Protective role of erythropoietin during testicular torsion of the rats

Abstract

Testicular torsion is an important clinical urgency. Similar mechanisms occurred after detorsion of the affected testis as in the ischemia reperfusion (I/R) damage. This study was designed to investigate the effects of erythropoietin (EPO) treatment after unilateral testicular torsion. Fifty male Sprague-Dawley rats were divided into five groups. Group 1 underwent a sham operation of the right testis under general anesthesia. Group 2 was same as sham, and EPO (3,000 IU/kg) infused i.p., group 3 underwent a similar operation but the right testis was rotated 720 degrees clockwise for 1 h, maintained by fixing the testis to the scrotum, and saline infused during the procedure. Group 4 underwent similar torsion but EPO was infused half an hour before the detorsion procedure, and in group 5, EPO was infused after detorsion procedure. Four hours after detorsion, ipsilateral and contralateral testes were taken out for evaluation. Treatment with EPO improved testicular structures in the ipsilateral testis but improvement was less in the contralateral testis histologically, but EPO treatment decreased germ cell apoptosis in both testes following testicular IR. TNF-alpha, IL-1beta, IL-6 and nitrite levels decreased after EPO treatment especially in the ipsilateral testis. We conclude that testicular I/R causes an increase in germ cell apoptosis both in the ipsilateral and contralateral testes. Erythropoietin has antiapoptotic and anti-inflammatory effects following testicular torsion.

<b><i>Nigella Sativa</i></b> Reduces Tissue Damage in Rat Ovaries Subjected to Torsion and Detorsion: Oxidative Stress, Proinflammatory Response and Histopathological Evaluation

“…When stimulated, neutrophils produce excessive amounts of ROS from membrane-bound NADPH oxidase. MPO activity and proinflammatory cytokine assay has been used as an index of neutrophil infiltration and as a marker for acute inflammation in various injuries [60,61,62,63]. The present study also revealed that NS significantly reduced ovarian tissue MPO levels and serum cytokine (IL-1β, IL-6, and TNF-α) levels compared to the ISC and ISC+REP control groups.…”

“…Several molecules and cells are involved in I/R damage [59], such as reactive oxygen species, cytokines and chemokines, complements, natural antibodies, and neutrophils, which are basic elements of the innate immune response [61]. There is an increase in proinflammatory cytokines such as IL-1β, IL-6, and TNF-α after I/R [62]. In addition, MPO is a marker of accumulation of neutrophils during I/R, as part of the acute inflammatory response.…”

Erythropoietin Accelerates the Regeneration of Ureteral Function in a Murine Model of Obstructive Uropathy

“…21 Evidence that EPO has beneficial effects for urological organs first emerged when it was noted to protect testicular tissue after torsion and ischemic injury. 22 Based on the current findings we believe that pharmacological intervention using EPO to accelerate hydronephrosis resolution and promote normal ureteral peristalsis and urine flow after obstruction removal may decrease the risk of renal dysfunction and secondary infection due to the impaired urine flow associated with aperistalsis. The fact that negative effects, including disruption of normal peristalsis, lasted far beyond obstruction removal and hydronephrosis resolution suggests the need for such agents.…”

The protective effect of erythropoietin infusion on testicular torsion/detorsion: an experimental study

“…Although recently three publications have shown the possible beneficial effects of EPO in TT [15][16][17], the present study contains substantial new aspects in this field. Recently published studies have shown an anti-apoptotic and anti-inflammatory effect of EPO [15] and its free radical scavenger's activity, which decreases lipid peroxidation levels and the attenuation of apoptosis [16].…”

“…Recently published studies have shown an anti-apoptotic and anti-inflammatory effect of EPO [15] and its free radical scavenger's activity, which decreases lipid peroxidation levels and the attenuation of apoptosis [16]. Moreover, one of the recently published studies has suggested that administration of darbepoetin-a, a novel EPO protein, caused a decrease of malondialdehyde and nitric oxide levels and an increase of glutathione levels in TT [17].…”