Phosphodiesterase inhibitors and testicular torsion: A systematic review and meta-analysis of animal studies.

IF 3.2 2区 医学 Q1 ANDROLOGY
Andrology Pub Date : 2024-10-29 DOI:10.1111/andr.13785
Alessandro V Oliveira, Ana Luiza N Sampaio, Rui W Mascarenhas Junior, Regis B Andriolo
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引用次数: 0

Abstract

Background: Testicular torsion is a common urological emergency in children and teenagers that, in most cases, requires surgical exploration and detorsion. However, even after a successful intervention, a high number of patients still develop irreversible damage.

Objectives: To investigate whether the administration of phosphodiesterase inhibitors (PDE) in animal models of testicular torsion can reduce damages caused by the ischemia-reperfusion syndrome.

Materials and methods: A systematic search of the Medline, Web of Science, Embase, and Ovid databases for studies up to December 2023 was performed using PRISMA guidelines. A detailed search was conducted using the following key terms: "testicles," "ischemia," "reperfusion," and "phosphodiesterase inhibitors." There was no restriction regarding language or year of publication. We investigated spermatogenesis by the Johnsen's biopsy score (JTBS) and histological damage by the Cosentino's biopsy score (CBS). Malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), and glutathione peroxidase (GPx) testicular levels were also analyzed.

Results: Initially, 296 articles were identified. However, only 20 studies met the inclusion criteria. PDE inhibitors improved JTBS (MD = 2.53, CI = 1.94 to 3.13), CBS (MD = -1.11, CI = -1.25 to -0.97) and SOD (SMD = 3.27, CI = 1.59 to 4.95) outcomes. PDE did not improve MDA (SMD = -0.93, CI = -2.19 to 0.34), NO (SMD = -0.54, CI = -1.56 to 0.48), and GPx (SMD = 0.77, CI = -0.38 to 1.92) outcomes. A higher dose of PDE inhibitors only improved CBS outcome.

Discussion and conclusion: This review indicates that the administration of PDE inhibitors in rats ameliorated the outcomes, representing a promising complementary strategy for spermatogenesis recovery following testicular torsion. Our review suggests that JTBS and CBS could be translated into future human studies, validating and extending these findings within the context of human physiopathology, while providing applicability of interventions in real clinical practice.

磷酸二酯酶抑制剂与睾丸扭转:动物研究的系统回顾和荟萃分析。
背景:睾丸扭转是儿童和青少年常见的泌尿外科急症,大多数情况下需要进行手术探查和剥离。然而,即使在成功干预后,仍有很多患者会出现不可逆的损伤:研究在睾丸扭转动物模型中使用磷酸二酯酶抑制剂(PDE)能否减轻缺血再灌注综合征造成的损伤:根据PRISMA指南,对Medline、Web of Science、Embase和Ovid数据库中截至2023年12月的研究进行了系统检索。使用以下关键词进行了详细检索:"睾丸"、"缺血"、"再灌注 "和 "磷酸二酯酶抑制剂"。对语言和发表年份没有限制。我们通过约翰森活检评分(JTBS)和科森蒂诺活检评分(CBS)对精子发生和组织损伤进行了调查。此外,还分析了丙二醛(MDA)、一氧化氮(NO)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GPx)的睾丸水平:初步确定了 296 篇文章。然而,只有 20 项研究符合纳入标准。PDE抑制剂改善了JTBS(MD=2.53,CI=1.94至3.13)、CBS(MD=-1.11,CI=-1.25至-0.97)和SOD(SMD=3.27,CI=1.59至4.95)的结果。PDE不能改善MDA(SMD = -0.93,CI = -2.19 to 0.34)、NO(SMD = -0.54,CI = -1.56 to 0.48)和GPx(SMD = 0.77,CI = -0.38 to 1.92)的结果。较高剂量的 PDE 抑制剂只能改善 CBS 结果:本综述表明,在大鼠体内施用 PDE 抑制剂可改善结果,是睾丸扭转后精子发生恢复的一种很有前景的补充策略。我们的综述表明,JTBS 和 CBS 可转化为未来的人类研究,在人类生理病理学的背景下验证和扩展这些研究结果,同时提供干预措施在实际临床实践中的适用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Andrology
Andrology ANDROLOGY-
CiteScore
9.10
自引率
6.70%
发文量
200
期刊介绍: Andrology is the study of the male reproductive system and other male gender related health issues. Andrology deals with basic and clinical aspects of the male reproductive system (gonads, endocrine and accessory organs) in all species, including the diagnosis and treatment of medical problems associated with sexual development, infertility, sexual dysfunction, sex hormone action and other urological problems. In medicine, Andrology as a specialty is a recent development, as it had previously been considered a subspecialty of urology or endocrinology
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