Sekerci C A, Tanidir Y, Sener T E, Sener G, Cevik O, Yarat A, Alev-Tuzuner B, Cetinel S, Kervancioglu E, Sahan A, Akbal C
Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey.
Department of Pharmacology, School of Pharmacy, Marmara University, Istanbul, Turkey.
J Pediatr Urol. 2017 Jun;13(3):317.e1-317.e9. doi: 10.1016/j.jpurol.2016.12.016. Epub 2017 Jan 23.
Testicular torsion is a common problem and, to date, there is no agent to preserve testicular function following detorsion. Platelet-rich plasma (PRP), with its rich growth factor composition, has proven beneficial in regenerative therapy. It is believed that PRP has not been studied in testis for ischemia/reperfusion (I/R) injury.
This study investigated the effect of PRP in an I/R rat model 1 month after detorsion.
Of 24 adult male Sprague-Dawley rats, 18 were randomly assigned into three groups, with six in each: control, I/R and I/R + PRP. The PRP was prepared from the remaining six. Each group underwent right orchiectomy. Ischemia was performed by rotating the left testis 720° and fixing with a nylon suture for 4 h. Reperfusion occurred 4 h later by removing the suture, and PRP was administered at a dose of 10 μl (2000 × 10/l) into the left testis via the intraparenchymal route. Animals were sacrificed at the fourth week, and testes were taken for malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), myeloperoxidase (MPO), transforming growth factor β (TGF-β), and caspase-3 measurements.
Ischemia/reperfusion caused a significant increase in MDA, MPO and caspase-3 activity, and significant decrease in GSH levels and SOD activity. The PRP treatment helped correct the alterations in SOD, caspase-3, and MPO activities and MDA levels. However, the mean MDA level and MPO activity were not totally restored compared with the controls. Serum testosterone levels of the I/R group were significantly lower compared with the control and I/R + PRP groups. TGF-β and caspase-3 protein expressions were significantly higher in the I/R group compared with the control group and were low with PRP administration compared with I/R groups (summary Table).
The findings of the present study suggest that PRP, by inhibiting neutrophil infiltration and oxidative stress and increasing antioxidant defense, exerts protective effects on testicular tissues against I/R. This study had some limitations: a scoring system was not used in the assessment of spermatogenesis in the histopathological findings and specific testis cell types were not histologically assessed.
In light of the biochemical, histological and, especially, hormonal findings, intraparenchymal PRP injection may have a protective effect in testicular tissue against I/R injury.
睾丸扭转是一个常见问题,迄今为止,尚无能够在扭转复位后保护睾丸功能的药物。富含血小板血浆(PRP)因其丰富的生长因子成分,已被证明在再生治疗中有益。据信,PRP尚未在睾丸缺血/再灌注(I/R)损伤方面进行研究。
本研究调查了PRP在扭转复位1个月后的I/R大鼠模型中的作用。
24只成年雄性Sprague-Dawley大鼠中,18只被随机分为三组,每组6只:对照组、I/R组和I/R + PRP组。PRP由其余6只大鼠制备。每组均行右侧睾丸切除术。通过将左侧睾丸旋转720°并用尼龙缝线固定4小时来制造缺血。4小时后移除缝线进行再灌注,并通过实质内途径以10μl(2000×10/μl)的剂量将PRP注入左侧睾丸。在第四周处死动物,取睾丸进行丙二醛(MDA)、谷胱甘肽(GSH)、超氧化物歧化酶(SOD)、髓过氧化物酶(MPO)、转化生长因子β(TGF-β)和半胱天冬酶-3的测量。
缺血/再灌注导致MDA、MPO和半胱天冬酶-3活性显著增加,GSH水平和SOD活性显著降低。PRP治疗有助于纠正SOD、半胱天冬酶-3和MPO活性以及MDA水平的改变。然而,与对照组相比,平均MDA水平和MPO活性并未完全恢复。I/R组的血清睾酮水平与对照组和I/R + PRP组相比显著降低。与对照组相比,I/R组中TGF-β和半胱天冬酶-3蛋白表达显著更高,与I/R组相比,PRP给药后表达较低(汇总表)。
本研究结果表明,PRP通过抑制中性粒细胞浸润和氧化应激并增强抗氧化防御,对睾丸组织免受I/R损伤发挥保护作用。本研究存在一些局限性:在组织病理学检查结果中评估精子发生时未使用评分系统,并且未对特定睾丸细胞类型进行组织学评估。
根据生化、组织学尤其是激素方面的研究结果,实质内注射PRP可能对睾丸组织免受I/R损伤具有保护作用。