A systematic review on the effectiveness of herbal interventions for the treatment of male infertility

Effect of alternative and complementary medicine on male infertility: An umbrella review

Background and Aims

There is increasing interest worldwide in using alternative and complementary approaches for treating male infertility. This interest has spawned a multitude of published systematic reviews and meta-analyses. The aim of this Umbrella review was to consolidate the available evidence regarding the effect of complementary and alternative medicine on male infertility to inform clinical decision-making processes.

Methods

A comprehensive search was conducted to identify systematic reviews and meta-analyses pertaining to the effects of complementary and alternative medicine on male infertility. This search encompassed various databases including MEDLINE, CINAHL, PubMed, Scopus, Proquest, Google Scholar, SID, EMBASE, Magiran, Cochrane Library, Iranmedex, ScienceDirect, SAGE. Subsequently, two researchers independently extracted the data from the selected meta-analyses and systematic reviews, and evaluated their methodological quality using the assessment of multiple systematic reviews 2 (AMSTAR2).

Results

This analysis encompassed 11 studies, with four originating from Iran, two from Korea and five from China. The results regarding the effectiveness of complementary and alternative medicine are controversial, indicating a need for further research. The methodological quality of the systematic reviews and meta-analyses appraised by AMSTAR 2 was rated as low or critically low. This assessment is attributed to inadequate examination of publication biases in the reviews and a lack of discussion regarding the effect of risk of bias.

Conclusion

The existing evidence regarding the effectiveness of alternative and complementary medicine in addressing male infertility is limited. Furthermore, the overall methodological quality of the published systematic reviews and meta-analyses may have been underestimated as the use of AMSTAR2 appears to be a more precise appraisal instrument compared to its predecessor.

Asperosaponin VI protects against spermatogenic dysfunction in mice by regulating testicular cell proliferation and sex hormone disruption

ETHNOPHARMACOLOGICAL RELEVANCE

Studies have found that the causes of male infertility are complex, and spermatogenic dysfunction accounts for 30%-65% of male infertility causes, which is the main cause of male infertility. Asperosaponin VI (ASVI) is a saponin extracted from the traditional Chinese herb Dipsacus asperoides C.Y.Cheng & T.M.Ai. However, the precise protective impact and underlying mechanism of ASVI in the therapy of spermatogenic dysfunction remain unknown.

AIM OF THE STUDY

To investigate the impact of ASVI on the spermatogenic dysfunction induced by cytoxan (CTX) in mice, as well as explore any potential mechanisms.

MATERIALS AND METHODS

Potential ASVI targets were screened using the Pharmapper and Uniprot databases, while genes related to spermatogenic dysfunction were collected from the GeneCards database. The String and Cytoscape databases were then used for PPI analysis for the common targets of ASVI and spermatogenic dysfunction. Meanwhile, the Metascape database was used for KEGG and GO analysis. In vivo experiments, spermatogenic dysfunction was induced in male mice by intraperitoneal administration of CTX (80 mg/kg). To demonstrate the possible protective effects of ASVI on reproductive organs, CTX-induced spermatogenic dysfunction mice with different dosages of ASVI (0.8, 4, 20 mg/kg per day) treatment were collected and gonad weight was detected. The testis and epididymis were detected again by H&E. To assess the impact of ASVI on fertility in male mice, we analyzed sperm quality, serum hormones, sexual behavior, and fertility. The mechanism was investigated using WB, IF, IHC, and Co-IP technology.

RESULTS

The ASVI exhibited interactions with 239 associated targets. Furthermore, 1555 targets associated with spermatogenic dysfunction were predicted, and further PPI analysis identified 6 key targets. Among them, the EGFR gene exhibited the highest degree of connection and was at the core of the network. Based on the GO and KEGG enrichment analysis, ASVI may affect spermatogenic dysfunction through the EGFR pathway. In vivo experiments, ASVI significantly improved CTX-induced damage to male fertility and reproductive organs, increasing sperm quality. At the same time, ASVI can resist CTX-induced testicular cell damage by increasing p-EGFR, p-ERK, PCNA, and p-Rb in the testis and by promoting the interaction of CyclinD1 with CDK4. In addition, ASVI can also regulate sex hormone disorders and protect male fertility.

CONCLUSIONS

ASVI improves CTX-induced spermatogenesis dysfunction by activating the EGFR signaling pathway and regulating sex hormone homeostasis, which may be a new potential protective agent for male spermatogenic dysfunction.

Bibliometric analysis of Kampo medicine hotspots and trends for the decade: 2013-2022

BACKGROUND

Kampo medicine is a traditional medicine that originated in ancient China and has since developed as a uniquely Japanese medicine. Although Kampo medicine is one of Japan's most important therapeutic modalities and numerous papers have been published recently, information on current hotspots and trends in Kampo research is lacking. This bibliometric analysis of Kampo medicine surveyed the latest research hotspots and trends.

METHODS

Articles on Kampo medicine were retrieved from the Web of Science Core Collection. We used medical subject headings related to Kampo medicine and searched for publications from 2013 to 2022. The retrieved articles were analyzed for countries, authors, journals, references, and keywords related to Kampo medicine using CiteSpace, VOSviewer, and SCImago Graphica.

RESULTS

A total of 1170 articles were included. The number of Kampo medicine-related publications and citations has recently increased, mainly from Japan. Author Keiko Ogawa-Ochiai published the most papers (40 papers), while Yoshio Kase had the highest frequency at 663 citations. Among the co-cited authors, Toru Kono was the most cited and had the highest total link strength. The journal with the most submissions was Evidence-based Complementary and Alternative Medicine. A comprehensive keyword and literature analysis revealed the following research hotspots: "Yokukansan and behavioral and psychological symptoms of dementia," "Ninjinyoeito and geriatric care," "Daikenchuto and postoperative gastrointestinal cancer," and "Rikkunshito and functional dyspepsia." We also identified a new research frontier by identifying an association between hochuekkito and COVID-19.

CONCLUSIONS

Our findings reveal trends in Kampo medicine research, with specific hotspots and the authors and publications with the largest research impact. Collecting a large volume of literature data, analyzing the impact of studies, and identifying research hotspots, as in this study, will provide researchers with future directions for Kampo research.

Carvacrol showed a curative effect on reproductive toxicity caused by Bisphenol AF via antioxidant, anti-inflammatory and anti-apoptotic properties

Bisphenol AF (BPAF) is an endocrine disruptor, and human exposure to these chemicals is growing in industrialized nations. BPAF has been demonstrated in studies to have toxic effects on reproductive health. This study examined the effects of oral exposure to BPAF on the reproductive system and the protective effects of carvacrol in rats. From 32 Wistar albino rats, four separate groups were set up for this purpose. Carvacrol 75 mg/kg and BPAF 200 mg/kg were administered by oral gavage method. Rat sperm parameters and serum testosterone levels were measured after 28 days of administration. The study looked at the MDA in the testis tissues, as well as CAT, GPx, and GSH as antioxidants parameters, NF-κB and TNF-α as inflammatory markers, caspase-3 and Bcl-2 as apoptosis parameters, and PCNA as cell proliferation markers. In addition, testis tissues underwent histological evaluation. As a result, in rats exposed to only BPAF, sperm counts declined, testosterone levels reduced, oxidative stress, inflammation, and apoptosis increased, and cell proliferation decreased. Furthermore, severe disruptions in tissue architecture and decreased spermatogenesis were reported. In contrast, sperm parameters improved, testosterone levels increased, oxidative stress and inflammation decreased, and apoptosis was prevented in the carvacrol-treated group compared to the BPAF-only group. It was also found that spermatogenesis was maintained, and structural abnormalities in testicular tissue were mostly avoided with an increase in PCNA expression. According to the findings, despite BPAF-induced testicular and reproductive toxicity, carvacrol had therapeutic potential due to its anti-inflammatory, antioxidant, cell proliferation-increasing, and anti-apoptotic activities.