Department of Surgery, Division of Urology, Human Reproduction Section, Universidade Federal de São Paulo, São Paulo, Brazil.
Miami Project to Cure Paralysis and Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.
Hum Fertil (Camb). 2022 Jul;25(3):548-556. doi: 10.1080/14647273.2020.1870756. Epub 2021 Jan 12.
Varicocele has been hypothesized to lead to seminal inflammation, which in turn interferes with sperm function. Thus, the aim of this study was to investigate the role of inflammatory cytokines in the pathogenesis of decreased semen quality observed in adult men with varicocele, and to determine if varicocelectomy corrects these potential alterations. A prospective study was carried out including fifteen control men without varicocele and with normal semen quality and 15 men with varicocele with surgical indication. Men with varicocele grades II or III underwent microsurgical subinguinal varicocelectomy. Controls collected one semen sample and men with varicocele collected one before and one 6 months after the surgery. Semen analysis, sperm function, and seminal lipid peroxidation levels were assessed. Seminal plasma inflammasome activity was evaluated by ELISA assays for IL-1β, IL-18 and caspase-1 and by Western blotting for ASC (apoptosis-associated speck-like protein). Groups were compared by an unpaired Student's T test. Varicocelectomy samples were compared using a paired Student's T test ( = 5%). Men with varicocele had decreased semen quality, and increased seminal IL-1β levels, when compared to control men. Varicocelectomy decreased levels of caspase-1, IL-18, and IL1β. Thus, varicocelectomy improves sperm morphology and decreases seminal plasma inflammatory activity, after a six-month post-operative period.
精索静脉曲张被认为会导致精液炎症，进而干扰精子功能。因此，本研究旨在探讨炎症细胞因子在精索静脉曲张成年男性精液质量下降中的发病机制中的作用，并确定精索静脉结扎术是否可以纠正这些潜在的改变。本前瞻性研究纳入了 15 名无精索静脉曲张且精液质量正常的对照组男性和 15 名具有手术指征的精索静脉曲张男性。精索静脉曲张 II 或 III 级的男性接受了显微精索下静脉结扎术。对照组收集了一份精液样本，精索静脉曲张男性在手术前和手术后 6 个月各收集了一份精液样本。评估了精液分析、精子功能和精液脂质过氧化水平。通过 ELISA 检测 IL-1β、IL-18 和 caspase-1 以及 Western blot 检测 ASC（凋亡相关斑点样蛋白）评估精液炎症小体活性。通过独立样本 t 检验对各组进行比较。使用配对样本 t 检验（n=5%）对精索静脉结扎术样本进行比较。与对照组男性相比，精索静脉曲张男性的精液质量下降，并且精液中 IL-1β 水平升高。精索静脉结扎术降低了 caspase-1、IL-18 和 IL1β 的水平。因此，在术后 6 个月，精索静脉结扎术可以改善精子形态并降低精液炎症活性。
