Medical perspective in testicular ischemia-reperfusion injury

Abstract

Abstract. Testicular torsion or torsion of the spermatic cord is one of the most serious urological conditions. It causes testicular injury, which potentially leads to male subfertility. The turning of the spermatic cord and spermatic structures around themselves results in biochemical and histological changes; however, following testicular detorsion, tissues undergo reperfusion that causes more severe damage than that induced by ischemia. Since the primary causes of testicular damage are reactive oxygen species production, an increase in intra-mitochondrial calcium concentration and an increased rate of cellular apoptosis, different medications may potentially be effective. It seems that several medications, experimentally and sometimes clinically, serve an adjuvant role in the cellular damage that occurs following ischemia-reperfusion. Antioxidants, calcium channel blockers, phytotherapeutical medicinals, anaesthetics, hormones and platelet inhibitors may potentially create a solid basis for an adjuvant restoring therapy and ameliorate testicular function following torsion. The current study aimed to review the relevant literature and discuss the actions of a number of molecules that may protect the testes during ischemia/reperfusion injury.

Paeonol protects against testicular ischaemia‐reperfusion injury in rats through inhibition of oxidative stress and inflammation

“…The testicular injury was thought to be a result of both the ischaemia and the reperfusion. However, the elaboration of free radicals during the period of reperfusion revealed to be the basis of pathogenesis of the injury (Arena et al, 2017; Asadi et al, 2017).…”

“…Ischaemia deprives the organ of its blood supply causing accumulation of waste products, while reperfusion results in elaboration of reactive oxygen species (ROS) and accumulation of calcium load in the testicular tissue. As a consequence, the oxidative stress and the inflammatory process are initiated (Arena et al, 2017). Deprivation of oxygen mainly affects the spermatogenesis, the most active replicative process with high degrees of mitochondrial oxygen consumption (Aitken & Roman, 2008).…”

The effects of verapamil and heparin co‐administration on sperm parameters and oxidative stress in prevention of testicular torsion/detorsion damage in rats

“…Previous studies have identified reperfusion as the major cause of tissue damage (Ünsal et al, 2006). Because the main reasons of testicular injury are the overproduction of reactive oxygen species, calcium accumulation inside mitochondria and increased cellular apoptosis, various drugs can be useful (Arena et al, 2017). Recent studies have demonstrated that reperfusion can cause a noticeable increment in the overgeneration of lipid peroxidation, nitric oxide and germ cell apoptosis (Yuluğ et al, 2014).…”

“…Calcium channel blockers are a group of medications that prevent Ca 2+ entrance to sensitive cells (Katz, 1986). Also, a lot of drugs in this group, like amlodipine, nifedipine, verapamil and lidocaine, have antioxidant properties (Arena et al, 2017). Sarica et al (1999) reduce the I/R damage and the sperm parameters assessment in various groups indicated that verapamil cannot remarkably meliorate the sperm characteristics; it is perhaps based on verapamil calcium channel-blocking activity that perhaps blocked the Ca2+/Na+ channels of spermatozoa and could not increase the motility and percentage of normal spermatozoa (Ameli et al, 2018).…”

Intratesticular Human Adipose-Derived Stem Cell (hADSC) Transplantation Decreased Oxidative Stress in Testicular Torsion Model of Wistar Rat

“…4,5 Such conditions can cause structural and functional loss of testicular tissue, which leads to the disruption of the spermatogenesis process, thus causing infertility. [5][6][7] Malondialdehyde (MDA) is an organic compound formed from ROS with the formula of CH2(CHO)2. Hence, MDA is used as an oxidative stress biomarker during ischemia and ischemia-reperfusion injury.…”