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Wiggins JW, Sledd JE, Coolen LM. Spinal Cord Injury Causes Reduction of Galanin and Gastrin Releasing Peptide mRNA Expression in the Spinal Ejaculation Generator of Male Rats. Front Neurol 2021; 12:670536. [PMID: 34239493 PMCID: PMC8258150 DOI: 10.3389/fneur.2021.670536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/21/2021] [Indexed: 01/23/2023] Open
Abstract
Spinal cord injury (SCI) in men is commonly associated with sexual dysfunction, including anejaculation, and chronic mid-thoracic contusion injury in male rats also impairs ejaculatory reflexes. Ejaculation is controlled by a spinal ejaculation generator consisting of a population of lumbar spinothalamic (LSt) neurons that control ejaculation through release of four neuropeptides including galanin and gastrin releasing peptide (GRP) onto lumbar and sacral autonomic and motor nuclei. It was recently demonstrated that spinal contusion injury in male rats caused reduction of GRP-immunoreactivity, but not galanin-immunoreactivity in LSt cells, indicative of reduced GRP peptide levels, but inconclusive results for galanin. The current study further tests the hypothesis that contusion injury causes a disruption of GRP and galanin mRNA in LSt cells. Male rats received mid-thoracic contusion injury and galanin and GRP mRNA were visualized 8 weeks later in the lumbar spinal cord using fluorescent in situ hybridization. Spinal cord injury significantly reduced GRP and galanin mRNA in LSt cells. Galanin expression was higher in LSt cells compared to GRP. However, expression of the two transcripts were positively correlated in LSt cells in both sham and SCI animals, suggesting that expression for the two neuropeptides may be co-regulated. Immunofluorescent visualization of galanin and GRP peptides demonstrated a significant reduction in GRP-immunoreactivity, but not galanin in LSt cells, confirming the previous observations. In conclusion, SCI reduced GRP and galanin expression in LSt cells with an apparent greater impact on GRP peptide levels. GRP and galanin are both essential for triggering ejaculation and thus such reduction may contribute to ejaculatory dysfunction following SCI in rats.
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Affiliation(s)
- James W Wiggins
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, United States.,Graduate Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS, United States
| | - Jonathan E Sledd
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, United States
| | - Lique M Coolen
- Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, United States.,Department of Biological Sciences, Kent State University, Kent, OH, United States
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SERBAN DE, DAIA CO, NEGOESCU CHEREGI I, CIOBANU V, ONOSE L, POPESCU C, ONOSE G. Topical Systematic and Synthetic Literature Review Regarding Men Sexual Dysfunctions after Spinal Cord Injury. BALNEO RESEARCH JOURNAL 2020. [DOI: 10.12680/balneo.2020.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Spinal cord injury (SCI) is a life-altering event usually associated with loss of motor and sensory, as well as with bladder, bowel and sexual, functions impairment. Recovering sexual function is one of the most important function tightly coupled with the life quality. In this respect, in the related literature can be found data regarding mainly: diagnosis/evaluation issues therapeutic/assistive-rehabilitative interventions (including connected to fertility troubles) and of psychological and or educational specific counseling, kind.
Materials and methods.This paper presents a current systematic (of Preferred Reporting Items for Systematic Reviews and Meta-Analyses – PRISMA – type) and synthetic literature review on sexual dysfunctions and respected available management options in male subjects with SCI, using the following search keywords/ combinations of key words: “men”, “sexual dysfunction”/ “fertility” / “erectile dysfunction”/ “ejaculatory problems” / “sexual disorder“, “spinal cord injury”, “paraplegia”/ ”tetraplegia” /“paraplegic”/ ”tetraplegic”, “management”/ “treatment”, by interrogating international renown data bases: NCBI/PubMed, NCBI/PMC, Elsevier, PEDro and respectively, ISI Web of Knowledge/Science – to check whether the selected articles are published in ISI indexed journals – considering publications from January 2009 to June 2019, written in English, open access articles and being “fair”/“high” quality on our PEDro inspired, customized quality classification of the selected papers – the basic criterion, being the weighted citations number per year.
Results. We have found initially 647 articles and eventually, after accomplishing the PRISMA stages (without meta-analysis), we have selected 16 articles matching all the above mentioned quest method’s requests (see further the figure representing our PRISMA type completed flow-diagram), covering (together with knowledge acquired from extra bibliographic resources, too).
Conclusions. Sexual disfunctions after SCI are complex and strongly add to the severe and multimodal disability the affected people – in the case of our work: men – experience. Therefore, they worth being fathomed and periodically reappraised.
Keywords: Spinal Cord injury (SCI), men sexual dysfunctions, systematic literature review, rehabilitation,
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Affiliation(s)
- Diana-Elena SERBAN
- Teaching Emergency Clinical Hospital “Bagdasar Arseni”, in Bucharest, Romania
| | - Cristina Octaviana DAIA
- Teaching Emergency Clinical Hospital “Bagdasar Arseni”, in Bucharest, Romania, University of Medicine and Pharmacy “Carol Davila”, in Bucharest, Romania
| | | | - Vlad CIOBANU
- Computer Science Department, Politehnica University of Bucharest, Bucharest, Romania
| | | | - Cristina POPESCU
- Teaching Emergency Clinical Hospital “Bagdasar Arseni”, in Bucharest, Romania
| | - Gelu ONOSE
- Teaching Emergency Clinical Hospital “Bagdasar Arseni”, in Bucharest, Romania, University of Medicine and Pharmacy “Carol Davila”, in Bucharest, Romania
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Yu B, Darves-Bornoz AL, Brannigan RE, Halpern JA. Acute anejaculation, hypogonadism, and fertility preservation in the setting of neurosarcoidosis: case report and literature review. F S Rep 2020; 1:317-325. [PMID: 34223263 PMCID: PMC8244293 DOI: 10.1016/j.xfre.2020.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/23/2020] [Accepted: 09/26/2020] [Indexed: 11/26/2022] Open
Abstract
Objective To examine fertility preservation techniques in the setting of neurosarcoidosis, and to review the impact of corticosteroid and methotrexate therapy on fertility. Design Case report of a patient with infertility secondary to anejaculation associated with spinal neurosarcoidosis, treated with systemic corticosteroids and methotrexate. Setting Academic tertiary-care hospital. Patient(s) A 39-year-old man presented with neurosarcoidosis complicated by acute anejaculation, erectile dysfunction, and hypogonadism. He underwent fertility consultation and sperm cryopreservation before initiating methotrexate therapy. His pretreatment total testosterone was low, at 157 ng/dL. Intervention(s) Unsuccessful pharmacologic therapy and penile vibratory stimulation (PVS) were followed by microdissection testicular sperm extraction (microTESE). Clomiphene was administered for optimization of spermatogenesis before microTESE. Main Outcome Measure(s) Vials of cryopreserved sperm, testis histopathology, and serum testosterone levels. Result(s) Eight vials of viable sperm were harvested by means of micro-TESE and cryopreserved. Despite intraoperative appearance of hypospermatogenesis, 90% of seminiferous tubules had active germ cell sloughing. Total testosterone increased to 278 ng/dL 2 months after initiating clomiphene. Conclusion(s) Conventional fertility preservation techniques may be effective in the setting of neurosarcoidosis-induced infertility owing to largely intact spermatogenesis. PVS, though not effective for this patient, should be considered along with electroejaculation, given high success rates in other patients with neurogenic anejaculation. Corticosteroid-mediated hypogonadism also must be considered in these patients, because it can negatively affect downstream spermatogenesis. In addition, evidence for the impact of paternal methotrexate exposure on fertility is limited and requires further investigation. As such, fertility consultation before initiating methotrexate is highly recommended.
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Affiliation(s)
- Benjamin Yu
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anne L Darves-Bornoz
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Robert E Brannigan
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Joshua A Halpern
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Miranda EP, Taniguchi H, Cao DL, Hald GM, Jannini EA, Mulhall JP. Application of Sex Aids in Men With Sexual Dysfunction: A Review. J Sex Med 2019; 16:767-780. [DOI: 10.1016/j.jsxm.2019.03.265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 03/17/2019] [Accepted: 03/20/2019] [Indexed: 01/14/2023]
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Choobineh H, Kazemi M, Sadighi Gilani MA, Heydari T, Shokri S, Bazrafkan M, Hassanzadeh G. Testosterone Reduces Spinal Cord Injury-Induced Effects on Male Reproduction by Preventing CADM1 Defect. CELL JOURNAL 2018; 20:138-149. [PMID: 29633590 PMCID: PMC5893284 DOI: 10.22074/cellj.2018.5003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 06/28/2017] [Indexed: 02/05/2023]
Abstract
Objective This study evaluated the effects of exogenous testosterone molecule-1 (CADM1) pathological defect during early
and chronic periods of spinal cord injury (SCI).
Materials and Methods In this experimental study, testosterone was administered immediately or after one week of SCI
induction. Along with quantification of CADM1 gene expression and its immunoreactivity, we evaluated sperm parameters and
serum testosterone level post-SCI.
Results Different grades of abnormalities in sperm parameters and testis architecture were observed along with
significant reductions in the level of CADM1 expression and its immunoreactivity in the seminiferous tubules of both
acute and chronic SCI groups. Exogenous testosterone, by compensating the serum testosterone level. reduced
the percentage of apoptotic and both short head and abnormal sperm froms in the caudal epididymis. Importantly,
the beneficial effects of immediate administration of testosterone were prominent. Increases in the level of CADM1
transcription and its immunoreactivity in the testis of SCI mice treated with testosterone were accompanied by
improvement of sperm motility as well as testicular Johnsen’s and Miller’s criteria.
Conclusion Since immediate testosterone treatment improved the immunoreactivity and transcription level of CADM1,
the observed beneficial effect of exogenouse testosterone can be attributed to its effect on CADM1 dynamics.
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Affiliation(s)
- Hamid Choobineh
- School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.,Zeoonosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Kazemi
- Department of Anatomy, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Tahereh Heydari
- Department of Biology, Islamic Azad University, Parand Branch, Iran
| | - Saeed Shokri
- Department of Anatomy, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahshid Bazrafkan
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Hassanzadeh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronicaddress:
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Fortune RD, Grill RJ, Beeton C, Tanner M, Huq R, Loose DS. Changes in Gene Expression and Metabolism in the Testes of the Rat following Spinal Cord Injury. J Neurotrauma 2016; 34:1175-1186. [PMID: 27750479 DOI: 10.1089/neu.2016.4641] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Spinal cord injury (SCI) results in devastating changes to almost all aspects of a patient's life. In addition to a permanent loss of sensory and motor function, males also will frequently exhibit a profound loss of fertility through poorly understood mechanisms. We demonstrate that SCI causes measureable pathology in the testis both acutely (24 h) and chronically up to 1.5 years post-injury, leading to loss in sperm motility and viability. SCI has been shown in humans and rats to induce leukocytospermia, with the presence of inflammatory cytokines, anti-sperm antibodies, and reactive oxygen species found within the ejaculate. Using messenger RNA and metabolomic assessments, we describe molecular and cellular changes that occur within the testis of adult rats over an acute to chronic time period. From 24 h, 72 h, 28 days, and 90 days post-SCI, the testis reveal a distinct time course of pathological events. The testis show an acute drop in normal sexual organ processes, including testosterone production, and establishment of a pro-inflammatory environment. This is followed by a subacute initiation of an innate immune response and loss of cell cycle regulation, possibly due to apoptosis within the seminiferous tubules. At 1.5 years post-SCI, there is a chronic low level immune response as evidenced by an elevation in T cells. These data suggest that SCI elicits a wide range of pathological processes within the testes, the actions of which are not restricted to the acute phase of injury but rather extend chronically, potentially through the lifetime of the subject. The multiplicity of these pathological events suggest a single therapeutic intervention is unlikely to be successful.
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Affiliation(s)
- Ryan D Fortune
- 1 Department of Integrative Biology and Pharmacology, UTHealth , Houston, Texas
| | - Raymond J Grill
- 1 Department of Integrative Biology and Pharmacology, UTHealth , Houston, Texas
| | - Christine Beeton
- 2 Department of Molecular Physiology and Biophysics, Baylor College of Medicine , Houston, Texas
| | - Mark Tanner
- 2 Department of Molecular Physiology and Biophysics, Baylor College of Medicine , Houston, Texas
| | - Redwan Huq
- 2 Department of Molecular Physiology and Biophysics, Baylor College of Medicine , Houston, Texas
| | - David S Loose
- 1 Department of Integrative Biology and Pharmacology, UTHealth , Houston, Texas
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Evidence of a new pattern of ejaculation in men with spinal cord injury: ejaculation dyssynergia and implications for fertility. Spinal Cord 2016; 54:1210-1214. [PMID: 27324318 DOI: 10.1038/sc.2016.78] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 03/24/2016] [Accepted: 04/26/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To describe the presence of sperm in the prostatic urethra as a stand-alone ejaculation entity and to assess its characteristics. METHODS Thirty-three patients with anejaculation during sexual stimulation were enroled. Penile vibratory stimulations were carried out following bladder catherization and instillation of a pink buffering medium (Ferticult). Two-step catheterisation was then performed: a catheter was inserted through the urethral sphincter into the prostatic urethra to aspirate its content, and then bladder catheterisation was performed to collect the Ferticult. The procedure was repeated in some patients after at least 1 week. The characteristics of the semen collected from each organ were analysed and compared. RESULTS A total of 42 trials were obtained from 22 patients. Sperms were found in the prostatic urethra in 21 samples (50%) from 12 patients (11 with spinal cord injury, 1 with diabetes). The colour of all 21 prostatic urethra sperm samples differed from the Ferticult. Sperm motility was greater in 8 samples, sperm count was higher in 10 and pH was different in 10, compared with the bladder samples. The higher overall quality of the sperm allowed cryopreservation in 10 prostatic urethra samples compared with only 5 bladder samples. Four of the five patients who underwent repeated trials had a reproducible pattern of prostatic urethra ejaculation. CONCLUSION The presence of sperm in the prostatic urethra most probably results from 'ejaculation dyssynergia', a lack of coordination between bladder neck and external sphincter. Sperm from the prostatic urethra should be systematically sought to improve the outcome of assisted reproduction.
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Choobineh H, Sadighi Gilani MA, Pasalar P, Jahanzad I, Ghorbani R, Hassanzadeh G. The Effects of Testosterone on Oxidative Stress Markers in Mice with Spinal Cord Injuries. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2016; 10:87-93. [PMID: 27123205 PMCID: PMC4845534 DOI: 10.22074/ijfs.2016.4773] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 05/24/2015] [Indexed: 11/23/2022]
Abstract
Background Spinal cord injury (SCI) causes infertility in male patients through erectile dysfunction, ejaculatory dysfunction, semen and hormone abnormalities. Oxidative stress (OS) is
involved in poor semen quality and subsequent infertility in males with SCI. The aim of this
study is to examine the effects of SCI on the level of testosterone hormone. Materials and Methods In this experimental study, we evaluated the effects of exogenous testosterone on the activity of the antioxidant enzymes superoxide dismutase (SOD)
and glutathione peroxidase (GPx) as well as the levels of malondialdehyde (MDA) and
protein carbonylation (PCO), as markers of OS, in 10 groups of SCI mice. Total antioxidant capacity (TAC) was determined using the 2,29-azinobis-(3-ethylbenzothiazoline-
6-sulfonic acid) (ABTS) radical cation assay. Results Exogenous testosterone administration in mice with SCI significantly reduced SOD
and GPx enzyme activities and MDA level. There was no significant decrease in PCO content. In addition, TAC remarkably increased in the sham and SCI groups not treated with testosterone but remained unchanged in all other experimental groups. Exogenous testosterone
also reduced serum testosterone levels in all groups except the positive control group. Conclusion Our cumulative data indicated that SCI could cause sterility by disturbing
the plasmatic testosterone balance. The normal level of endogenous testosterone was not
completely restored by exogenous testosterone administration.
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Affiliation(s)
- Hamid Choobineh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran; Zoonosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Parvin Pasalar
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Issa Jahanzad
- Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Rostam Ghorbani
- Department of Anatomy, School of Medicine, Kermanshah University of Medical Science, Kermanshah, Iran
| | - Gholamreza Hassanzadeh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Krebs J, Göcking K, Kissling-Niggli M, Pannek J. Cross-sectional study of the sperm quality in semen samples from spinal cord injured men after long-term cryopreservation. Andrology 2015; 3:213-9. [DOI: 10.1111/andr.12017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 01/06/2015] [Accepted: 01/15/2015] [Indexed: 11/27/2022]
Affiliation(s)
- J. Krebs
- Clinical Trial Unit; Swiss Paraplegic Centre; Nottwil Switzerland
| | - K. Göcking
- Neurourology; Swiss Paraplegic Centre; Nottwil Switzerland
| | | | - J. Pannek
- Neurourology; Swiss Paraplegic Centre; Nottwil Switzerland
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Bacterial Persistence in the Prostate After Antibiotic Treatment of Chronic Bacterial Prostatitis in Men With Spinal Cord Injury. Urology 2014; 83:515-20. [DOI: 10.1016/j.urology.2013.11.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 11/14/2013] [Accepted: 11/20/2013] [Indexed: 11/22/2022]
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