Schanaider A, Aiex C A, Errico G
Federal University of Rio de Janeiro, Surgery, Cidade Universitária, Brazil.
Eur J Pediatr Surg. 2011 Dec;21(6):370-4. doi: 10.1055/s-0031-1285841. Epub 2011 Aug 30.
The mechanism by which unilateral testicular torsion leads to injury of the contralateral testis is still controversial. The present study aimed to evaluate immunohistopathological changes in the contralateral testis of rats after acute testicular torsion.
40 pubertal rats were randomly divided into 3 groups. Group 1 (n=10) functioned as controls. Group 2 rats (n=10) underwent a sham operation, and Group 3 (n=20) underwent 720° torsion of the left spermatic cord (3 h) followed by detorsion (24 h).
Immunofluorescence tests were done to investigate contralateral lesions in half of the animals in Group 3. Nitro blue tetrazolium (NBT) was injected in both testes to identify the presence of oxygen-derived free radicals. 24 h after reperfusion, bilateral samples of the testes were obtained for histological analysis. Fisher's exact test was used for statistical analysis with p-values <0.05 considered significant.Immunofluorescence tests were positive for the contralateral (right) testis but with a lower intensity than that of the testis submitted to torsion. NBT reaction was intense all over the left testis while a minor reaction was visible in the right testis. In Group 3 the left distorted testicle showed diffuse edema with cell elimination and extensive necrosis of the seminiferous tubules. Histological lesions were moderate to mild in the contralateral testis.
An autoimmune IgG-mediated mechanism deposited on the basement membrane of seminiferous tubules seems to be involved in the genesis of contralateral testis injury.
单侧睾丸扭转导致对侧睾丸损伤的机制仍存在争议。本研究旨在评估急性睾丸扭转后大鼠对侧睾丸的免疫组织病理学变化。
40只青春期大鼠随机分为3组。第1组（n = 10）作为对照组。第2组大鼠（n = 10）进行假手术，第3组（n = 20）进行左侧精索720°扭转（3小时），随后进行扭转复位（24小时）。
对第3组半数动物进行免疫荧光试验以研究对侧损伤情况。在双侧睾丸注射硝基蓝四唑（NBT）以鉴定氧衍生自由基的存在。再灌注24小时后，获取双侧睾丸样本进行组织学分析。采用Fisher精确检验进行统计分析，p值<0.05认为具有统计学意义。免疫荧光试验显示对侧（右侧）睾丸呈阳性，但强度低于扭转侧睾丸。左侧睾丸NBT反应强烈，而右侧睾丸可见轻微反应。在第3组中，左侧扭转睾丸表现为弥漫性水肿伴细胞清除和生精小管广泛坏死。对侧睾丸组织学损伤为中度至轻度。
沉积在生精小管基底膜上的自身免疫性IgG介导机制似乎参与了对侧睾丸损伤的发生。
