Khezri Mohammad Rafi, Ghasemnejad-Berenji Hojjat, Ghasemnejad-Berenji Morteza
Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran.
Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran.
J Pediatr Urol. 2023 Oct;19(5):545.e1-545.e7. doi: 10.1016/j.jpurol.2023.06.016. Epub 2023 Jun 21.
Testicular torsion is a known urologic emergency condition and one of the common causes of infertility in males. Hence, prompt diagnosis and treatment play a crucial role in prevention of testicular injury. It has been observed that empagliflozin, a drug for management of hyperglycemia, has anti-oxidative properties against different pathologies, the most important of which are ischemia reperfusion related injuries.
This study aims to evaluate the protective effects of empagliflozin on a testicular torsion injury in adolescent rats followed by ischemia/reperfusion (I/R) phenomena.
Thirty-six rats were randomly assigned into three groups including sham-operated group received all surgical procedures except testicular torsion-detorsion, torsion/detorsion + dimethyl sulfoxide (DMSO) as vehicle, and torsion/detorsion + empagliflozin (10 mg/kg). Testicular torsion was performed for 2 h through rotating right testis 720° in the clockwise direction. Thirty minutes before detorsion, a single intraperitoneal dose of empagliflozin was injected to treatment group. Four hours later, orchiectomy was conducted for histopathological and biochemical examinations of testicular tissue specimens.
The malondialdehyde (MDA) content in the torsion/detorsion animals was markedly greater than in the animals under sham operated procedure. Moreover, the testicular MDA levels in the torsion/detorsion + empagliflozin group were significantly lower than in the torsion/detorsion group. Also, significant decreases observed in catalase, superoxide dismutase, and glutathione peroxidase activities in the torsion/detorsion group in comparison with sham operated group. These values were significantly improved in the empagliflozin group. Furthermore, histopathological examinations also revealed severe testicular injury which were improved by empagliflozin administration.
Empagliflozin prevented increases in oxidative stress markers and subsequently reduced the tissue injury induced by torsion/detorsion in the current study.
It can be concluded that administration of empagliflozin before prevents I/R related cellular damage in testicular torsion, possibly via oxidative stress inhibition.
睾丸扭转是一种已知的泌尿外科急症，也是男性不育的常见原因之一。因此，及时诊断和治疗对预防睾丸损伤起着至关重要的作用。据观察，恩格列净是一种用于治疗高血糖的药物，对不同病理状况具有抗氧化特性，其中最重要的是与缺血再灌注相关的损伤。
本研究旨在评估恩格列净对青春期大鼠睾丸扭转损伤后缺血/再灌注（I/R）现象的保护作用。
36只大鼠被随机分为三组，包括假手术组，该组接受除睾丸扭转-复位之外的所有手术操作；扭转/复位+二甲亚砜（DMSO）作为赋形剂组；以及扭转/复位+恩格列净（10毫克/千克）组。通过将右侧睾丸顺时针旋转720°进行2小时的睾丸扭转。在复位前30分钟，向治疗组腹腔注射单次剂量的恩格列净。4小时后，进行睾丸切除术，以对睾丸组织标本进行组织病理学和生化检查。
扭转/复位组动物的丙二醛（MDA）含量明显高于假手术组动物。此外，扭转/复位+恩格列净组的睾丸MDA水平明显低于扭转/复位组。而且，与假手术组相比，扭转/复位组的过氧化氢酶、超氧化物歧化酶和谷胱甘肽过氧化物酶活性显著降低。恩格列净组的这些值有显著改善。此外，组织病理学检查还显示存在严重的睾丸损伤，而恩格列净给药可使其得到改善。
在本研究中，恩格列净可防止氧化应激标志物增加，进而减少扭转/复位诱导的组织损伤。
可以得出结论，术前给予恩格列净可预防睾丸扭转中与I/R相关的细胞损伤，可能是通过抑制氧化应激实现的。
