Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Front Endocrinol (Lausanne). 2023 Jan 31;14:1123999. doi: 10.3389/fendo.2023.1123999. eCollection 2023.
BACKGROUND: Modern societies face infertility as a global challenge. There are certain environmental conditions and disorders that damage testicular tissue and may cause male infertility. Melatonin, as a potential antioxidant, may protect testicular tissue. Therefore, we conducted this systematic review and meta-analysis to evaluate the effects of melatonin in animal models against physical, heat, and ischemic damage to the testicular tissue. METHODS: PubMed, Scopus, and Web of Science were systematically searched to identify animal trials evaluating the protective effect of melatonin therapy on rodent testicular tissue when it is exposed to physical, thermal, ischemic, or hypobaric oxygen stress. Random-effect modeling was used to estimate the standardized mean difference and 95% confidence intervals based on the pooled data. Additionally, the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool was used to assess the risk of bias. The study protocol was prospectively registered in PROSPERO (CRD42022354599). RESULTS: A total of 41 studies were eligible for review out of 10039 records. Studies employed direct heat, cryptorchidism, varicocele, torsion-detorsion, testicular vascular occlusion, hypobaric hypoxia, ischemia-reperfusion, stress by excessive or restraint activity, spinal cord injury, and trauma to induce stress in the subjects. The histopathological characteristics of testicular tissue were generally improved in rodents by melatonin therapy. Based on the pooled data, sperm count, morphology, forward motility, viability, Johnsen's biopsy score, testicular tissue glutathione peroxidase, and superoxide dismutase levels were higher in the melatonin treatment rodent arms. In contrast, the malondialdehyde level in testicular tissue was lower in the treatment rodent arms. The included studies suffered from a high risk of bias in most of the SYRCLE domains. CONCLUSION: This study concludes that melatonin therapy was associated with improved testicular histopathological characteristics, reproductive hormonal panel, and tissue markers of oxidative stress in male rodents with physical, ischemic, and thermal testicular injuries. In this regard, melatonin deserves scientific investigations as a potential protective drug against rodent male infertility. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022354599.
背景:现代社会面临着不孕不育这一全球性挑战。某些环境条件和疾病会损害睾丸组织,导致男性不育。褪黑素作为一种潜在的抗氧化剂,可能对睾丸组织具有保护作用。因此,我们进行了这项系统评价和荟萃分析,以评估褪黑素在动物模型中对物理、热和缺血性睾丸组织损伤的作用。
方法:系统检索了 PubMed、Scopus 和 Web of Science,以确定评估褪黑素治疗对暴露于物理、热、缺血或低氧应激的啮齿动物睾丸组织的保护作用的动物试验。根据汇总数据,采用随机效应模型估计标准化均数差和 95%置信区间。此外,还使用实验室动物实验系统评价中心(SYRCLE)工具评估偏倚风险。该研究方案已在 PROSPERO(CRD42022354599)中进行了前瞻性注册。
结果:从 10039 条记录中筛选出 41 项符合条件的研究。这些研究采用直接加热、隐睾、精索静脉曲张、扭转-复位、睾丸血管闭塞、低氧、缺血再灌注、过度或限制活动应激、脊髓损伤和创伤等方法诱导动物模型产生应激。褪黑素治疗后,啮齿动物睾丸组织的组织病理学特征通常得到改善。根据汇总数据,褪黑素治疗组的精子计数、形态、前向运动、活力、约翰森睾丸组织活检评分、睾丸组织谷胱甘肽过氧化物酶和超氧化物歧化酶水平较高,而睾丸组织丙二醛水平较低。纳入的研究在 SYRCLE 的大多数领域都存在较高的偏倚风险。
结论:本研究表明,褪黑素治疗与改善物理、缺血和热睾丸损伤的雄性啮齿动物的睾丸组织学特征、生殖激素谱和氧化应激组织标志物有关。在这方面,褪黑素作为一种潜在的保护药物,值得对其进行科学研究,以预防雄性啮齿动物不育。
系统评价注册:https://www.crd.york.ac.uk/PROSPERO/,标识符 CRD42022354599。
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