P-086 AZF Microdeletions: A New Look at Past Paradigms

Study question

To elucidate whether AZF screening is indicated in men with proven non-obstructive azoospermia (NOA) or severe oligozoospermia (<5x106 sperm/mL) who concomitantly harbor chromosomal abnormalities.

Summary answer

Some chromosomal aberrations are concomitant with AZF microdeletions, and hence Y chromosome microdeletion (YCM) screening is necessary for these patients.

What is known already

In the era of assisted reproduction, finding cost-minimization strategies in infertility clinics without affecting the quality of diagnosis and treatment is becoming one of the top-priority topics for future research. Formulating definitive guidelines concerning the indications for paraclinical testing could be one of the strategies. Accordingly, definitive guidelines for AZF screening do not exist especially in men who also have chromosomal abnormalities. The current clinical practice is to decide per case whether to pursue further molecular testing, with the accompanying added psychological and socio-economic burden.

Study design, size, duration

An observational retrospective cohort study of 10,388 consecutive cases from a tertiary infertility referral center (Royan institute, Tehran, Iran) over the last 12 years. A comprehensive literature review was also performed to summarize scientific evidence.

Participants/materials, setting, methods

The study recruited the largest cohort of men with primary infertility (NOA or severe oligozoospermia) ever presented who underwent screening for cytogenetic abnormalities and YCMs using sequence-tagged sites-polymerase chain reaction (STS-PCR) with a primer set covering the AZF regions according to the EAA/EMQN guidelines, as part of the infertility workup prior to ART.

Main results and the role of chance

In total, one-third of men with YCMs concomitantly had an abnormal karyotype (excluding those with heteromorphisms) (169/565; 29.9%, 95% CI: 26.3-33.8). In respect to the frequency of YCMs, our findings suggest that the cases diagnosed with 46,X,add(X) with incidence of 1.8% (3/169; 95% CI: 0.6-5.1); 45,X and mosaic forms: 45,X/46,X,inv(Y)(p11.2q12); 45,X/46,X,del(Y); 45,X,der(Y;Autosome); 45,X/46,X,idic(Y)(p11.2); 45,X/46,XY,r(Y); and 45,X/46,X,idic(Y)(q11.2) (19/169; 11.2%, 95% CI: 7.3-16.9); and inv(Y)(p11.2q12) (2/169; 1.2%, 95% CI: 0.3-4.2) should also be referred for AZF deletion screening, as data suggests they are accompanied with YCMs.

Limitations, reasons for caution

The extension of the outcomes beyond the described population could introduce concerns on appropriate medical management. Confirmatory studies in other geographic/ethnic groups are still necessary to reach a consensus regarding the outcomes.

Wider implications of the findings

It has been recommended that all men with NOA who have chromosomal abnormalities, except those with 46,XY/45,X karyotype, do not need AZF testing. The results reflect a crucial need for reconsidering whether YCM testing is indicated in the population of men with certain karyotypic abnormalities.

Trial registration number

Not Applicable

Taurine effects on Bisphenol A-induced oxidative stress in the mouse testicular mitochondria and sperm motility

Objectives:

This study was performed to investigate the protective effects of taurine (2-aminoethanesulfonic acid, TAU) on oxidative stress in the isolated mouse testicular mitochondria, mitochondrial membrane potential (MMP), viability and motility of the exposed sperms to the BPA.

Methods:

We treated epididymal spermatozoa obtained from mice and isolated mouse testicular mitochondria with BPA (0.8 mmol/mL) and various doses of TAU (5, 10, 30 and 50 µmol/L). We used the MTT assay and Rhodamine 123 uptake to assess sperm viability and MMP. We assessed the oxidative stress through measuring ROS (reactive oxygen species), MDA (malondialdehyde), GSH (glutathione), and SOD (super-oxide dismutase) levels in the testicular mitochondrial tissue.

Results:

BPA significantly elevated ROS, MDA and MMP levels, and markedly reduced SOD and GSH levels in the isolated mitochondria. BPA also considerably impaired spermatozoa viability and motility. Pretreatment with 30 and 50 µmol/L of TAU could considerably suppressed mitochondrial oxidative stress, enhanced MMP, and improved sperm motility and viability.

Conclusion:

TAU may attenuate the BPA-induced mitochondrial toxicity and impaired sperm motility via decreasing oxidative stress.

Upregulation of Nrf2-related cytoprotective genes expression by acetaminophen-induced acute hepatotoxicity in mice and the protective role of betaine

Overdose of acetaminophen (APAP) is the main reason for acute liver failure. Oxidative stress is associated with hepatotoxicity caused by APAP. Betaine is a methyl donor and S-adenosylmethionine precursor. The present study investigated the effect of betaine and the role of nuclear factor-erythroid-2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) genes in hepatotoxicity induced by APAP in mice. In this study, male Naval Medical Research Institute (NMRI) mice were treated with 500 mg/kg of betaine for 5 days followed with a single dose of APAP 300 mg/kg on the fifth day. Biochemical, histological, immunohistochemical, Western blot, and real-time polymerase chain reaction (PCR) analyses were then conducted. The results of the present study showed that betaine pretreatment improved hepatotoxicity through the reduction of serum ALT and AST levels and ameliorating histopathological finding. Betaine pretreatment also increased glutathione level and decreased malondialdehyde level. Importantly, the results of immunohistochemical, Western blot and real-time PCR showed that the APAP increased the expression of the genes and proteins of Nrf2 and HO-1. While betaine decreased Nrf2 and HO-1 expression in comparison with the APAP group. The findings of this study demonstrated that the increased expression of Nrf2 and HO-1 genes and proteins by APAP is a compensatory mechanism to combat acute liver toxicity. While the protective effect of betaine against acute liver injury induced by APAP is independent on the Nrf2 and HO-1 genes but occurs via modifying cysteine supply as a precursor of glutathione in the transsulfuration pathway in the liver.

Decline in peripheral blood NKG2D+CD3+CD56+ NKT cells in metastatic colorectal cancer patients

OBJECTIVE

Colorectal cancer (CRC) is one of the main causes of cancer deaths in the world. This cancer can be divided into non-metastatic and metastatic CRC stages. CD3+CD56+ NKT cell subsets are a minor T cell subset in peripheral blood and conduct the killing of tumor cells in direct manner. Little is obvious about levels and surface markers of these cells such as NKG2D in different cancers, especially in CRC.

METHODS

We included 15 non-metastatic (low-grade), 11 non-metastatic (high-grade), 10 metastatic colorectal cancer patients and 18 healthy controls. The percentages of CD3+CD56+ NKT cells and NKG2D+CD56+ NKT cells from samples were analyzed by flow cytometry in peripheral blood mononuclear cells (PBMCs) of samples.

RESULTS

We found that there was a significantly lower number of NKG2D+CD3+CD56+ cells in peripheral blood of patients with metastatic colorectal cancer compared with normal controls (77.53 ± 5.79 % vs 90.74 ± 9.84 %; p<0.01).

CONCLUSION

The fact that frequency of NKG2D+CD56+ NKT cells was significantly lower in patients with metastatic colorectal cancer compared to healthy controls strengthens the hypothesis that NKT cells can play a substantial role in the protection against human colorectal cancer, and this opens up avenues for novel studies about elucidating the other aspects of tumor surveillance in CRC progression and immunotherapy (Tab. 2, Fig. 2, Ref. 46).

Chemical composition and antifungal effect of hydroalcoholic extract of Allium tripedale (Tvautv.) against Candida species

Background and Purpose

Treatment of life-threatening fungal infections caused by Candida species has become a major problem. Candida spp. are the most important causative agents of candidiasis. Allium tripedale is a medicinal plant that has been traditionally used to treat infections. In the present study, we aimed to determine the chemical compounds and antimicrobial activity of hydroalcoholic extract of A. tripedale against different species of Candida.

Materials and Methods

Phytochemical analysis was performed to identify the possible bioactive components of this extract by using gas chromatography and mass spectroscopy (GC-MS). The hydroalcoholic extract of A. tripedale were collected. Different concentrations of A. tripedale (50, 25, 12.5, and 6.25 mg/ml) were used to evaluate its antifungal activity against Candida species (C. albicans, C. parapsilosis, and C. krusei) using disk diffusion assay.

Results

The GC-MS analysis revealed the presence of 40 different phytoconstituents with peak area; the major compounds were tetracosane, hexadecanoic acid, 1-eicosanol, 1,2-dihydro-pyrido[3,2,1-kl]phenothiazin-3-one, 2-hexadecen-1-ol, and 3,7,11,15-tetramethyl. Hydroalcoholic extract showed strong antimicrobial activity (inhibition zone ⩾ 20 mm), moderate antimicrobial activity (inhibition zone < 12-20 mm), and no inhibition (zone < 12 mm). In addition, the hydroalcoholic extract exhibited the highest antimicrobial properties against C. albicans strains.

Conclusion

A. tripedale extract had a considerable inhibitory effect against various Candida species, but its highest inhibitory effect was against Candid albicans. Further investigations are required to detect the performance of this plant in the treatment of Candida infection.

Glyoxal toxicity in isolated rat liver mitochondria

Glyoxal is a physiological metabolite formed by lipid peroxidation, ascorbate autoxidation, oxidative degradation of glucose, and degradation of glycated proteins. Glyoxal has been linked to oxidative stress and can cause a number of cellular damages, including covalent modification of amino and thiol groups of proteins to form advanced glycation end products. However, the mechanism of glyoxal toxicity has not been fully understood. In this study, we have focused on glyoxal toxicity in isolated rat liver mitochondria. Isolated mitochondria (0.5 mg protein per milliliter) were prepared from the Wistar rat liver using differential centrifugation and incubated with various concentrations of glyoxal (1, 2.5, 5, 7.5, and 10 mM) for 30 min. The activity of mitochondrial complex II was determined by measurement of MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) conversion. The mitochondrial membrane potential (MMP), lipid peroxidation (MDA), reactive oxygen species (ROS) formation, glutathione (GSH) content, and protein carbonylation were also assessed. After an incubation of isolated liver mitochondria with glyoxal, disrupted electron transport chain, increased mitochondrial ROS formation, lipid peroxidation, mitochondrial membrane damage, GSH oxidation, and protein carbonylation ensued as compared to the control group ( p < 0.05). Glyoxal toxicity in isolated rat liver mitochondria was dose-dependent. In conclusion, glyoxal impaired the electron transport chain, which is the cause of increased ROS and MDA production, depletion of GSH, and disruption of MMP. Mitotoxicity of glyoxal might be related to the pathomechanisms involved in diabetes and its complications.

The decrease in NKG2D+ Natural Killer cells in peripheral blood of patients with metastatic colorectal cancer

BACKGROUND

Natural killer (NK) cells play important roles in the immune defense against tumors such as colorectal cancer. In humans, NKG2D is an activating immune receptor constitutively expressed in most cytotoxic lymphocytes including NK and CD8+ T cells. In this study, the expression of NKG2D molecule was investigated in peripheral blood NK cells from colorectal cancer patients and compared with healthy subjects.

METHODS

We studied 21 non-metastatic (low-grade), 17 non-metastatic (high-grade), 16 metastatic colorectal cancer patients, and 24 healthy controls. Peripheral blood samples were obtained to isolate peripheral blood mononuclear cells (PBMCs) and the percentage of peripheral blood NKG2D+CD3-CD56+ NK cells was analyzed by flow cytometry. The expression of NKG2D at mRNA level was also measured by real-time PCR in both, patients and control subjects.

RESULTS

The results showed a significant reduction in the percentage of NKG2D+NK cells as well as NKG2D mRNA expression in peripheral blood of metastatic colon cancer patients.

CONCLUSION

This result suggests that decreased expression of activating NKG2D receptor in metastatic colorectal cancer might compromise NK cell function and allow tumor to evade immunity (Tab. 3, Fig. 4, Ref. 33).

Cardiorespiratory fitness, activity level, health-related anthropometric variables, sedentary behaviour and socioeconomic status in a sample of Iranian 7-11 year old boys

The purpose of this study was to evaluate cardiorespiratory fitness (CRF), activity level, some health-related anthropometric variables, sedentary behaviour and socioeconomic status (SES) of 7-11 year old boys in the city of Ardabil, Iran. Of 21 253 school boys aged 7-11 years, 766 participated in this study using the cluster sampling method. Subjects underwent standard anthropometry. One-mile test was used to evaluate V.O₂ max. BMI cut-off points were used to identify weight status. Child's TV watching and video playing daily time (TVVPT) was taken for sedentary behaviour evaluation. SES and activity level were measured by standard questionnaires. Of all participants, 8.9% (N=68) of students had CRF lower than normal and 58.6% (N=449) of them had inadequate physical activity. There was a significant adverse relationship between V.O₂ max and body mass index (BMI), waist to height ratio (WHtR), waist circumference (WC), and fat mass (FM) (p<0.05). A significant direct association between SES and both FM and TVVPT was observed (p<0.05). Significantly lower physical activity and V.O₂ max, and higher TVVPT were observed in the obese boys than their counterparts (p<0.05). The results of this study indicated a significant relationship between CRF and physical activity, and health-related anthropometric variables in a selected sample of 7-11 year boys. Moreover, the obese subjects had not only lower physical activity but also longer sedentary behaviour time than their counterparts.

Genotoxicity study of Hypiran and Chamomilla herbal drugs determined by in vivo supervital micronucleus assay with mouse peripheral reticulocytes

The growth in popularity of Over The Counter (OTC) of medicinal products or other natural sources have taken a very large share of healthcare system therefore it is essential to determine their safety as for as public health is concerned.In this study Maximum Tolerated Dose (MTD) was obtained according to CSGMT protocol presented by the Environmental Mutagen Society of Japan. The positive group received mitomycin C in dose of 0.5 mg/kg. The peripheral blood samples before treatment (zero time) were considered as negative control. The MTD of Hypiron was 12 ml/kg and for Chamomilla was 10 ml/kg. Doses of MTD, 1/2 MTD and 1/4 MTD were considered for test groups. Then blood samples were prepared 48 hours after first administration of drugs and kept on precoated Acridine orange slides. The scoring of micronucleated reticulocytes were carried out per 2000 counted reticulocytes in each slide by fluorescent microscope. The results were statistically analyzed. Results of Hypiran were compared with negative control group and the P value was P > 0.05, but the p value of Chamomilla was P < 0.05. Also, the p value of Hypiran and Chamomilla compared with historical negative control group was less, therefore Chamomilla herbal drog can be classified as equivocul category of genotoxicity and Hypiran did not show genotoxicity.

The genotoxicity study of garlic and pasipy herbal drops by peripheral blood micronucleus test

The in vivo rodent micronucleus test is widely used as a genotoxic assay to detect the clastogenic activity of chemicals. In this research the genotoxic effects of herbal drops of garlic and pasipy were evaluated using the micronucleus test. Maximum Tolerated Dose (MTD) was determined by a dose-response test. For each medicine three treatment groups were considered with doses of MTD, 1/2 MTD and 1/4 MTD according to the CSGMT protocol (1995 Japan). Drugs were administered orally to mice (test groups). Mitomicin C was used as a known genotoxic agent in positive control group. The peripheral blood samples before treatment (zero time samples) were considered as negative control. The appearance of a micronucleus is used as an index for genotoxic potential. The results obtained indicated that the herbal drops showed genotoxicity effect and it was dose-dependent compared to the negative control group. This genotoxicity was significant (p < 0.05) but the genotoxic effects of garlic and pasipy were "not significant" compared to the historical negative control group (p > 0.05). Therefore our results if compared to the negative control group is significant and it is worthy of consideration.

The protective effect of garlic oil on hepatotoxicity induced by acetaminophen in mice and comparison with N-acetylcysteine

OBJECTIVE

The aim and purpose of this study was to find out the protective effect of garlic oil in liver toxicity induced by acetaminophen overdose and the comparison of its effect with N-acetylcysteine in albino male mice (18-22 g).

METHODS

This study was undertaken during the period from January 1999 through to August 2000, at the School of Pharmacy, Ahwaz University of Medical Sciences, Ahwaz, Iran. All animals were fasted over night and were divided into 8 groups. Each group consisted of 10 mice. Garlic oil was administered intraperitoneally in doses of 100mg/kg, 200mg/kg and 500 mg/kg. Immediately after this, a toxic dose of acetaminophen (500 mg/kg orally) was administered followed by another administration one hour later (500 mg/kg orally). Twenty-four hours after the last administration, blood was withdrawn from the jugular vein of the mice and serum enzyme activities were measured and compared with the control groups. The liver samples were studied for the histopathological examination.

RESULTS

The results in group which received 200mg/kg of garlic oil showed good protection activity as compared with the positive control group. The histopathological observations also showed that the area of liver damage was reduced significantly as compared with the positive control group. The severity of injury was variable among the animals and there was less evidence of necrosis in this group. Some protection was observed in other doses of garlic oil but these were not much significant. The results obtained one hour after acetaminophen intoxication (post treatment) showed a less protective effect as compared with the group which received garlic oil simultaneously after acetaminophen intoxication.

CONCLUSION

Garlic oil, as similar to N-acetylcysteine, can eliminate electrophilic intermediates and free radicals through conjugation and reduction reactions. Therefore it protects the liver from toxic doses of acetaminophen. In the present study we also observed the protection by the garlic oil. The clearance of the toxic metabolites of the acetaminophen from the liver occurs much faster in immediate treatment with garlic oil (200mg/kg).

Application of some of Iranian medicinal plants in the treatment of liver injury

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