Ketotifen, a mast cell blocker improves sperm motility in asthenospermic infertile men

Semen's parameters after varicocelectomy surgery with mast cell stabilizers treatment in infertile varicocele patients: Randomized clinical trial study

Background and Aims

Varicocele is one of the most common causes of male infertility in which testicular function is progressively damaged. This study aims to investigate the effect of varicocelectomy and mast cell stabilizers on reducing sperm DNA fragmentation in infertile patients with varicocele.

Methods

In this randomized clinical trial, after obtaining ethical approval and informed consent, infertile patients with varicocele were randomly assigned to three groups: varicocelectomy, 1 mg ketotifen, and varicocelectomy plus with 1 mg ketotifen for 3-month follow-up. Semen analysis and estimation of DNA fragmentation index (DFI) were obtained from all people in the studied time periods.

Results

In this study, 420 infertile patients with varicocele were included with an average age of 31.6 years. The results showed that sperm morphology, sperm motility, sperm count, and sperm DFI had significant differences after the intervention (p < 0.05). Also, the results of semen analysis for each group showed that there was a significant improvement in sperm morphology, motility, count, and DFI index of infertile people with varicocele after the intervention (p < 0.05). But the difference was statistically higher in the varicocelectomy plus with 1 mg ketotifen group than in the other groups (p < 0.01).

Conclusion

The evidence and results of this study showed that the use of varicocelectomy plus ketotifen in infertile people with varicocele was more effective in improving Semen parameters than the use of mast cell stabilizers or varicocelectomy alone.

Effect of ketotifen fumarate on experimental autoimmune orchitis and torsion of the spermatic cord

The aim of this work was to study effects of ketotifen fumarate (KF) on prevention of tissue damage in testes of rats with experimental autoimmune orchitis (EAO) and on the contralateral testis in a model of prolonged testicular cord torsion (TCT). Rats with EAO or TCT were injected intraperitoneally once daily with KF or saline solution (vehicle group). Incidence and severity of testicular damage were evaluated by histopathology using an EAO score or a Johnsen score. Mast cells (MC) were identified by histochemistry and quantified. In EAO model, KF significantly reduced severity of histopathological testicular damage compared to rats in the vehicle group. KF also reduced the number of testicular MC compared to vehicle group. Similarly, in TCT model, multifocal damage of the contralateral testis was observed 30 days after testicular torsion characterized by sloughing of the germinal epithelium, seminiferous tubule atrophy, and interstitial edema. Focal signs of inflammation and fibrosis of seminiferous tubular walls were also observed. In contrast, sections of contralateral testis of rats injected with KF and killed 30 days after surgery showed normal histological features. A significant decrease in the number of MC was observed in rats treated with KF compared to untreated animals. In conclusion, we demonstrated that treatment with KF reduced testicular inflammatory process and MC infiltrates in both EAO and TCT models. The results suggest a promising treatment for infertile male patients with testicular pathologies associated with inflammation and germ cell loss.

Spontaneous pregnancies and determinant factors in infertility: A cross-sectional study

Background

The phenomenon of infertility may be derived from different factors - either in males or females or both genders, including few unexplained factors. It is generally managed by medical and surgical treatments.

Objective

To find a relation of occurrence of spontaneous pregnancy (SP) with effective factors in infertility.

Materials and Methods

This cross-sectional study was conducted at two referral infertility centers (university and privacy center) in the southwest of Iran from March 2015 and March 2016 on 655 infertile couples, who were divided in two groups of with (n = 31) and without (n = 624) SP. The variables included female and male age, male smoking, male job, the place of living, the causes of infertility, the type and duration of infertility, and the subgroups of infertility causes.

Results

Infertility may be caused due to both male- and female- related factors (47.5%). While female-related infertility was found in 31.5%, male-related infertility in 14.5%, and infertility due to unexplained factors in 6.6% of our patients. The rate of SP was 4.7%, which had a significant relation with the duration of infertility (p = 0.01), with women's age (p = 0.048), unexplained infertility (p = 0.001), and husband's job (p = 0.004).

Conclusion

The occurrence of SP in infertile couples was related to age of the female partner, the duration of unexplained infertility, and the male partner's job.

Effect of a short-term vitamin E supplementation on oxidative stress in infertile PCOS women under ovulation induction: a retrospective cohort study

Background

Vitamin E, which is critically important in the whole process of reproduction, can antagonize the oxidative stress caused by the oxygen free radicals and antioxidant imbalance and regulate normal physiological function of the reproductive system. The effect of short-term supplementation of vitamin E on outcomes of infertile women with polycystic ovary syndrome (PCOS) when they underwent ovulation induction with clomiphene citrate (CC) and human menopausal gonadotropin (HMG) remains unknown.

Methods

This was a retrospective cohort clinical trial from October 2015 to April 2017. A total of 321 PCOS cases underwent ovulation induction with CC and HMG. Patients in group A (n = 110) did not receive vitamin E while patients in group B (n = 105) and group C (n = 106) received oral treatment of vitamin E at 100 mg/day during follicular phase and luteal phase, respectively.

Results

It was observed no significant differences of ovulation rate, clinical pregnancy rate, and ongoing pregnancy rate among the three groups. It was interesting that dosage of HMG were significant lower in group B compared with those in group A and group C (P<0.05).

Conclusions

A short-term supplementation of vitamin E can improve oxidative stress, and reduce exogenous HMG dosage to lower the economic cost with a similar pregnancy rate in the ovulation induction cycle. However, the supplementation does not alter the pregnancy rate in the ovulation induction cycle.

Trial registration

ChiCTR-OOC-14005389, 2014.

Significance of mast cells in spermatogenesis, implantation, pregnancy, and abortion: Cross talk and molecular mechanisms

Both subsets of MCs including MC_TC (tryptase-positive, chymase-positive) and MC_T (tryptase-positive, chymase-negative) are present in the testis and epididymis. Increased number of MCs, higher levels of MC-released tryptase in testis and seminal plasma of males with fertility problems, and promoting sperm motility in individuals with oligozoospermia after using MC blockers provide evidence that MCs may play a role in male infertility/subfertility disturbances. MC-released tryptase and histamine contribute to the fibrosis and may disrupt spermatogenesis. MCs not only influence the process of spermatogenesis but also have effects on the function of other testis-residing cells. MC-derived histamine may influence the steroidogenesis of Leydig cells by acting through H1R and H2R receptors. Additionally, the interaction between MC-released ATP and P2X receptors expressed on the peritubular cells may induce the production of the pro-inflammatory mediators by peritubular cells. Further investigations showed that MCs may be involved in the pathology of female infertility during implantation, pregnancy, and abortion. In the uterus, MC_T subtype is abundant in myometrium and adjacent basal layer while MC_TC subtype is distributed in all layers. MCs in response to hormones mainly estradiol and progesterone become activated and release a wide range of mediators including histamine, VEGF, proteases, and metalloproteinases (MMPs) that have a role in different stages of pregnancy. An increasing influx of MCs to the cervix during the pregnancy occurs that helps to the physiologic cervical ripening. While MMPs degrade the extracellular matrix (ECM), VEGF modulates neovascularization and histamine influences the embryo implantation. MC-derived histamine may have a positive effect during implantation due to its participation in tissue remodeling. MC proteases including tryptase and chymase activate the precursors of MMP2 and MMP9 to mediate ECM degradation during the physiologic menstrual cycle. There is a line of evidence that MCs have a role in abortion by releasing TNF-α.

Swimming modifies the effect of noise stress on the HPG axis of male rats

BACKGROUND

Few studies have examined the effect of noise pollution on the hypothalamic-pituitary-gonadal (HPG) axis. In this study, the effects of noise pollution and swimming on the HPG hormone axis of male rats were investigated.

METHODS

Forty male Sprague Dawley rats were assigned to four groups of equal size, including control (C), swimming (S), noise (N), and noise with swimming (NS). Serum levels of GnRH, LH, FSH, and testosterone were measured through blood samples taken 48 h following the last session of treatment. The main treatment programs of voluntary swimming and noise stress were performed 5 days per week over 7 weeks.

RESULTS

Serum levels of GnRH, LH, FSH, and testosterone decreased after exposure to the noise compared with the S and C groups, while in the S group, all hormone levels were higher than those in the C and N groups. Hormone levels of the SN group were higher than those in the N group but lower than those in the C group.

CONCLUSIONS

Long-term exposure to noise is known to have a negative impact on male sex hormones, while submaximal swimming exercise is likely to reduce these effects and improve HPG axis hormones.

Ketotifen fumarate attenuates feline gingivitis related with gingival microenvironment modulation

Gingivitis is evidenced by inflammation of the free gingiva, and still reversible. If left untreated, it may then progress to periodontitis. In the present study, the therapeutical effect of ketotifen fumarate on gingivitis was explored. Domestic cats with varying degrees of gingivitis naturally were enrolled in this study. Subgroups of animals were treated twice daily for one week with or without ketotifen fumarate (5 mg/kg). Effects of ketotifen fumarate were measured on gingival index, cells accumulation, mediators release, receptor-ligand interaction, oxidative stress, MAPK and NF-κB pathways, epithelial barrier and apoptosis. Ketotifen fumarate attenuated the initiation and progression of gingivitis, inhibited the infiltrations of mast cells, B lymphocytes, T lymphocytes, macrophages, neutrophils and eosinophils as well as the release of IgE, β-hexosaminidase, tryptase, chymase, TNF-α, IL-4, and IL-13, influenced endothelial cells, fibroblasts and epithelial cells proliferation and apoptosis, and induced Th2 cells polarization, where ketotifen fumarate also might affect their interactions. Ketotifen fumarate reduced the oxidative stress, and inhibited NF-κB and p38 MAPK related with mast cells and macrophages accumulation. Ketotifen fumarate improved the aberrant expression of ZO-1 and inhibits the following apoptosis. On the other hand, these cells and mediators augmented functional attributes of them involving SCF/c-Kit, α4β7/VCAM-1 and IL-8/IL-8RB interactions, thus creating a positive feedback loop to perpetuate gingivitis, where an inflammation microenvironment was modeled. Our results showed a previously unexplored therapeutic potential of ketotifen fumarate for gingivitis and further suggest that, in addition to biofilms, targeting inflammation microenvironment could be new strategy for the treatment of gingivitis/periodontitis.

Weighted single-step GWAS and gene network analysis reveal new candidate genes for semen traits in pigs

Background

In recent years, there has been increased interest in the study of the molecular processes that affect semen traits. In this study, our aim was to identify quantitative trait loci (QTL) regions associated with four semen traits (motility, progressive motility, number of sperm cells per ejaculate and total morphological defects) in two commercial pig lines (L1: Large White type and L2: Landrace type). Since the number of animals with both phenotypes and genotypes was relatively small in our dataset, we conducted a weighted single-step genome-wide association study, which also allows unequal variances for single nucleotide polymorphisms. In addition, our aim was also to identify candidate genes within QTL regions that explained the highest proportions of genetic variance. Subsequently, we performed gene network analyses to investigate the biological processes shared by genes that were identified for the same semen traits across lines.

Results

We identified QTL regions that explained up to 10.8% of the genetic variance of the semen traits on 12 chromosomes in L1 and 11 chromosomes in L2. Sixteen QTL regions in L1 and six QTL regions in L2 were associated with two or more traits within the population. Candidate genes SCN8A, PTGS2, PLA2G4A, DNAI2, IQCG and LOC102167830 were identified in L1 and NME5, AZIN2, SPATA7, METTL3 and HPGDS in L2. No regions overlapped between these two lines. However, the gene network analysis for progressive motility revealed two genes in L1 (PLA2G4A and PTGS2) and one gene in L2 (HPGDS) that were involved in two biological processes i.e. eicosanoid biosynthesis and arachidonic acid metabolism. PTGS2 and HPGDS were also involved in the cyclooxygenase pathway.

Conclusions

We identified several QTL regions associated with semen traits in two pig lines, which confirms the assumption of a complex genetic determinism for these traits. A large part of the genetic variance of the semen traits under study was explained by different genes in the two evaluated lines. Nevertheless, the gene network analysis revealed candidate genes that are involved in shared biological pathways that occur in mammalian testes, in both lines.

Electronic supplementary material

The online version of this article (10.1186/s12711-018-0412-z) contains supplementary material, which is available to authorized users.

Chronic epididymitis and Grade III varicocele and their associations with semen characteristics in men consulting for couple infertility

Chronic epididymitis and varicocele are frequently observed genital disorders in men consulting for couple infertility, but their impact on semen characteristics at the time of infertility consultation is still a matter of debate. We investigated 652 male partners of couples who had their first infertility consultation between 1999 and 2015 in Argentina. Men with chronic epididymitis (n = 253), Grade III varicocele (n = 106), and both conditions (n = 125) were compared with a control group (n = 168) composed of men without these disorders or any other recognized causes of male infertility. We showed that men who presented isolated chronic epididymitis were more likely to have high percentages of low sperm motility and abnormal sperm morphology as well as a high number of white blood cells. Men with isolated Grade III varicocele had low sperm production and motility and an increased percentage of abnormal sperm morphology. Finally, men who simultaneously presented chronic epididymitis with Grade III varicocele had a low sperm motility and increased percentage of abnormal sperm morphology as well as a high number of white blood cells. Physical examination of the genital organs may identify common disorders, potentially involved as causal factors of patient's infertility. These disorders are associated with specific seminal profiles that should help in identifying the best treatment from the available therapeutic options, effectiveness, safety, and allowing as much as possible natural conception.

Sperm motility is enhanced by Low Level Laser and Light Emitting Diode photobiomodulation with a dose-dependent response and differential effects in fresh and frozen samples

Background

The effects of Low Level Light Therapy (LLLT) on cellular function arise predominantly from stimulation of ATP production and reduction of oxidative stress. These effects are dose dependent and a function of beam irradiance and irradiation time. Human sperm motility has been shown to increase with LLLT irradiation. The objective of this study was to investigate the effects of laser and Light Emitting Diode (LED) LLLT photobiomodulation on human spermatozoa motility and DNA integrity.

Methods

An in-vitro controlled trial was performed within an IVF clinic laboratory using three human semen specimens, one fresh and two frozen. Sperm were exposed to light from a GaAlAs single laser (810 nm 200 mW) and an LED cluster (660 nm and 850 nm total power 2 W) for various irradiation times. Sperm motility for the test and control aliquots was assessed using a SQA-IIB analyser, but fertilizing ability was not. Sperm chromatin integrity was tested using the Sperm Chromatin Structure Assay.

Results

The Sperm Motility Index and Total Functional Sperm Count increased up to four fold compared to controls with inhibitory effects observed at higher doses (longer irradiation times). The maximum effect varied with irradiance and irradiation time and whether the sample was fresh or frozen.

Discussion

Human sperm motility is modified by exposure to LLLT and this motility modification is dependent upon beam irradiance and irradiation time as well as the condition of the sample. A higher stimulatory dose provides a rapid increase in motility that is short in duration, while a lower stimulatory dose provides a slower increase in motility. An inhibitory does causes reduced motility. Future research could consider animal models, such as the mouse, to test fertilization capacity and the safety of resulting fetuses.

Effect of varicocelectomy and/or mast cells stabilizer on sperm DNA fragmentation in infertile patients with varicocele

This study aimed to assess the effect of varicocelectomy and/or mast cells (MCs) stabilizer on sperm DNA fragmentation in infertile men with varicocele (Vx). Overall, 120 infertile patients were randomized to three equal treatment arms; patients that underwent varicocelectomy, patients on 1 mg ketotifen twice daily for three months, and patients that underwent varicocelectomy followed with 1 mg ketotifen twice daily for three months. These patients were subjected to history taking, clinical examination, semen analysis, and estimation of sperm DNA fragmentation index (DFI). After 3 months, all investigated groups showed significant improvement regarding the mean total sperm count, sperm concentration, total sperm motility, and sperm normal forms percentage compared with the pre-treatment data. As well, the mean sperm DFI was significantly improved compared with the pre-treatment data; in men that underwent varicocelectomy (34.6% vs. 28.3%), in men on MC stabilizer only (33.4% vs. 27.8%), and in men that underwent varicocelectomy followed by MC stabilizer (34.3% vs. 25.1%). Sperm DFI improvement percentages showed the highest improvement in men that underwent varicocelectomy followed with MC stabilizer compared with the other two groups (26.8% vs. 18.2%, 16.8%). Sperm DFI improvement percentages showed significant increases in the infertile patients with Vx grade III compared to Vx grade II in all investigated groups. It is concluded that in infertile men associated with Vx and high sperm DFI, surgical repair followed with MCs stabilizer significantly improve sperm DFI compared with either surgical repair or MCs stabilizer alone.

[Necrozoospermia: From etiologic diagnosis to therapeutic management]

This review describes necrospermia, its diagnosis, causes and management. Sperm vitality is commonly assessed in the laboratory of reproductive biology, with the eosin test or with the hypo-osmotic swelling test. Necrospermia is defined by a percentage of living spermatozoa inferior to 58%, and can be related to male infertility. Several pathological mechanisms may be involved and can be classified either in testicular causes (hyperthyroidism, local hyperthermia, varicocele), or post-testicular causes (epididymal necrospermia, dysregulation of seminal plasma, adult polycystic kidney disease, vasectomy reversal, anti-sperm antibodies) or both (infection, toxic, age, spinal cord injury). The first treatment is to correct the underlying cause, if possible. Repetitive ejaculation has demonstrated to be effective as well. Many drugs would also improve the sperm vitality (antioxidants, non-and-steroidal anti-inflammatory drugs) but there is currently no guideline to recommend their use. With necrospermia, fertilization rates are lower but in vitro fertilization (IVF) with Intracytoplasmic sperm injection (ICSI) improves the chances of conception.