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Ferreiro ME, Méndez CS, Glienke L, Sobarzo CM, Ferraris MJ, Pisera DA, Lustig L, Jacobo PV, Theas MS. Unraveling the effect of the inflammatory microenvironment in spermatogenesis progression. Cell Tissue Res 2023; 392:581-604. [PMID: 36627392 DOI: 10.1007/s00441-022-03703-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/02/2022] [Indexed: 01/12/2023]
Abstract
Experimental autoimmune orchitis (EAO) is a chronic inflammatory disorder that causes progressive spermatogenic impairment. EAO is characterized by high intratesticular levels of nitric oxide (NO) and tumor necrosis factor alpha (TNFα) causing germ cell apoptosis and Sertoli cell dysfunction. However, the impact of this inflammatory milieu on the spermatogenic wave is unknown. Therefore, we studied the effect of inflammation on spermatogonia and preleptotene spermatocyte cell cycle progression in an EAO context and through the intratesticular DETA-NO and TNFα injection in the normal rat testes. In EAO, premeiotic germ cell proliferation is limited as a consequence of the undifferentiated spermatogonia (CD9+) cell cycle arrest in G2/M and the reduced number of differentiated spermatogonia (c-kit+) and preleptotene spermatocytes that enter in the meiotic S-phase. Although inflammation disrupts spermatogenesis in EAO, it is maintained in some seminiferous tubules at XIV and VII-VIII stages of the epithelial cell cycle, thereby guaranteeing sperm production. We found that DETA-NO (2 mM) injected in normal testes arrests spermatogonia and preleptotene spermatocyte cell cycle; this effect reduces the number of proliferative spermatogonia and the number of preleptotene spermatocytes in meiosis S-phase (36 h after). The temporal inhibition of spermatogonia clonal amplification delayed progression of the spermatogenic wave (5 days after) finally altering spermatogenesis. TNFα (0.5 and 1 µg) exposure did not affect premeiotic germ cell cycle or spermatogenic wave. Our results show that in EAO the inflammatory microenvironment altered spermatogenesis kinetics through premeiotic germ cell cycle arrest and that NO is a sufficient factor contributing to this phenomenon.
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Affiliation(s)
| | - Cinthia Soledad Méndez
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas (INBIOMED), Paraguay 2155, Piso 10, Laboratorio 7, Ciudad Autónoma de Buenos Aires, Buenos Aires, C1421ABG, Argentina
| | - Leilane Glienke
- Universidad de Buenos Aires, Facultad de Medicina, Departamento de Biología Celular, Cátedra II de Histología, Buenos Aires, Argentina.,CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas (INBIOMED), Paraguay 2155, Piso 10, Laboratorio 7, Ciudad Autónoma de Buenos Aires, Buenos Aires, C1421ABG, Argentina
| | - Cristian Marcelo Sobarzo
- Universidad de Buenos Aires, Facultad de Medicina, Departamento de Biología Celular, Cátedra II de Histología, Buenos Aires, Argentina.,CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas (INBIOMED), Paraguay 2155, Piso 10, Laboratorio 7, Ciudad Autónoma de Buenos Aires, Buenos Aires, C1421ABG, Argentina
| | - María Jimena Ferraris
- Department of Biochemistry and Biophysics, Stockholm University, Svante Arrhenius väg 16C SE-106 91, Stockholm, Sweden
| | - Daniel Alberto Pisera
- CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas (INBIOMED), Paraguay 2155, Piso 10, Laboratorio 7, Ciudad Autónoma de Buenos Aires, Buenos Aires, C1421ABG, Argentina
| | - Livia Lustig
- Universidad de Buenos Aires, Facultad de Medicina, Departamento de Biología Celular, Cátedra II de Histología, Buenos Aires, Argentina.,CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas (INBIOMED), Paraguay 2155, Piso 10, Laboratorio 7, Ciudad Autónoma de Buenos Aires, Buenos Aires, C1421ABG, Argentina
| | - Patricia Verónica Jacobo
- Laboratorio de Reproducción y Fisiología Materno-Placentaria (CONICET), Departamento de Biodiversidad y Biología Experimental (DBEE), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, Pabellón 2, Piso 4, Ciudad Autónoma de Buenos Aires, Buenos Aires, C1428EGA, Argentina
| | - María Susana Theas
- Universidad de Buenos Aires, Facultad de Medicina, Departamento de Biología Celular, Cátedra II de Histología, Buenos Aires, Argentina. .,CONICET-Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas (INBIOMED), Paraguay 2155, Piso 10, Laboratorio 7, Ciudad Autónoma de Buenos Aires, Buenos Aires, C1421ABG, Argentina.
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Bonfill X, Rigau D, Esteban-Fuertes M, Barrera-Chacón JM, Jáuregui-Abrisqueta ML, Salvador S, Alemán-Sánchez CM, Borau A, Bea-Muñoz M, Hidalgo B, Andrade MJ, Espinosa JR, Martínez-Zapata MJ, Rigau D, Martínez-Zapata MJ, Cánovas E, Zazo N, Gich I, Martínez-Zapata MJ, Bea M, Garran M, Borau A, Herrero MP, Morcillo M, Alemán CM, Bárbara E, Jáuregui ML, Cuadrado M, Sánchez NC, Mendieta IL, Salvador S, Montoto A, Ferreiro ME, Espinosa JR, Moraleda S, Barrera-Chacón JM, Méndez B, Zarco MJ, García I, Esteban M, Florencio M, Hidalgo B, de Miguel JI, Lanzillotti CM, Navarro J, Andrade MJ, Soares D, Akkoc Y, Senocak O, Vásquez NN, Orrego V, Courbis M, Seguel M. Efficacy and safety of urinary catheters with silver alloy coating in patients with spinal cord injury: a multicentric pragmatic randomized controlled trial. The ESCALE trial. Spine J 2017; 17:1650-1657. [PMID: 28578163 DOI: 10.1016/j.spinee.2017.05.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/25/2017] [Accepted: 05/25/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Patients with spinal cord injury (SCI) who carry indwelling urinary catheters have an increased risk of urinary tract infection (UTI). Antiseptic silver alloy-coated (SAC) silicone urinary catheters prove to be a promising intervention to reduce UTIs; however, current evidence cannot be extrapolated to patients with SCI. PURPOSE This study aimed to assess the efficacy of SAC urinary catheters for preventing catheter-associated urinary tract infections. DESIGN/SETTING This is an open-label, multicenter (developed in Spain, Portugal, Chile, Turkey, and Italy), randomized clinical trial conducted in 14 hospitals from November 2012 to December 2015. PATIENT SAMPLE Eligible patients were men or women with traumatic or medical SCI, aged ≥18 years, requiring an indwelling urinary catheter for at least 7 days. OUTCOME MEASURES The primary outcome was the incidence of symptomatic UTIs. The secondary outcome included bacteremia in the urinary tract and adverse events. MATERIALS AND METHODS Patients were randomized to receive a SAC urinary catheter (experimental group) or a standard catheter (control group) for at least 7 days. Data were compared using chi-squared test and also calculating the absolute risk difference with a 95% confidence interval. An adjusted analysis including different risk factors of UTI was performed. This study was mainly funded by La Marató de TV3 Foundation (grant number # 112210) and the European Clinical Research Infrastructures Network organization. The funders had no role in the interpretation or reporting of results. RESULTS A total of 489 patients were included in the study, aged 55 years in the experimental group and aged 57 in the control group (p=.870); 72% were men; 43% were hospitalized patients, and 57% were outpatients (p=1.0). The most frequent cause of SCI was traumatic (73.75%), and the localization was mainly the cervical spine (42.74%). Most of the patients had an A score (complete spinal injury and no motor and sensory is preserved) on the ASIA scale (62.37%). The median time of urethral catheterization was 27 days in the experimental group and 28 days in the control group (p=.202). Eighteen patients (7.41%) in the experimental group and 19 in the control (7.72%) group had a symptomatic UTI (odds ratio [OR] 0.96 [0.49-1.87]). The adjusted analysis revealed no change in the results. Only three patients in the experimental group had bacteremia within the urinary tract. The experimental group presented more adverse events related to the use of a catheter than the control group (OR 0.03 [0.00-0.06]). CONCLUSIONS The results of this study do not support the routine use of indwelling antiseptic SAC silicone urinary catheters in patients with SCI. However, UTIs associated to long-term urinary catheter use remain a challenge and further investigations are still needed.
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Affiliation(s)
- Xavier Bonfill
- Service of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Spain; Iberoamerican Cochrane Centre, Barcelona, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain; CIBERESP (CIBER de Epidemiología y Salud Pública), Barcelona, Spain; Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - David Rigau
- Iberoamerican Cochrane Centre, Barcelona, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | | | | | | | - Sebastian Salvador
- Department of Urology, Complexo Hospitalario Universitario A Coruña, Spain
| | | | - Albert Borau
- Department of Urology, Hospital de Neurorrehabilitación-Instituto Guttmann, Spain
| | - Manuel Bea-Muñoz
- Department of Urology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Begoña Hidalgo
- Department of Urology, Hospital Universitario Miguel Servet, Spain
| | | | - Juan R Espinosa
- Department of Urology, Hospital Universitario Puerta del Mar de Cádiz, Spain
| | - María José Martínez-Zapata
- Iberoamerican Cochrane Centre, Barcelona, Spain; Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain; CIBERESP (CIBER de Epidemiología y Salud Pública), Barcelona, Spain.
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