Henkel Ralf, Sandhu Inderpreet Singh, Agarwal Ashok
Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.
American Centre for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio.
Andrologia. 2019 Feb;51(1):e13162. doi: 10.1111/and.13162. Epub 2018 Sep 26.
Reactive oxygen species and oxidative stress are closely associated with various pathologies such as neurodegenerative diseases, ageing and male infertility. Hence, antioxidants such as vitamin C, vitamin E, N-acetyl cysteine, L-carnitine and folic acid are regularly used in various treatment regimens to protect cells from the damage induced by free radicals. However, given their over-the-counter availability at unnaturally high concentrations and also the fact that they are commonly added to various food products, patients may run a risk of consuming excessive dosages of these compounds, which may then be toxic. The few studies that have assessed antioxidant overuse and the associated adverse effects found that large doses of dietary antioxidant supplements have varying-if any-therapeutic effects even though free radicals clearly damage cells-a phenomenon that has been termed the "antioxidant paradox." Furthermore, overuse of antioxidants such as vitamin C, vitamin E, N-acetyl cysteine may lead to reductive stress, which is reported to be as dangerous to cells as oxidative stress and can be the cause of diseases such as cancer or cardiomyopathy. Therefore, we feel that there is a need for more elaborate research to establish the clear benefits and risks involved in antioxidant therapy for male infertility.
活性氧和氧化应激与多种病理状况密切相关,如神经退行性疾病、衰老和男性不育。因此,维生素C、维生素E、N-乙酰半胱氨酸、左旋肉碱和叶酸等抗氧化剂经常被用于各种治疗方案中,以保护细胞免受自由基诱导的损伤。然而,鉴于它们以非自然的高浓度在非处方可得,而且它们通常被添加到各种食品中,患者可能有摄入过量这些化合物的风险,而这可能是有毒的。少数评估抗氧化剂过度使用及其相关不良反应的研究发现,即使自由基明显会损伤细胞,但大剂量的膳食抗氧化剂补充剂的治疗效果各不相同(如果有效果的话)——这一现象被称为“抗氧化剂悖论”。此外,过度使用维生素C、维生素E、N-乙酰半胱氨酸等抗氧化剂可能会导致还原应激,据报道,还原应激对细胞的危害与氧化应激一样大,并且可能是癌症或心肌病等疾病的病因。因此,我们认为有必要进行更详尽的研究,以明确抗氧化剂治疗男性不育的益处和风险。