Abstract
BackgroundTesticular torsion/detorsion triggers tissue ischemia/reperfusion, leading to reactive oxygen species overgeneration and apoptosis. The saliva of leeches is full of anti-inflammatory, anticoagulants, antioxidants, and antimicrobial agents. Therefore, this study aimed to assess the protective mechanism of leech therapy on testicular ischemia/reperfusion damage.Methods18 adult male rats were randomly divided into three groups: 1-Sham-operated group (SO). 2-Torsion/detorsion (T.D) group: two hours of testicular torsion with two hours of testicular detorsion was performed. 3-Torsion/detorsion + Leech therapy (TDL) group. Sperm parameters (motility, vitality, morphology, and concentration), oxidative stress biomarkers (MDA, CAT, GPx, and TAC), histopathological factors (Mean seminiferous tubular diameter, Germinal epithelial cell thickness, Testicular capsule thickness, Johnson’s score, and Cosentino’s score), and immunohistochemical markers for apoptosis detection (Bax, Bcl-2, and Caspase-3) were measured.ResultsThere was a significant difference for all sperm parameters in the T. D group compared to the sham group. Leech therapy significantly increased progressive motility and normal morphology and reduced non-progressive motility. In the TDL group, MDA concentration significantly reduced, and levels of GPx, TAC, and CAT remarkably increased. All evaluated histopathological parameters in the TDL group significantly increased compared to the T. D group except for the testicular capsule thickness. T. D notably increased the expression of Bax and Caspase-3, while the treatment group slowed the rate of apoptosis compared to the control group. Bcl-2 expression in the T. D group was significantly lower than that in the sham group. Leech therapy increased the Bcl-2 expression.ConclusionLeech therapy attenuates damages to testicular tissue following torsion/detorsion due to its antioxidant, anti-inflammatory, and anti-apoptotic effects. Hence, it can be considered as an effective remedy for testicular ischemia/reperfusion.Graphical abstract
Highlights
Testicular torsion/detorsion triggers tissue ischemia/reperfusion, leading to reactive oxygen species overgeneration and apoptosis
Our findings revealed that testicular ischemia/reperfusion caused oxidative damage by increasing MDA levels and reducing glutathione peroxidase (GPx), total antioxidant capacity (TAC), and catalase activity (CAT) both in the plasma and testicular tissue samples compared to the sham group
Evaluation of sperm parameters in the present study indicated that testicular torsion/detorsion reduced progressive motility and increased non-progressive and immotile sperm cells compared to the sham group
Summary
Testicular torsion/detorsion triggers tissue ischemia/reperfusion, leading to reactive oxygen species overgeneration and apoptosis. One in 4000 men may experience this complication in their life [1] Once this complication is diagnosed, surgical intervention should be performed as soon as possible to correct it [2]. The sooner this disorder is diagnosed and treated, the less testicular tissue remains in the ischemic state, and the injury to testicular tissue is reduced [3]. Ischemia/reperfusion (I/R) of testicular tissue occurring after torsion/detorsion is responsible for testicular damages and is known to be the main pathophysiology of this disorder [4]. Previous studies concerning testicular torsion revealed that several groups of drugs are effective in decreasing testicular injuries including antioxidants, calcium channel blockers, antiinflammatory agents, vasodilator agents, anti-platelets, phytotherapeutics, and anti-thrombotic agents [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
