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Wang LH, Zheng L, Jiang H, Jiang T. Research advances in inflammation and oxidative stress in varicocele-induced male infertility: a narrative review. Asian J Androl 2025; 27:177-184. [PMID: 39422624 PMCID: PMC11949455 DOI: 10.4103/aja202488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/28/2024] [Indexed: 10/19/2024] Open
Abstract
ABSTRACT Varicocele, the most common and treatable cause of male infertility, significantly impacts fertility. The pathophysiological mechanisms of varicocele have not been fully understood yet. Recent studies have focused on the pathophysiology of varicocele-induced infertility, highlighting inflammation and oxidative stress as key contributing factors. We reviewed recent research on the roles of inflammation and oxidative stress in the pathophysiology of varicocele and found that they negatively impact semen parameters, spermatogenesis, and testicular and epididymal function. In addition, this article summarizes the related factors of inflammation and oxidative stress caused by varicocele. Finally, a brief consideration on the treatments to address inflammation and oxidative stress is proposed. This review may provide treatment options and targets for varicocele-induced infertility. However, the relationship between inflammation and oxidative stress in varicocele still needs further study.
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Affiliation(s)
- Li-Hong Wang
- Department of Andrology and Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian 116023, China
- Institution of Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian 116023, China
| | - Lei Zheng
- Department of Andrology and Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian 116023, China
- Institution of Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian 116023, China
| | - Hui Jiang
- Department of Andrology, Peking University First Hospital, Beijing 100191, China
| | - Tao Jiang
- Department of Andrology and Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian 116023, China
- Institution of Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian 116023, China
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Mei Y, Xie P, Liu D, Zhang B, Feng X. Mean platelet volume might be an effective indicator of poor semen quality in varicocele patients. Int Urol Nephrol 2024; 56:3437-3446. [PMID: 38789870 PMCID: PMC11464651 DOI: 10.1007/s11255-024-04089-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVE To delve into the relationship between mean platelet volume (MPV) and semen quality in patients with varicocele. MATERIALS AND METHODS A total of 246 varicocele patients and 120 healthy adult males were enrolled. Physical examinations and the color Doppler ultrasonography were conducted on patients with varicocele to confirm the diagnosis. Venous blood samples and semen samples were collected from all participants for subsequent analysis. A series of statistical analyses were conducted to assess the relationship between their MPV levels and semen quality. A series of statistical analyses were performed to assess the relationship between MPV and semen quality. RESULTS No statistically significant differences were found between body mass index (BMI), sexual hormones, semen volume, platelet count, and right testicular volume in all three groups (health subjects, varicocele without symptoms, and varicocele with infertility). When conducting regression analysis on two groups with varicocele, the results indicated that a lower MPV is associated with a reduced risk of varicocele accompanied by infertility (OR = 0.557 95% CI: 0.432-0.719, P < 0.001). Further correlation analysis in varicocele patients revealed that high MPV had a statistically negative impact on the occurrence of poor semen quality, affecting sperm concentration, progressive motility, and morphology (all P < 0.001). More importantly, when predicting varicocele associated with infertility, MPV demonstrated high diagnostic sensitivity (AUC = 0.745, P < 0.001). CONCLUSION Our results indicate that MPV is higher in varicocele with infertility and is closely related to semen quality, which may suggest an accompanying decline in semen quality associated with varicocele. However, these conclusions require further experimental validation.
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Affiliation(s)
- Yangyang Mei
- Department of Urology, Jiangyin People's Hospital of Jiangsu Province, Jiangyin, China
| | - Pinpeng Xie
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, Anhui, China
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Dalu Liu
- Department of General Surgery, The Affiliated Chuzhou Hospital of Anhui Medical University, Chuzhou, Anhui, China.
| | - Bo Zhang
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Xingliang Feng
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
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Panner Selvam MK, Agarwal A, Baskaran S. Proteomic analysis of seminal plasma from bilateral varicocele patients indicates an oxidative state and increased inflammatory response. Asian J Androl 2020; 21:544-550. [PMID: 31006709 PMCID: PMC6859669 DOI: 10.4103/aja.aja_121_18] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Seminal plasma is a rich source of proteins and serves as an ideal sample for proteomic analysis of male infertility. In varicocele-associated infertility, the contributory role of seminal plasma proteins specific to unilateral and bilateral varicocele is not clear. Furthermore, there is a lack of specific protein biomarker to differentiate bilateral from unilateral varicocele. The main objective is to identify the differentially regulated molecular and cellular pathways in bilateral varicocele. Furthermore, we intend to identify seminal plasma biomarkers to differentiate bilateral and unilateral varicocele patients in comparison with fertile healthy men. Global proteomic analysis of seminal plasma proteins has identified the functionality of differentially expressed proteins (DEPs) in varicocele patients. Bioinformatic analysis has revealed response to reactive oxygen species and oxidative stress, and tissue homeostasis as top process pathways that are affected in bilateral varicocele patients compared to fertile healthy men. In comparison with unilateral varicocele patients, inflammatory response pathways were dysregulated, especially interleukin 6 (IL-6) signaling and Janus kinase-signal transducer and activator of transcription (Jak-STAT) pathways, in bilateral varicocele patients, owing to the involvement of underexpressed DEPs. Key DEPs associated with oxidative stress (peroxiredoxin 2; PRDX2), DNA fragmentation (fatty acid synthase; FASN), and inflammatory response (fibronectin 1; FN1) validated by western blot analysis revealed differential expression of these proteins in unilateral and bilateral varicocele groups. Altered expression of DEPs and its association with key processes show that the seminal plasma homeostasis is compromised in bilateral varicocele patients. Furthermore, we propose PRDX2, FASN, and FN1 as potential noninvasive seminal plasma markers for the differentiation of unilateral and bilateral varicocele patients.
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Affiliation(s)
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
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Demirer Z, Karademir I, Uslu AU, Güragac A, Aksu Y. The relationship between inflammation and mean platelet volume in varicocele pathophysiology. Rev Int Androl 2018; 16:137-142. [PMID: 30286867 DOI: 10.1016/j.androl.2017.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 05/09/2017] [Accepted: 06/04/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The mean platelet volume (MPV) is an extensively employed laboratory indicator related to platelet volume and function in inflammatory circumstances. The aim of this study was to assess the relationship between inflammation and mean platelet volume in varicocele pathophysiology. METHODS We conducted a recent study, which included 131 varicocele subjects and 82 healthy controls. The identification of varicocele was based on the results from both physical examination and color Doppler ultrasound. We analyzed some laboratory markers including haemogram tests in two groups. RESULTS There were no significant differences in the two groups in terms of baseline characteristics. MPV values were statistically higher in the varicocele group (9.73±0.86fL) than in the control group (9.03±0.70fL) (p<0.001). However, no significant relationship between MPV and varicocele grade was found. Furthermore, the receiver-operating characteristic curve analysis suggested the optimum MPV cut-off value for patients with varicocele as 9.05, with a sensitivity and specificity of 77% and 50%, respectively (p<0.001). CONCLUSION MPV can offer information on varicocele pathophysiology. Increased MPV levels in varicocele patients may be associated with inflammation.
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Affiliation(s)
- Zafer Demirer
- Department of Urology, Eskisehir Military Hospital, Eskisehir, Turkey.
| | - Ibrahim Karademir
- Department of Radiology, Eskisehir Military Hospital, Eskisehir, Turkey
| | - Ali Ugur Uslu
- Department of Internal Medicine, Eskisehir Military Hospital, Eskisehir, Turkey
| | - Ali Güragac
- Department of Urology, Tatvan Military Hospital, Bitlis, Turkey
| | - Yusuf Aksu
- Department of Radiology, Eskisehir Military Hospital, Eskisehir, Turkey
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Demirer Z, Güragac A, Uguz S, Uslu AU, Zor M. RE: White blood cell counts and neutrophil to lymphocyte ratio in the diagnosis of testicular cancer: a simple secondary serum tumor marker. Int Braz J Urol 2016; 42:1251-1252. [PMID: 27813388 PMCID: PMC5117987 DOI: 10.1590/s1677-5538.ibju.2016.0319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 07/06/2016] [Indexed: 02/07/2023] Open
Affiliation(s)
- Zafer Demirer
- Department of Urology, Eskisehir Military Hospital, Eskisehir, Turkey
| | - Ali Güragac
- Department of Urology, Tatvan Military Hospital, Bitlis Turkey
| | - Sami Uguz
- Department of Urology, Gülhane Military Medical Faculty School of Medicine, Ankara, Turkey
| | - Ali Ugur Uslu
- Department of Internal Medicine, Eskisehir Military Hospital, Eskisehir, Turkey
| | - Murat Zor
- Department of Urology, Gülhane Military Medical Faculty School of Medicine, Ankara, Turkey
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Gürağaç A, Demirer Z. The neutrophil-to-lymphocyte ratio in clinical practice. Can Urol Assoc J 2016; 10:141. [PMID: 27217863 DOI: 10.5489/cuaj.3587] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ali Gürağaç
- Tatvan Military Hospital, Department of Urology, Bitlis, Turkey
| | - Zafer Demirer
- Eskisehir Military Hospital, Department of Urology, Eskisehir, Turkey
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Uslu AU, Demirer Z, Aydogmus Y. Predictive value of neutrophil–lymphocyte ratio in renal cancer. World J Urol 2016; 34:1701-1702. [DOI: 10.1007/s00345-016-1851-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 05/09/2016] [Indexed: 12/29/2022] Open
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Soner C, Ibrahim K, Ismail B, Muhammet G, Rıza TA, Nihal O. Author response: The relationship between mean platelet volume and inflammation in varicocele pathophysiology. Can Urol Assoc J 2015; 9:E640. [PMID: 26425229 DOI: 10.5489/cuaj.3253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Coban Soner
- Department of Urology, Sevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Keles Ibrahim
- Department of Urology, School of Medicine, AfyonKocatepe University, Afyonkarahisar, Turkey
| | - Biyik Ismail
- Department of Obstetrics and Gynecology, Karacabey State Hospital, Bursa, Turkey
| | - Guzelsoy Muhammet
- Department of Urology, Sevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Turkoglu Ali Rıza
- Department of Urology, Sevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Ocak Nihal
- Department of Biochemistry, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
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