Pistacia Terebinthus L. Ekstresinin Testiste Deneysel Torsiyon/Detorsiyonun Neden Olduğu İskemi/Reperfüzyon Hasarı Üzerindeki Etkisinin Araştırılması

Abstract

Amaç: Acil müdahale gerektiren ürolojik acil durumlardan biri olan testis torsiyonu (TT), zamanında tedavi edilmezse bazı hastalarda testis atrofisine, testis fonksiyon bozukluğuna ve kısırlığa yol açabilir. İskemi-reperfüzyon (I/R) hasarı nedeniyle reaktif oksijen türlerinin (ROS) aşırı birikimi ve artışından kaynaklanan oksidatif stres, I/R sırasında meydana gelen patolojik değişikliklerin birincil nedenidir. Pistacia terebinthus, fenolik bileşikler, tokoferoller ve flavonoidler açısından son derece zengindir. Bu özellikleri nedeniyle, antiinflamatuar, antimikrobiyal ve sitotoksik özelliklerin yanı sıra antioksidan aktivite de sergiler. Bu çalışma, deneysel olarak oluşturulan testis T/D modelinde PT ekstresinin testis dokusu üzerindeki potansiyel koruyucu ve terapötik etkilerini araştırmayı amaçlamıştır. Bu amaçla, histokimyasal ve immünohistokimyasal teknikler kullanılmıştır. Yöntem: Toplam 48 erkek Sprague-Dawley sıçanı rastgele altı deney grubuna ayrıldı: Sham, Pistacia terebinthus (PT), Torsiyon/Detorsiyon (T/D), PT+T/D, T/D+PT ve PT+T/D+PT. Torsiyon-detorsiyon prosedürü, hayvanların sağ ve sol testislerinin üç saat boyunca 720° döndürülmesini ve ardından detorsiyon prosedürlerinin uygulanmasını içeriyordu. PT ekstresi, protokole göre hayvanlara 2 ml/kg dozunda oral olarak uygulandı. Deneyin tamamlanmasının ardından testisler, histopatolojik ve immünohistokimyasal değerlendirmeler yapmak üzere alındı. Bulgular: Sham ve PT gruplarında benzer şekilde, seminifer tübüller normaldi ve bazal laminada 5-6 sıra germinal epitel gözlendi. İnterstisyel alanda kılcal damarların ve Leydig hücrelerinin görünümü normaldi. T/D grubundaki hayvanlarda seminifer tübüllerde hasar, spermatogenik hücrelerde bozulma, interstisyel alanda kanama, ödem ve damar tıkanıklığı gözlendi. P+T/D grubundaki hayvanların seminifer tübüllerinde kısmi iyileşme, dilatasyon ve vasküler oklüzyon gözlendi. T/D+PT ve PT+T/D+PT gruplarında, bazal laminada sham grubuna benzer özellikler gözlendi ve vasküler oklüzyon gözlendi. Sonuç: PT ekstraktının testiste torsiyon-detorsiyonun neden olduğu hasar üzerinde rejeneratif bir etkiye sahip olduğu gösterilmiştir. Ayrıca, PT ekstraktının Apaf-1 ekspresyonunu baskılayarak hücre sağkalımını desteklediği ve aynı zamanda tedavi gruplarında Sox-9 ekspresyonunu artırarak spermatogenezin devamını sağladığı bulunmuştur. Bu sonuçlar, T/D hasarı vakalarında PT ekstraktının koruyucu ve terapötik potansiyeli hakkında daha fazla araştırma yapılmasının önemini vurgulamaktadır.

Keywords

• İskemi-reperfüzyon
• Antioksidan
• Pistacia terebinthus
• Testis
• Torsiyon-detorsiyon

INVESTIGATION OF THE EFFECT OF Pistacia Terebinthus L. EXTRACT ON ISCHEMIA/REPERFUSION INJURY INDUCED BY EXPERIMENTAL TORSION/DETORSION IN THE TESTIS

Abstract

Objective: Testicular torsion (TT), one of the urological emergencies requiring urgent intervention, can lead to testicular atrophy, impaired testicular function, and infertility in some patients if not treated promptly. Oxidative stress resulting from the excessive accumulation and increase of reactive oxygen species (ROS) due to ischemia-reperfusion (I/R) injury is the primary cause of pathological changes occurring during I/R. Pistacia terebinthus is extremely rich in phenolic compounds, tocopherols, and flavonoids. Due to these properties, it exhibits antioxidant activity along with anti-inflammatory, antimicrobial, and cytotoxic properties. This study aimed to investigate the potential protective and therapeutic effects of PT extract on testicular tissue in an experimentally generated testicular T/D model. For this purpose, histochemical and immunohistochemical techniques were used. Methods: A total of 48 male Sprague-Dawley rats were randomly divided into six experimental groups: Sham, Pistacia terebinthus (PT), Torsion/Detorsion (T/D), PT+T/D, T/D+PT, and PT+T/D+PT. The torsion-detorsion procedure involved rotating the animals' right and left testes 720° for three hours, followed by detorsion procedures. The PT extract was administered orally to the animals at a dose of 2 ml/kg according to the protocol. The testes were collected after completion of the experiment to perform histopathological and immunohistochemical evaluations. Results: Similarly in the Sham and PT groups, seminiferous tubules were normal, and 5-6 rows of germinal epithelium were observed in the basal lamina. The appearance of capillaries and Leydig cells in the interstitial area was normal. In animals in the T/D group, damage to the seminiferous tubules, deterioration of spermatogenic cells, bleeding in the interstitial area, edema, and blockage of the vessels were observed. Partial improvement, dilatation, and vascular occlusion were observed in the seminiferous tubules of animals in the P+T/D group. In the T/D+PT and PT+T/D+PT groups, features similar to the sham group were observed in the basal lamina, and vascular occlusion was observed. A total of 80 seminiferous tubules, randomly selected from sections taken from each group, were evaluated according to the Johnsen biopsy grading system. The evaluation revealed similar results between the sham and PT groups, while significant differences were observed among the other groups. Conclusion: PT extract has been shown to have a regenerative effect on damage caused by torsion-detorsion in the testis. Furthermore, PT extract was found to support cell survival by suppressing Apaf-1 expression, while also ensuring the continuation of spermatogenesis by increasing Sox-9 expression in the treatment groups. These results highlight the importance of further research into the protective and therapeutic potential of PT extract in cases of T/D damage.

Keywords

• Ischemia-reperfusion
• Antioxidant
• Pistacia terebinthus
• Testis
• Torsion-detorsion

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