were significantly higher compared to post-SD (3.70±0.53 vs. 1.53±0.55, p<0.05), but remained low compared to the control group. CONCLUSIONS In conclusion, 96 hours of SD deteriorated the parameters of sperm motility and the number of morphologically normal sperm in rats, probably due to the decrease in serum testosterone levels and the disruption of testicular tissue structure when compared to the control group. After 7 days of recovery sleep, semen parameter, especially sperm motility and testosterone levels did not return to baseline levels compared to the control group.
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Affiliation(s)
- Wei Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiao Shi
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yuyang Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Guodong Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xu Wu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Houbao Huang
- Department of Urology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Hui Jiang
- Andrology Center, Peking University First Hospital, Beijing, China.
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
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Smeltzer EA, Stead SM, Li MF, Samson D, Kumpan LT, Teichroeb JA. Social sleepers: The effects of social status on sleep in terrestrial mammals. Horm Behav 2022; 143:105181. [PMID: 35594742 DOI: 10.1016/j.yhbeh.2022.105181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/12/2022] [Accepted: 04/22/2022] [Indexed: 11/18/2022]
Abstract
Social status among group-living mammals can impact access to resources, such as water, food, social support, and mating opportunities, and this differential access to resources can have fitness consequences. Here, we propose that an animal's social status impacts their access to sleep opportunities, as social status may predict when an animal sleeps, where they sleep, who they sleep with, and how well they sleep. Our review of terrestrial mammals examines how sleep architecture and intensity may be impacted by (1) sleeping conditions and (2) the social experience during wakefulness. Sleeping positions vary in thermoregulatory properties, protection from predators, and exposure to parasites. Thus, if dominant individuals have priority of access to sleeping positions, they may benefit from higher quality sleeping conditions and, in turn, better sleep. With respect to waking experiences, we discuss the impacts of stress on sleep, as it has been established that specific social statuses can be characterized by stress-related physiological profiles. While much research has focused on how dominance hierarchies impact access to resources like food and mating opportunities, differential access to sleep opportunities among mammals has been largely ignored despite its potential fitness consequences.
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Affiliation(s)
- E A Smeltzer
- Department of Anthropology, University of Toronto Scarborough, 1265 Military Trail, Scarborough, Ontario M1C 1A4, Canada
| | - S M Stead
- Department of Anthropology, University of Toronto Scarborough, 1265 Military Trail, Scarborough, Ontario M1C 1A4, Canada.
| | - M F Li
- Department of Anthropology, University of Toronto, 19 Russell St., Toronto, Ontario M5S 2S2, Canada
| | - D Samson
- Department of Anthropology, University of Toronto Mississauga, 3359 Mississauga Rd., Mississauga, Ontario L5L 1C6, Canada
| | - L T Kumpan
- Department of Anthropology, University of Toronto Scarborough, 1265 Military Trail, Scarborough, Ontario M1C 1A4, Canada
| | - J A Teichroeb
- Department of Anthropology, University of Toronto Scarborough, 1265 Military Trail, Scarborough, Ontario M1C 1A4, Canada
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Impaired Human Sexual and Erectile Function Affecting Semen Quality, in Obstructive Sleep Apnea: A Pilot Study. J Pers Med 2022; 12:jpm12060980. [PMID: 35743765 PMCID: PMC9225560 DOI: 10.3390/jpm12060980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022] Open
Abstract
Obstructive sleep apnea (OSA) is a rising problem, with important implications for public health. Recent evidence has revealed a link between OSA and reduced male fertility. We investigated the association between OSA and sexual and erectile function, as well as semen quality, and the effect of treatment by continuous positive airway pressure (CPAP). A total of 41 male subjects, who underwent polysomnography for suspected OSA, participated in the study. Erectile and sexual function were assessed with the 15-item International Index of Erectile Function (IIEF-15) questionnaire, blood samples, and sperm analysis. OSA patients after the initiation of CPAP treatment were followed for a period of 1 year. Thirty-two patients were diagnosed with OSA, and nine subjects without OSA were used as a control group. OSA patients demonstrated significantly impaired erectile function, reduced testosterone levels, and lower semen quality. Multivariable regression analysis showed that BMI and IIEF score were independent determinants of AHI. Sexual function improved after a year of CPAP therapy in OSA patients. This study provides further evidence regarding the association between OSA and erectile function impairment, as well as semen quality. Longitudinal adherence to CPAP treatment has a beneficial effect on erectile function.
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Li T, Bai Y, Jiang Y, Jiang K, Tian Y, Gu J, Sun F. The potential impacts of circadian rhythm disturbances on male fertility. Front Endocrinol (Lausanne) 2022; 13:1001316. [PMID: 36277693 PMCID: PMC9582279 DOI: 10.3389/fendo.2022.1001316] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
A circadian rhythm is an internalized timing system that synchronizes the cellular, behavioral, and physiological processes of organisms to the Earth's rotation. Because all physiological activities occur at a specific time, circadian rhythm disturbances can lead to various pathological disorders and diseases. Growing evidence has shown that the circadian clock is tightly connected to male fertility, and circadian perturbations contribute to infertility. The night shiftwork, insufficient sleep, and poor sleep quality are common causes of circadian disturbances, and many studies have reported that they impair sperm quality and increase the risk of male infertility. However, research on the impacts of light, body temperature, and circadian/circannual rhythms is relatively lacking, although some correlations have been demonstrated. Moreover, as the index of sperm quality was diverse and study designs were non-uniform, the conclusions were temporarily inconsistent and underlying mechanisms remain unclear. A better understanding of whether and how circadian disturbances regulate male fertility will be meaningful, as more scientific work schedules and rational lifestyles might help improve infertility.
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Affiliation(s)
- Tao Li
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Yunjin Bai
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yiting Jiang
- Department of Otorhinolaryngology, The Ninth People’s Hospital of Chongqing, Chongqing, China
| | - Kehua Jiang
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Ye Tian
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Jiang Gu
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- *Correspondence: Fa Sun, ; Jiang Gu,
| | - Fa Sun
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China
- *Correspondence: Fa Sun, ; Jiang Gu,
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Souza ACF, Monico-Neto M, Le Sueur-Maluf L, Pidone FAM, Antunes HKM, Ribeiro DA. Inflammatory activity and apoptosis are associated with tissue degeneration in the submandibular gland of rats submitted to paradoxical sleep deprivation. Odontology 2021; 110:278-286. [PMID: 34536167 DOI: 10.1007/s10266-021-00657-6] [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: 05/24/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
The aim of this study was to evaluate if paradoxical sleep deprivation is able to induce tissue degeneration, inflammatory activity and apoptosis in the submandibular gland of rats. A total of 24 male Wistar rats were distributed into the following groups: group 1-control (CTRL; n = 8): the animals were not submitted to any procedures; group 2-sleep deprivation (PS; n = 8): the animals were submitted to paradoxical sleep deprivation for 96 h and group 3-recovery (R; n = 8): the animals were submitted to sleep deprivation for 96 h, followed by a period of 96 h without any intervention. The following parameters were evaluated: histopathological analysis, immunohistochemistry for Ki-67, COX-2 and cleaved caspase-3 and gene expression of TNF-α, Interleukin 6 (IL-6), Interleukin 10 (IL-10) and cytochrome C by real-time PCR. The results pointed out cytoplasmic vacuoles and congested vessels in the parenchyma of submandibular gland the in PS and R groups. The expression of interleukins 6, 10 and TNF-ɑ was differentially expressed in the PS and R groups. Apoptosis was also triggered by means of increasing cleaved caspase-3 and cytochrome c expression. The cellular proliferation (Ki-67 index) was also positive in the R group. Taken together, our results demonstrate that sleep deprivation is capable of promoting tissue degeneration in the submandibular gland, as a result of inflammatory response and cellular death in rats.
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Affiliation(s)
- Ana Carolina Flygare Souza
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | - Marcos Monico-Neto
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | - Luciana Le Sueur-Maluf
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | - Flavia Andressa Mazzuco Pidone
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | - Hanna Karen Moreira Antunes
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil
| | - Daniel Araki Ribeiro
- Department of Biosciences, Institute of Health and Society, Federal University of São Paulo, UNIFESP, Rua Silva Jardim, 136, Room 332, Vila Mathias, Santos, SP, 11050-020, Brazil.
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Medubi LJ, Nwosu NC, Medubi OO, Lawal OR, Ama C, Kusemiju TO, Osinubi AAA. Increased de novo glutathione production enhances sexual dysfunctions in rats subjected to paradoxical sleep deprivation. JBRA Assist Reprod 2021; 25:215-222. [PMID: 33150783 PMCID: PMC8083868 DOI: 10.5935/1518-0557.20200070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 09/30/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Poor quality of sexual life has been reported secondary to poor sleep or sleep deprivation. Paradoxical sleep is an integral part of the sleep-wakefulness physiology and prolonged paradoxical sleep deprivation (PSD) may even be fatal. The objective of this investigation was to determine if D-ribose-L-cysteine (RibCys) and zinc (Zn) administration can attenuate the effect of PSD on the sexual function of male rats. METHODS Following acclimatization, 25 male rats were randomly distributed into five groups of 5 rats each. The PSD, PSD+RibCys, PSD+Zn, PSD+RibCys+Zn, and Control groups were sleep-deprived only, sleep-deprived and given 100mg/kg body-weight of pure RibCys, sleep-deprived and given 10mg/kg body weight Zn, sleep-deprived and given a combination of 100mg/kg of RibCys and 10mg/kg of Zn, and given distilled water without sleep deprivation, respectively. PSD lasted for 20 hours per day for 14 days. Subsequently, the sexual behavioral study was carried out and the animals were sacrificed for biochemical assays. RESULTS Analyses of results show that for animals treated with RibCys or Zn, all sexual parameters such as mount frequency and latency, intromission frequency and latency and ejaculation frequency and latency were significantly improved compared with animals subjected to PSD only. This improvement correlates strongly with serum glutathione (GHS) levels. CONCLUSION In summary, riboceine increases circulating GHS, which leads to improved sexual function during sleep deprivation.
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Affiliation(s)
- Leke Jacob Medubi
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Nkechi Clara Nwosu
- Department of Anatomy, Faculty of Basic Medical Sciences, Gregory University, Uturu, Anabra State, Nigeria
| | - Oluwatoyi Ojuolape Medubi
- Department of Physiology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Olarenaju Ramat Lawal
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Cecilia Ama
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Taiwo Olabisi Kusemiju
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Abraham AA Osinubi
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
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Maestro-Gonzalez A, Sánchez-Zaballos M, Mosteiro-Díaz MP, Zuazua-Rico D. Quality of sleep among social media users during the lockdown period due to COVID-19 in Spain. Sleep Med 2021; 80:210-215. [PMID: 33607556 PMCID: PMC9188780 DOI: 10.1016/j.sleep.2021.01.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/01/2020] [Accepted: 01/26/2021] [Indexed: 11/06/2022]
Abstract
Aims To analyse the quality of sleep of the Spanish population during the lockdown due to COVID-19. Design Cross-sectional descriptive study using a web based survey design. Methods Pittsburgh Sleep Quality Index questionnaire and sociodemographic, occupational, health and sleep quality variables were used to collect data during the first month of the lockdown period due to COVID-19 (March–April 2020). A snowball sampling was carried out, where participants were asked to disseminate and distribute the questionnaire among their own profiles in social networks. Results A representative sample of 5220 participants aged ≥18 years old took part in the study. The global PSQI score was 8.17 points (SD 4.43). A statistical association was found between the global PSQI score and several of the variables collected. Findings show that the quality of sleep was worse among women (p < 0.001), single participants (p 0.02), those working in rotating shifts (p < 0.001), on-site workers (p < 0.001), and people diagnosed with COVID-19 or who had someone in their environment diagnosed with the virus (p < 0.001). Conclusion Findings show that the Spanish population has experienced poor quality of sleep during the lockdown period. Being a woman, working in rotating shifts, having suffered from COVID-19 or having someone close suffering from COVID-19, being unemployed or being affected by a Temporary Redundancy Scheme, as well as spending long hours in bed were associated with poorer sleep quality. On the contrary, being older and sleeping longer hours were associated with a better sleep quality.
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Affiliation(s)
- Alba Maestro-Gonzalez
- Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Marta Sánchez-Zaballos
- Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | | | - David Zuazua-Rico
- Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Universitario Central de Asturias, Oviedo, Spain
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Gao X, Chen X, Huang W, Tan S, Liu X, Zhang X. The effect of sleep on male reproductive system: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2020; 99:e22595. [PMID: 33019478 PMCID: PMC7535664 DOI: 10.1097/md.0000000000022595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND the purpose of this study was to evaluate the effects of sleep deprivation on semen analyses, hormone levels and testicular histopathology in men. METHODS this review will be included in a qualified case-control study. The search strategy will be implemented in PubMed, Embase, Web of science, Cochrane library, China National knowledge Infrastructure database, Wanfang Database, and the Cochrane library. We will solicit both English and Chinese case-control studies published from its beginning to July 31, 2020. The 2 examiners will independently screen, select research, extract data and evaluate quality. We use Revman5.3 software to generate funnel map, heterogeneity assessment, data analysis, subgroup analysis and sensitivity analysis. RESULTS in the current meta-analysis, we will provide some more practical and targeted results for the study of the effects of sleep on the male reproductive system, and sum up the main limitations of previous studies. CONCLUSION this study will provide new evidence for the effect of sleep on male reproductive system.
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Kim YH, Hong J, Park H, Jung AY, Lee MK, Choi JH. Effect of Sleep Deprivation on the Inflammatory Response in Rats: A Pilot Study. SLEEP MEDICINE RESEARCH 2020. [DOI: 10.17241/smr.2020.00528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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15
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Hvidt JEM, Knudsen UB, Zachariae R, Ingerslev HJ, Philipsen MT, Frederiksen Y. Associations of bedtime, sleep duration, and sleep quality with semen quality in males seeking fertility treatment: a preliminary study. Basic Clin Androl 2020; 30:5. [PMID: 32341784 PMCID: PMC7181488 DOI: 10.1186/s12610-020-00103-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/03/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Poor sleep has been linked to a number of adverse health outcomes. Recent studies suggest that late bedtimes, short or long sleep durations, and poor sleep quality may impair semen quality. No study has previously explored all three factors in relation to semen quality. RESULTS One hundred and four men and their partners treated at three fertility clinics in Denmark between 2010 and 2012 completed an online-version of the Pittsburgh Sleep Quality Index (PSQI). The results of the semen analyses conducted at the fertility clinics were self-reported and categorised as normal or reduced.Early bedtime (< 10:30 PM) was more often associated with normal semen quality compared with both regular (10:30 PM-11:29 PM) and late (≥11:30 PM) bedtime (OR: 2.75, 95%CI: 1.1-7.1, p = 0.04 and OR: 3.97, 95%CI: 1.2-13.5, p = 0.03). Conventional sleep duration (7.5-7.99 h) was more often associated with normal semen quality than both short (7.0-7.49 h) and very short (< 7.0 h) sleep duration (OR: 1.36, 95% CI: 1.2-12.9, p = 0.03 and OR: 6.18, 95%CI: 1.6-24.2, p = 0.01). Although poor sleep quality was associated with reduced semen quality in the descriptive statistics (p = 0.04), no differences were found between optimal (PSQI ≤6) and either borderline (PSQI 7-8) or poor (PSQI ≥9) sleep quality (OR: 1.19, 95%CI: 0.4-3.4, p = 0.75 and OR: 2.43, 95%CI: 0.8-7.1, p = 0.11) in multivariate regression models. CONCLUSION Early bedtimes (< 10:30 PM) and conventional sleep duration (7.5-7.99 h) were associated with self-reported normal semen quality. The role of subjective sleep quality remains uncertain.
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Affiliation(s)
| | - Ulla Breth Knudsen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
- Horsens Fertility Clinic, Horsens Regional Hospital, 8700 Horsens, Denmark
| | - Robert Zachariae
- Department of Psychology and Behavioural Sciences, Aarhus University, 8000 Aarhus, Denmark
- Department of Oncology, Aarhus University Hospital, 8000 Aarhus, Denmark
| | - Hans Jakob Ingerslev
- Fertility Unit, Aalborg University Hospital, Søndre Skovvej 3, 9000 Aalborg, Denmark
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | | | - Yoon Frederiksen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
- The Unit for Clinical Sexology, the Department of Affective Disorders, Aarhus University Hospital, Psychiatry, Palle-Juul Jensens Boulevard 175, 8200 Aarhus N, Denmark
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Abstract
The reproductive function of humans is regulated by several sex hormones which are secreted in synergy with the circadian timing of the body. Sleep patterns produce generic signatures that physiologically drive the synthesis, secretion, and metabolism of hormones necessary for reproduction. Sleep deprivation among men and women is increasingly reported as one of the causes of infertility. In animal models, sleep disturbances impair the secretion of sexual hormones thereby leading to a decrease in testosterone level, reduced sperm motility and apoptosis of the Leydig cells in male rats. Sleep deprivation generates stressful stimuli intrinsically, due to circadian desynchrony and thereby increases the activation of the Hypothalamus-Pituitary Adrenal (HPA) axis, which, consequently, increases the production of corticosterone. The elevated level of corticosteroids results in a reduction in testosterone production. Sleep deprivation produces a commensurate effect on women by reducing the chances of fertility. Sleeplessness among female shift workers suppresses melatonin production as well as excessive HPA activation which results in early pregnancy loss, failed embryo implantation, anovulation and amenorrhea. Sleep deprivation in women has also be found to be associated with altered gonadotropin and sex steroid secretion which all together lead to female infertility. Poor quality of sleep is observed in middle-aged and older men and this also contributes to reduced testosterone concentrations. The influence of sleep disturbances post-menopausal is associated with irregular synthesis and secretion of female sex steroid hormones.
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Chen W, Guo X, Jin Z, Li R, Shen L, Li W, Cai W, Zhang G. Transcriptional alterations of genes related to fertility decline in male rats induced by chronic sleep restriction. Syst Biol Reprod Med 2020; 66:99-111. [DOI: 10.1080/19396368.2019.1678694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Wenyang Chen
- Hebei Provincial Key Laboratory of Neuropharmacology, Department of Pharmacy, Hebei North University, Zhangjiakou, China
- Research and Development Department, Peking Medriv Academy of Genetics and Reproduction, Peking, China
| | - Xingdao Guo
- Research and Development Department, Peking Medriv Academy of Genetics and Reproduction, Peking, China
| | - Zhiping Jin
- Research and Development Department, Peking Medriv Academy of Genetics and Reproduction, Peking, China
| | - Runan Li
- Hebei Provincial Key Laboratory of Neuropharmacology, Department of Pharmacy, Hebei North University, Zhangjiakou, China
- Research and Development Department, Peking Medriv Academy of Genetics and Reproduction, Peking, China
| | - Lixia Shen
- Hebei Provincial Key Laboratory of Neuropharmacology, Department of Pharmacy, Hebei North University, Zhangjiakou, China
| | - Wei Li
- Hebei Provincial Key Laboratory of Neuropharmacology, Department of Pharmacy, Hebei North University, Zhangjiakou, China
| | - Wangting Cai
- Research and Development Department, Peking Medriv Academy of Genetics and Reproduction, Peking, China
| | - Guirong Zhang
- Hebei Provincial Key Laboratory of Neuropharmacology, Department of Pharmacy, Hebei North University, Zhangjiakou, China
- Research and Development Department, Peking Medriv Academy of Genetics and Reproduction, Peking, China
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Chen HG, Sun B, Chen YJ, Chavarro JE, Hu SH, Xiong CL, Pan A, Meng TQ, Wang YX, Messerlian C. Sleep duration and quality in relation to semen quality in healthy men screened as potential sperm donors. ENVIRONMENT INTERNATIONAL 2020; 135:105368. [PMID: 31830732 DOI: 10.1016/j.envint.2019.105368] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/26/2019] [Accepted: 11/26/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Short sleep duration and poor sleep quality are increasingly prevalent in modern society and may be associated with impaired semen quality, yet studies are inconclusive. OBJECTIVES To investigate the reproducibility of semen quality parameters among 842 healthy men screened as potential sperm donors and explore the associations of sleep duration and quality with repeated measures of semen quality parameters. METHODS We assessed sleep duration (night sleep and daytime napping) and sleep quality using the Pittsburgh Sleep Quality Index (PSQI) among 842 healthy men screen as potential sperm donors. We examined sleep characteristics in relation to repeated measurements (n = 5601) of semen parameters using linear mixed-effects models. RESULTS High degrees of within-individual variability were found for total and progressive sperm motility with intraclass correlation coefficient (ICC) of 0.20 and 0.22, respectively; while fair-to-good reproducibilities were observed for sperm volume, concentration, and total count (ICC = 0.54, 0.62, and 0.50, respectively). Compared to men with total sleep duration of 8.0-8.5 h/day (h/d), men who slept less than 6.0 h/d and higher than 9.0 h/d had lower sperm volume of 12% [95% confidence interval (CI): -22%, -0.68%] and 3.9% (95% CI: -7.3%, -0.44%), respectively. Compared to men with night sleep duration of 7.5-8.0 h/d, men who slept less than 6.0 h/d had lower total and progressive sperm motility of 4.4% (95 CI:-8.4%, -0.24%) and 5.0% (95% CI: -9.2%, -0.48%), respectively. Compared to men who reported good sleep quality (total PSQI score ≤5.0), those reporting poor sleep quality (total PSQI score >5.0) had lower total sperm count, total motility, and progressive motility of 8.0% (95% CI: -15%, -0.046%), 3.9% (95% CI: -6.2%, -1.5%), and 4.0% (95% CI: -6.5%, -1.4%), respectively. CONCLUSIONS Both long and short sleep duration and poor sleep quality were associated with impaired semen quality parameters. The high within-individual variability of total and progressive sperm motility suggests that a single measurement may result in a moderate degree of classification error.
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Affiliation(s)
- Heng-Gui Chen
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Bin Sun
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Ying-Jun Chen
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Si-Heng Hu
- Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Hubei Province Human Sperm Bank, Wuhan, Hubei, PR China
| | - Cheng-Liang Xiong
- Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Hubei Province Human Sperm Bank, Wuhan, Hubei, PR China
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
| | - Tian-Qing Meng
- Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Hubei Province Human Sperm Bank, Wuhan, Hubei, PR China.
| | - Yi-Xin Wang
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Carmen Messerlian
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Rizk NI, Rizk MS, Mohamed AS, Naguib YM. Attenuation of sleep deprivation dependent deterioration in male fertility parameters by vitamin C. Reprod Biol Endocrinol 2020; 18:2. [PMID: 31926565 PMCID: PMC6954532 DOI: 10.1186/s12958-020-0563-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/06/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Male fertility is multifaceted and its integrity is as well multifactorial. Normal spermatogenesis is dependent on competent testicular function; namely normal anatomy, histology, physiology and hormonal regulation. Lifestyle stressors, including sleep interruption and even deprivation, have been shown to seriously impact male fertility. We studied here both the effects and the possible underlying mechanisms of vitamin C on male fertility in sleep deprived rats. METHODS Thirty male Wistar albino rats were used in the present study. Rats were divided (10/group) into: control (remained in their cages with free access to food and water), sleep deprivation (SD) group (subjected to paradoxical sleep deprivation for 5 consequent days, rats received intra-peritoneal injections of vehicle daily throughout the sleep deprivation), and sleep deprivation vitamin C-treated (SDC) group (subjected to sleep deprivation for 5 consequent days with concomitant intra-peritoneal injections of 100 mg/kg/day vitamin C). Sperm analysis, hormonal assay, and measurement of serum oxidative stress and inflammatory markers were performed. Testicular gene expression of Nrf2 and NF-κβ was assessed. Structural changes were evaluated by testicular histopathology, while PCNA immunostaining was conducted to assess spermatogenesis. RESULTS Sleep deprivation had significantly altered sperm motility, viability, morphology and count. Serum levels of cortisol, corticosterone, IL-6, IL-17, MDA were increased, while testosterone and TAC levels were decreased. Testicular gene expression of Nrf2 was decreased, while NF-κβ was increased. Sleep deprivation caused structural changes in the testes, and PCNA immunostaining showed defective spermatogenesis. Administration of vitamin C significantly countered sleep deprivation induced deterioration in male fertility parameters. CONCLUSION Treatment with vitamin C enhanced booth testicular structure and function in sleep deprived rats. Vitamin C could be a potential fertility enhancer against lifestyle stressors.
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Affiliation(s)
- Nermin I Rizk
- Clinical Physiology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Mohamed S Rizk
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Asmaa S Mohamed
- Pathology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Yahya M Naguib
- Clinical Physiology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
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Du CQ, Yang YY, Chen J, Feng L, Lin WQ. Association Between Sleep Quality and Semen Parameters and Reproductive Hormones: A Cross-Sectional Study in Zhejiang, China. Nat Sci Sleep 2020; 12:11-18. [PMID: 32021520 PMCID: PMC6957102 DOI: 10.2147/nss.s235136] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 12/28/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The effects of sleep duration on semen quality have been documented in many epidemiological studies. However, the association between sleep quality and semen parameters and reproductive hormones is still unclear. PATIENTS ENROLLMENT AND METHODS We conducted a cross-sectional study among 970 outpatients from the Reproductive Medicine Center in Zhejiang, China between October 2017 and July 2019. All participants delivered a semen sample, underwent a physical examination, and answered a questionnaire to provide the following information: demographics, life habits, and sleep habits. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). We first divided the patients into two groups according to sleep quality (good sleep: PQSI < 5 and poor sleep: PSQI ≥ 5). Then, we analyzed routine sperm parameters (semen volume, sperm total motility, progressive motility, sperm concentration, total sperm number, and normal sperm morphology) and reproductive hormones (follicle-stimulating hormone, luteinizing hormone, estrogen, testosterone, and prolactin) of each group. Finally, we used multivariate linear regression analysis and Spearman correlation coefficients to examine the relationship between sleep quality (discrete variable or dichotomous variable) and sperm parameters, reproductive hormones. RESULTS A negative correlation was found between the general PSQI scores and several semen parameters: total motility (r= -0.187979, p< 0.001), progressive motility (r= -0.192902, p< 0.001), concentration (r= -0.167063, p< 0.001), total sperm number (r= -0.160008, p< 0.001), and normal sperm morphology (r= -0.124511, p< 0.001). However, there was no significant correlation between the semen volume, all reproductive hormones and the general PSQI scores. After adjusting for confounders, men with poor sleep had lower total motility (β= -9.287; 95% CI, -12.050, -6.523), progressive motility (β= -8.853; 95% CI, -11.526, -6.180), concentration (log scale, β= -0.131; 95% CI, -0.181, -0.082), total sperm number (log scale, β= -0.137; 95% CI, -0.189, -0.084), and normal sperm morphology (β= -1.195; 95% CI, -1.844, -0.547), but semen volume and all reproductive hormones were not markedly altered. CONCLUSION Poor sleep quality might be related to impaired semen quality, but we found no evidence that poor sleep quality affects reproductive hormones.
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Affiliation(s)
- Cong-Qi Du
- Reproductive Medicine Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Yong-Yi Yang
- Department of Gynaecology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Jing Chen
- Reproductive Medicine Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Lei Feng
- Information Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Wen-Qin Lin
- Reproductive Medicine Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China
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Zhang X, Wang Y, Zhao R, Hu X, Zhang B, Lv X, Guo Z, Zhang Z, Yuan J, Chu X, Wang F, Li G, Geng X, Liu Y, Sui L, Wang F. Folic Acid Supplementation Suppresses Sleep Deprivation-Induced Telomere Dysfunction and Senescence-Associated Secretory Phenotype (SASP). OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:4569614. [PMID: 31949878 PMCID: PMC6948340 DOI: 10.1155/2019/4569614] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 09/04/2019] [Accepted: 09/13/2019] [Indexed: 02/05/2023]
Abstract
Sleep deprivation is reported to cause oxidative stress and is hypothesized to induce subsequent aging-related diseases including chronic inflammation, Alzheimer's disease, and cardiovascular disease. However, how sleep deprivation contributes to the pathogenesis of sleep deficiency disorder remains incompletely defined. Accordingly, more effective treatment methods for sleep deficiency disorder are needed. Thus, to better understand the detailed mechanism of sleep deficiency disorder, a sleep deprivation mouse model was established by the multiple platform method in our study. The accumulation of free radicals and senescence-associated secretory phenotype (SASP) was observed in the sleep-deprived mice. Moreover, our mouse and human population-based study both demonstrated that telomere shortening and the formation of telomere-specific DNA damage are dramatically increased in individuals suffering from sleeplessness. To our surprise, the secretion of senescence-associated cytokines and telomere damage are greatly improved by folic acid supplementation in mice. Individuals with high serum baseline folic acid levels have increased resistance to telomere shortening, which is induced by insomnia. Thus, we conclude that folic acid supplementation could be used to effectively counteract sleep deprivation-induced telomere dysfunction and the associated aging phenotype, which may potentially improve the prognosis of sleeplessness disorder patients.
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Affiliation(s)
- Xiaoning Zhang
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
- Institute of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Shandong 250012, China
| | - Yuwen Wang
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
| | - Rui Zhao
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
| | - Xianyun Hu
- Department of Medical Examination, Tianjin Worker's Hospital, Tianjin 300050, China
| | - Baoren Zhang
- Department of General Surgery, Tianjin General Surgery Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xin Lv
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Zhenglong Guo
- Department of Cell Biology, School of Basic Medical University, Tianjin Medical University, Tianjin 300070, China
| | - Zhiqiang Zhang
- Department of Pathology, Tianjin Hospital of ITCWM, Nankai Hospital, Tianjin 300100, China
| | - Jinghua Yuan
- School of Medicine, Hangzhou Normal University, Zhejiang 310036, China
| | - Xu Chu
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
| | - Fei Wang
- Department of Neurology, General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - Guang Li
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
| | - Xin Geng
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
| | - Yang Liu
- Department of Radiobiology, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China
| | - Lei Sui
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin 300070, China
| | - Feng Wang
- Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Tianjin University of Sport, Tianjin 300381, China
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Carter JR, Fonkoue IT, Greenlund IM, Schwartz CE, Mokhlesi B, Smoot CA. Sympathetic neural responsiveness to sleep deprivation in older adults: sex differences. Am J Physiol Heart Circ Physiol 2019; 317:H315-H322. [PMID: 31149842 PMCID: PMC6732487 DOI: 10.1152/ajpheart.00232.2019] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/24/2019] [Accepted: 05/28/2019] [Indexed: 02/06/2023]
Abstract
Our laboratory has previously reported that total sleep deprivation (TSD) modifies muscle sympathetic neural activity (MSNA) differently in young men and women. Because postmenopausal women are among the highest risk for hypertension, this study compares MSNA responses with TSD in older men and women. We hypothesized that TSD would alter MSNA in older adults, with greater sympathoexcitation in postmenopausal women. Twenty-seven participants (14 men and 13 women) between the ages of 55 and 75 yr were tested twice, once after 24-h TSD and once after normal sleep (randomized, crossover design). Our primary outcome measure of MSNA (microneurography) was successful across both conditions in 20 participants (10 men and 10 women). Secondary outcome measures included seated blood pressure, heart rate, and fasting plasma testosterone, estradiol, and progesterone. Age (60 ± 1 vs. 61 ± 2 yr) and BMI (27 ± 1 vs. 26 ± 1 kg/m2) were not different between groups. TSD increased systolic blood pressure in both men (124 ± 5 to 130 ± 4 mmHg) and women (107 ± 5 to 116 ± 4 mmHg), but the increases were not different between groups (condition, P = 0.014; condition × sex, P > 0.05). In contrast, TSD elicited divergent MSNA responses in older men and women. Specifically, MSNA burst frequency increased in postmenopausal women (28 ± 3 to 34 ± 3 burst/min), but not older men (38 ± 3 to 35 ± 3 bursts/min; condition × sex, P = 0.032). In conclusion, TSD elicited sympathoexcitation in postmenopausal women but not age-matched men. These findings provide new mechanistic insight into reported links between sleep deprivation and hypertension.NEW & NOTEWORTHY Epidemiological studies report that sleep deprivation is more strongly associated with hypertension in women than in men. In the present study, 24-h total sleep deprivation (TSD) increased blood pressure in postmenopausal women and age-matched men. In contrast, only women demonstrated increases in muscle sympathetic nerve activity after TSD. The sympathoexcitation observed in postmenopausal women suggests a potential contributing mechanism for epidemiological observations and advances our understanding of the complex relations between sleep, sex, and hypertension.
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Affiliation(s)
- Jason R Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Ida T Fonkoue
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | - Ian M Greenlund
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
| | | | - Babak Mokhlesi
- Sleep Research Center, Department of Medicine, University of Chicago, Chicago, Illinois
| | - Carl A Smoot
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan
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23
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Zhou Y, Zhang D, Hu D, Liu B, Peng J, Shen L, Long C, Yu Y, Zhang Y, Liu X, Tao X, Timashev P, Lin T, He D, Wei G. Retinoic acid: A potential therapeutic agent for cryptorchidism infertility based on investigation of flutamide-induced cryptorchid rats in vivo and in vitro. Reprod Toxicol 2019; 87:108-117. [PMID: 31170451 DOI: 10.1016/j.reprotox.2019.05.063] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/07/2019] [Accepted: 05/25/2019] [Indexed: 11/27/2022]
Abstract
Cryptorchidism is a common disorder in children and may cause infertility in adults. The BTB is essential for maintaining the microenvironment necessary for normal spermatogenesis. This study investigated whether retinoic acid (RA) may regulate the proteins that are essential for integrity of the BTB in cryptorchidism. Female Sprague-Dawley rats were administrated flutamide during late pregnancy to induce a model of cryptorchidism in male offspring. The concentrations of RA and BTB tight and gap junction protein levels were significantly lower in untreated cryptorchid pups compared with normal pups, but almost normal in cryptorchid pups given RA. Studies in vitro corroborated these findings. The sperm quality of RA-treated model pups was better compared with the untreated model. RA treatment may have therapeutic potential to restore retinoic acid and proteins associated with integrity of the BTB in cryptorchid testis.
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Affiliation(s)
- Yu Zhou
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China; Chongqing Key Laboratory of Pediatrics, China
| | - Deying Zhang
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China; Chongqing Key Laboratory of Pediatrics, China.
| | - Dong Hu
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
| | - Bo Liu
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China; Chongqing Key Laboratory of Pediatrics, China
| | - Jinpu Peng
- Department of Pediatric Surgery, Guizhou Provincial People's Hospital, Guiyang 550002, China
| | - Lianju Shen
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
| | - Chunlan Long
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
| | - Yihang Yu
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China
| | - Yuanyuan Zhang
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27101, USA
| | - Xing Liu
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China; Chongqing Key Laboratory of Pediatrics, China
| | - Xu Tao
- Biomanufacturing Center, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | - Tao Lin
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China; Chongqing Key Laboratory of Pediatrics, China
| | - Dawei He
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China; Chongqing Key Laboratory of Pediatrics, China
| | - Guanghui Wei
- Department of Urology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China; Chongqing Key Laboratory of Pediatrics, China.
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24
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Effect of sleep deprivation on hearing levels in rats. Int J Pediatr Otorhinolaryngol 2018; 112:169-175. [PMID: 30055728 DOI: 10.1016/j.ijporl.2018.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To our knowledge, the influence of sleep deprivation on hearing levels has yet to be assessed in animals. Therefore, we evaluated whether auditory function was affected by sleep deprivation in rats. METHODS Male Wistar rats (aged 9 weeks, weighing 300-400 g) were used for the study and were randomly assigned to a control (n = 15) or sleep deprivation group (n = 12). Hearing levels were evaluated at baseline and 9 days after sleep deprivation using auditory evoked brainstem responses (ABRs) and distortion product otoacoustic emission (DPOAE) measurements. Blood was collected for the measurement of interleukin-1β and corticosterone levels. RESULTS The ABR thresholds (at 8, 16, and 32 kHz) at 9 days were significantly elevated in the sleep deprivation group compared to the control group (p < 0.05, respectively). The sleep deprivation group showed a defect in the function of outer hair cells, as evidenced by decreased levels of distortion product otoacoustic emission. IL-1β was significantly increased in the sleep deprivation group. Sleep-deprived rats exhibited rupture of Reissner's membrane and morphological damage to stereocilia. CONCLUSION These results suggest that sleep deprivation induces damage to the cochlea and results in hearing loss in Wistar rats.
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25
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Palnitkar G, Phillips CL, Hoyos CM, Marren AJ, Bowman MC, Yee BJ. Linking sleep disturbance to idiopathic male infertility. Sleep Med Rev 2018; 42:149-159. [PMID: 30377037 DOI: 10.1016/j.smrv.2018.07.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 06/13/2018] [Accepted: 07/26/2018] [Indexed: 12/22/2022]
Abstract
Recently published data suggests that male fertility has declined over the past four decades. The reasons for the decline are unclear with up to 50% of cases of male infertility remaining unexplained (idiopathic male infertility). Whilst environmental factors and rising rates of obesity have been implicated, there is now growing evidence that sleep disturbance may be an independent causative factor. Indeed, the prevalence of sleep disturbance appears to be increasing in parallel with deterioration in population sperm quality, a commonly used surrogate marker of male fertility. Although there is some understanding of the relationship between sleep, gonadal hormone secretion and sexual function, it remains to be seen whether sleep disturbance is implicated in idiopathic male infertility. This review will detail the current evidence supporting a link between sleep disturbance and male infertility. Potential mechanistic pathways will be proposed and evidence supporting these pathways will be discussed. Further research is needed in clarifying links between sleep disturbance and idiopathic male infertility. At present the only available treatment option for men with idiopathic infertility is assisted reproductive technology. Demonstration of a causative link between sleep disturbance and idiopathic male infertility may in the future lead to additional treatment options in selected cases.
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Affiliation(s)
- Gaurie Palnitkar
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia; Discipline of Sleep Medicine, Sydney Medical School, University of Sydney, New South Wales, Australia.
| | - Craig L Phillips
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia; Discipline of Sleep Medicine, Sydney Medical School, University of Sydney, New South Wales, Australia; Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, Australia
| | - Camilla M Hoyos
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia; School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
| | - Anthony J Marren
- Department of Reproductive Endocrinology and Infertility, Royal Prince Alfred Hospital for Women and Babies, Camperdown, New South Wales, Australia; Genea Fertility, Sydney, New South Wales, Australia; Queen Elizabeth II Research Institute for Mothers and Infants, Department of Obstetrics, Gynaecology and Neonatology, The University of Sydney, New South Wales, Australia
| | - Mark C Bowman
- Department of Reproductive Endocrinology and Infertility, Royal Prince Alfred Hospital for Women and Babies, Camperdown, New South Wales, Australia; Genea Fertility, Sydney, New South Wales, Australia; Department of Obstetrics and Gynaecology, University of Sydney, New South Wales, Australia
| | - Brendon J Yee
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia; Discipline of Sleep Medicine, Sydney Medical School, University of Sydney, New South Wales, Australia; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, New South Wales, Australia
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26
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Zaidouni A, Fatima O, Amal B, Siham A, Houyam H, Jalal K, Rachid B. Predictors of Infertility Stress among Couples Diagnosed in a Public Center for Assisted Reproductive Technology. J Hum Reprod Sci 2018; 11:376-383. [PMID: 30787524 PMCID: PMC6333041 DOI: 10.4103/jhrs.jhrs_93_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: All around the world, infertility, in many ways, is recognized as a stressful and a critical experience that can have impact on social and marital life of a couple. Infertility stress may affect the treatment and its outcome for such couples. The objective of the present study is to assess the predictors of high stress of infertility among married couples. Materials and Methods: This cross-sectional study was conducted on 120 couples (240 patients) who were diagnosed with primary and secondary infertility from June 2017 to June 2018. A psychological self-assessment questionnaire (Perceived Stress Scale-10) was used as a tool to evaluate the presence of high infertility stress among couples after obtaining their consent. Furthermore, other socioepidemiological data of patients were collected. Statistical Analysis: Data were analyzed using SPSS software (version 20). Univariate statistical analysis was used followed by multiple logistic regressions between high infertility stress and the predictor variables. Results and Discussion: The prevalence of high infertility stress was 53.3% among women and 40.8% among men. For women, multivariate analysis showed leading associations of high infertility stress with level of education, infertility type, infertility duration, and etiologies of infertility. However, for men, multivariate analysis showed leading associations between high infertility stress and alcohol status and inadequate sleep and infertility type.
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Affiliation(s)
- Asmaa Zaidouni
- Assisted Reproductive Technology Center of the Reproductive Health Hospital, University Hospital Ibn Sina, Rabat, Morocco.,Departement of Medical Biotechnology (Med Biotech), Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Ouasmani Fatima
- Department of Nursing, Higher Institute of Nursing Professions and Technics of Health, Rabat, Morocco
| | - Benbella Amal
- Assisted Reproductive Technology Center of the Reproductive Health Hospital, University Hospital Ibn Sina, Rabat, Morocco.,Departement of Medical Biotechnology (Med Biotech), Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Aboulmakarim Siham
- Assisted Reproductive Technology Center of the Reproductive Health Hospital, University Hospital Ibn Sina, Rabat, Morocco.,Departement of Medical Biotechnology (Med Biotech), Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Hardizi Houyam
- Assisted Reproductive Technology Center of the Reproductive Health Hospital, University Hospital Ibn Sina, Rabat, Morocco.,Departement of Medical Biotechnology (Med Biotech), Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Kasouati Jalal
- Department of Bacteriology, Military Teaching Hospital Mohamed V, Rabat, Morocco.,Laboratory of Biostatistics, Epidemiology and Clinical Research, Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Bezad Rachid
- Assisted Reproductive Technology Center of the Reproductive Health Hospital, University Hospital Ibn Sina, Rabat, Morocco.,Departement of Medical Biotechnology (Med Biotech), Faculty of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
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27
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Abu-Samak MS, Mohammad BA, Abu-Taha MI, Hasoun LZ, Awwad SH. Associations Between Sleep Deprivation and Salivary Testosterone Levels in Male University Students: A Prospective Cohort Study. Am J Mens Health 2017; 12:411-419. [PMID: 29025356 PMCID: PMC5818117 DOI: 10.1177/1557988317735412] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Sleep deprivation is a common health problem that is growing rapidly worldwide and it is associated with short- and long-term impacts on health. The aim of this study was to detect potential predictors of salivary testosterone (sT) association with sleep deprivation in Arab male university students. In this prospective cohort study, 77 university male students in the age range of 18 to 26 years were divided into two groups, sleep-deprived (SD) participants and non-sleep-deprived (NSD) participants. Sleep deprivation was defined as sleeping less than 5 hr per night. Blood samples and sT were collected from fasting participants to measure serum levels of glucose, lipid profile, leptin, serotonin, sT, and body mass index (BMI) values. The multiple linear correlation model of high-density lipoprotein cholesterol (HDL-C), BMI, and serotonin was positively correlated with sT (r = .977, p < .05) in the SD group. No correlations were identified with sT in the NSD group. In the SD study group, the multiple linear regression model of HDL-C, BMI, and serotonin was significantly influenced by sT (R² = .955, p < .05). These predictors together explained approximately 96% of the variance in sT levels in the SD study group. No predictive variables for sT were reported in the NSD group. Results indirectly confirmed the presence of a positive association between sT and sleep deprivation in young men. This association is mediated by three factors, HDL-C, BMI, and serum serotonin, which are collectively considered as part of a significant physiological adaptation to sleep deprivation in young men.
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Affiliation(s)
| | - Beisan Ali Mohammad
- 1 Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan
| | - May Ibrahim Abu-Taha
- 1 Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan
| | - Luai Zidan Hasoun
- 1 Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan
| | - Shady Helmi Awwad
- 2 Department of Pharmaceutical Chemistry and Pharmacognosy, Applied Science Private University, Amman, Jordan
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28
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Wang X, Chen Q, Zou P, Liu T, Mo M, Yang H, Zhou N, Sun L, Chen H, Ling X, Peng K, Ao L, Yang H, Cao J, Cui Z. Sleep duration is associated with sperm chromatin integrity among young men in Chongqing, China. J Sleep Res 2017; 27:e12615. [PMID: 28994211 DOI: 10.1111/jsr.12615] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 09/04/2017] [Indexed: 12/29/2022]
Abstract
This study explores whether sleep duration is associated with sperm chromatin integrity. To do so, we conducted a three-phase panel study of 796 male volunteers from colleges in Chongqing (China) from 2013 to 2015. Sleep duration was measured using a modified Munich Chronotype Questionnaire. Sperm DNA integrity was examined via Sperm Chromatin Structure Assay and Comet assay. Setting 7-7.5 h day-1 of sleep duration as a reference, either longer or shorter sleep duration was associated negatively with high DNA stainability (HDS) (P = 0.009), which reflected the immaturity of sperm chromatin. The volunteers with > 9.0 h day-1 sleep and those with ≤ 6.5 h day-1 sleep had 40.7 and 30.3% lower HDS than did volunteers with 7-7.5 h day-1 sleep. No association was found between sleep duration and DNA fragmentation index or Comet assay parameters. This study suggests that sleep duration is associated with sperm chromatin integrity. Further studies are required to validate these findings and investigate the mechanism underlying this association.
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Affiliation(s)
- Xiaogang Wang
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Qing Chen
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Peng Zou
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Taixiu Liu
- School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Min Mo
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Huan Yang
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Niya Zhou
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Lei Sun
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Hongqiang Chen
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Xi Ling
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Kaige Peng
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Lin Ao
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Huifang Yang
- School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Jia Cao
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
| | - Zhihong Cui
- Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing, China
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29
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Viganò P, Chiaffarino F, Bonzi V, Salonia A, Ricci E, Papaleo E, Mauri PA, Parazzini F. Sleep disturbances and semen quality in an Italian cross sectional study. Basic Clin Androl 2017; 27:16. [PMID: 28835845 PMCID: PMC5563907 DOI: 10.1186/s12610-017-0060-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 08/03/2017] [Indexed: 02/02/2023] Open
Abstract
Introduction In order to obtain information about the relationship between sleep disturbances and sperm parameters, we analyzed data from a study conducted in a Italian Fertility Clinic, in men of couples seeking help for infertility. Patients and methods Male partners with or without a medical history of reproductive organ diseases (cryptorchidism, varicocele, orchitis, testicular torsion) were eligible for the study. There were 382 men evaluated from May 2014 to November 2016, all of whom completed a self-administered questionnaire on general lifestyle habits. Then all men underwent semen analysis. A total of 382 men aged 26 to 67 years (median age 39 year interquartile range 37–42) were recruited. Main results A total of 46.3% reported having sleep disturbances. In multivariate analysis, in absence of reproductive organ diseases, semen volume was lower in patients with difficulty in initiating sleep (2.0 ml, IQR 1.5–3.0 vs 3.0 ml, IQR 2.0–3.3, p = .01), whereas in presence of reproductive organ diseases motility A was lower in patients with early morning awakening (25.0%, IQR 15.0–35.0 vs. 40.0%, IQR 30.0–50.0, p = .001). In overweight men, semen volume was lower in patients with difficulty in initiating sleep (2.0 ml, IQR 1.5–3.0 vs 3.0 ml, IQR 2.0–3.0, p = .03). Moreover, among current smokers, patients with difficulty in initiating sleep had semen volume lower (1.5 ml, IQR 1.5–2.5 vs 3.0 ml, IQR 2.0–3.5, p = .0003) and sperm concentration higher (40 millions/ml, IQR 15–60 vs 10 millions/ml, IQR 5–50 p = .03) but total sperm count was not significant different. Conclusion Further studies are necessary to elucidate the relationship between sleep quality and semen parameters, which may have important public health implication. Electronic supplementary material The online version of this article (doi:10.1186/s12610-017-0060-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paola Viganò
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesca Chiaffarino
- Dipartimento della Donna, del Neonato e del Bambino, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milano, Italy
| | - Viviana Bonzi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Elena Ricci
- Dipartimento della Donna, del Neonato e del Bambino, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milano, Italy
| | - Enrico Papaleo
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Agnese Mauri
- Dipartimento della Donna, del Neonato e del Bambino, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milano, Italy
| | - Fabio Parazzini
- Dipartimento della Donna, del Neonato e del Bambino, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milano, Italy.,Dipartimento di Scienze Cliniche e di Comunità, Università degli studi di Milano, Milano, Italy
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30
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Serum and Brain Metabolomic Variations Reveal Perturbation of Sleep Deprivation on Rats and Ameliorate Effect of Total Ginsenoside Treatment. Int J Genomics 2017; 2017:5179271. [PMID: 28900617 PMCID: PMC5576418 DOI: 10.1155/2017/5179271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/19/2017] [Indexed: 02/06/2023] Open
Abstract
Sleep loss or sleep deprivation (SD) refers to shorter sleep than average baseline need, and SD has been a serious problem of modern societies which affects health and well-being. Panax ginseng is a well-known traditional Chinese medicine (TCM). Our previous study has demonstrated that total ginsenosides (GS), the extracts from Panax ginseng, could effectively improve cognition and behavior on SD rats. However, little is known about its metabolomic study. In this study, serum and brain metabolomic method based on gas chromatography coupled with mass spectrometry (GC/MS) was employed to evaluate the efficacy and study the mechanism of GS on a rat model of SD. With pattern recognition analysis of serum and brain tissue metabolite profile, a clear separation of the model group and control group was acquired for serum and brain tissue samples; the MGS (model + GS) group showed a tendency of recovering when compared to control group, which was consistent with behavioral and biochemical parameters. 39 and 40 potential biomarkers of brain tissues and serum samples, respectively, were identified and employed to explore the possible mechanism. Our work revealed that GS has significant protective effects on SD, and metabolomics is a useful tool for evaluating efficacy and elucidating mechanism in TCM.
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31
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Valvassori SS, Resende WR, Dal-Pont G, Sangaletti-Pereira H, Gava FF, Peterle BR, Carvalho AF, Varela RB, Dal-Pizzol F, Quevedo J. Lithium ameliorates sleep deprivation-induced mania-like behavior, hypothalamic-pituitary-adrenal (HPA) axis alterations, oxidative stress and elevations of cytokine concentrations in the brain and serum of mice. Bipolar Disord 2017; 19:246-258. [PMID: 28612976 DOI: 10.1111/bdi.12503] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 04/16/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The goal of the present study was to investigate the effects of lithium administration on behavior, oxidative stress parameters and cytokine levels in the periphery and brain of mice subjected to an animal model of mania induced by paradoxical sleep deprivation (PSD). METHODS Male C57 mice were treated with saline or lithium for 7 days. The sleep deprivation protocol started on the 5th day during for the last 36 hours of the treatment period. Immediately after the sleep deprivation protocol, animals locomotor activity was evaluated and serum and brain samples was extracted to evaluation of corticosterone and adrenocorticotropic hormone circulating levels, oxidative stress parameters and citokynes levels. RESULTS The results showed that PSD induced hyperactivity in mice, which is considered a mania-like behavior. PSD increased lipid peroxidation and oxidative damage to DNA, as well as causing alterations to antioxidant enzymes in the frontal cortex, hippocampus and serum of mice. In addition, PSD increased the levels of cytokines in the brains of mice. Treatment with lithium prevented the mania-like behavior, oxidative damage and cytokine alterations induced by PSD. CONCLUSIONS Improving our understanding of oxidative damage in biomolecules, antioxidant mechanisms and the inflammatory system - alterations presented in the animal models of mania - is important in helping us to improve our knowledge concerning the pathophysiology of BD, and the mechanisms of action employed by mood stabilizers.
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Affiliation(s)
- Samira S Valvassori
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Wilson R Resende
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Gustavo Dal-Pont
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Heron Sangaletti-Pereira
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Fernanda F Gava
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Bruna R Peterle
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - André F Carvalho
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Roger B Varela
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Felipe Dal-Pizzol
- Laboratory of Pathophysiology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - João Quevedo
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) Medical School, Houston, TX, USA.,Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) Medical School, Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA
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Induction of oxidative stress by paradoxical sleep deprivation in different body organs of rats. ACTA ACUST UNITED AC 2017. [DOI: 10.22376/ijpbs.2017.8.1.b420-427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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