对行睾丸精子抽吸术的非梗阻性无精子症不育患者氧化还原状态的评估：一项前瞻性研究。

Redox status assessment in infertile patients with non-obstructive azoospermia undergoing testicular sperm extraction: A prospective study.

机构信息

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.

出版信息

Andrology. 2020 Mar;8(2):364-371. doi: 10.1111/andr.12721. Epub 2019 Nov 13.

DOI:10.1111/andr.12721

PMID:31654557

Abstract

BACKGROUND

Oxidative stress (OS) is one of the most prevalent causes of sperm damage, through the toxic effects of endogenously generated hydrogen peroxide, superoxide anion, and hydroxyl radicals. Peripheral leukocytes represent a feasible model for studying the pathophysiology of OS-mediated homeostasis, which can be responsible for cell dysfunction and cell injury.

OBJECTIVE

To evaluate the redox status in patients with non-obstructive azoospermia (NOA), establishing the potential role exerted by reactive oxygen species (ROS) in the genesis of testicular secretory injury.

MATERIAL AND METHODS

From May 2018 to March 2019, 39 patients were enrolled in this prospective single-center cohort study and divided into two groups. Group 1 included 19 patients with NOA, and Group 2 included 20 normozoospermic men, partners of women with infertility tubal factor. All patients underwent serum blood tests. NOA underwent testicular sperm extraction (TeSE). ROS production (in lymphocytes, monocytes, and granulocytes) was assessed by fluorescence-activated cell sorting (FACS) analysis. Plasma oxidative stress was evaluated by lipid peroxidation markers (MDA) and total antioxidant capacity (TAC) both assessed by fluorometric techniques.

RESULTS

Mean lymphocyte ROS production resulted 967.0 ± 224.5 vs 728.0 ± 98.0 (NOA vs Controls, P < .001), monocyte ROS resulted 2102.5 ± 517.5 vs 1253 ± 171 (P < .001), and granulocyte ROS were 2366.5 ± 595.4 vs 1751.0 ± 213.0 (P < .001). Significant increases plasma lipid peroxidation markers were found in NOA patients compared with controls (2.7 ± 0.8 vs 0.37 ± 0.2 nmol/mL, P < .001). Significant decreased TAC was evident in NOA compared with controls (13.4 ± 3.9 vs 3.0 ± 0.2 µmol/mL Trolox equivalents, P < .001). No significant differences were found in blood leukocyte subpopulations ROS production, plasma lipid peroxidation, and TAC comparing groups (positive vs negative sperm retrieval, P > .05).

CONCLUSION

ROS production can be directly related to disorders of spermatogenesis, leading to severe conditions of male infertility, including azoospermia.

摘要

背景

氧化应激（OS）是精子损伤最常见的原因之一，通过内源性产生的过氧化氢、超氧阴离子和羟自由基的毒性作用。外周白细胞代表研究 OS 介导的体内平衡的病理生理学的可行模型，它可能导致细胞功能障碍和细胞损伤。

目的

评估非梗阻性无精子症（NOA）患者的氧化还原状态，确定活性氧（ROS）在睾丸分泌损伤发生中的潜在作用。

材料和方法

本前瞻性单中心队列研究于 2018 年 5 月至 2019 年 3 月纳入 39 例患者，分为两组。第 1 组包括 19 例 NOA 患者，第 2 组包括 20 例正常精子计数的男性，为女性不孕输卵管因素的伴侣。所有患者均进行血清学检查。NOA 患者行睾丸精子抽吸术（TeSE）。通过荧光激活细胞分选（FACS）分析评估淋巴细胞、单核细胞和粒细胞中的 ROS 产生。通过荧光技术评估血浆氧化应激标志物（丙二醛（MDA）和总抗氧化能力（TAC））。

结果

平均淋巴细胞 ROS 产生量为 967.0±224.5 比 728.0±98.0（NOA 比对照组，P<.001），单核细胞 ROS 为 2102.5±517.5 比 1253±171（P<.001），粒细胞 ROS 为 2366.5±595.4 比 1751.0±213.0（P<.001）。与对照组相比，NOA 患者的血浆脂质过氧化标志物显著增加（2.7±0.8 比 0.37±0.2 nmol/mL，P<.001）。与对照组相比，NOA 患者的 TAC 显著降低（13.4±3.9 比 3.0±0.2 μmol/mL Trolox 当量，P<.001）。在 ROS 产生、血浆脂质过氧化和 TAC 方面，两组间（精子提取阳性与阴性，P>.05）无显著差异。