Roidos Christos, Batakoias Christos-Alexandros, Symeonidis Evangelos N, Kaltsas Aris, Tzikoulis Vasileios, Tsampoukas Georgios, Tsiampali Chara, Palapela Natalia, Zachariou Athanasios, Sofikitis Nikolaos, Dimitriadis Fotios
First Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Medical Faculty, Aristotle University, 54124 Thessaloniki, Greece.
Diagnostics (Basel). 2024 Dec 12;14(24):2789. doi: 10.3390/diagnostics14242789.
BACKGROUND/OBJECTIVES: Beta-thalassemia (BTH), a genetic disorder resulting from beta-globin gene mutations, affects over 1.5 million people globally. The disorder's multifactorial impact on male fertility, particularly through oxidative stress (OS), warrants focused study. This review examines the mechanisms of OS in TM, its implications for male infertility, and the potential of antioxidant therapies to mitigate fertility challenges.
A non-systematic review was conducted using the PubMed, Cochrane, and Medscape databases, focusing on studies on beta-thalassemia (BTH), erectile dysfunction (ED), hormonal alterations, and OS. Studies were screened based on relevance, language, and topic, with 71 articles meeting the inclusion criteria after removing duplicates.
The findings reveal that OS, exacerbated by iron overload from regular blood transfusions, is significantly associated with impaired sperm quality and fertility in patients with TM. Iron toxicity affects gonadotropin levels, reduces sperm quality, and contributes to hypogonadism. Additionally, antioxidant therapies show promise in reducing OS-induced sperm damage, though efficacy is limited by a lack of robust clinical trials.
OS plays a considerable role in male infertility among patients with TM, primarily through iron-induced sperm damage and hormonal disruptions. While antioxidant therapies may offer a partial remedy, further research is necessary to understand OS's mechanisms in TM and develop effective fertility treatments. This review highlights the need for personalized antioxidant approaches to improve reproductive outcomes in this population.
背景/目的：β地中海贫血（BTH）是一种由β珠蛋白基因突变引起的遗传性疾病，全球有超过150万人受其影响。该疾病对男性生育能力的多因素影响，尤其是通过氧化应激（OS）产生的影响，值得重点研究。本综述探讨了OS在β地中海贫血中的机制、其对男性不育的影响以及抗氧化疗法缓解生育挑战的潜力。
使用PubMed、Cochrane和Medscape数据库进行了非系统性综述，重点关注关于β地中海贫血（BTH）、勃起功能障碍（ED）、激素改变和OS的研究。根据相关性、语言和主题对研究进行筛选，去除重复项后有71篇文章符合纳入标准。
研究结果表明，定期输血导致的铁过载加剧了氧化应激，这与β地中海贫血患者的精子质量受损和生育能力显著相关。铁毒性会影响促性腺激素水平，降低精子质量，并导致性腺功能减退。此外，抗氧化疗法在减少OS诱导的精子损伤方面显示出前景，不过由于缺乏有力的临床试验，其疗效有限。
氧化应激在β地中海贫血患者的男性不育中起重要作用主要是通过铁诱导的精子损伤和激素紊乱。虽然抗氧化疗法可能提供部分补救措施，但需要进一步研究以了解氧化应激在β地中海贫血中的机制并开发有效的生育治疗方法。本综述强调需要采用个性化的抗氧化方法来改善该人群的生殖结局。
