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Protective effect of famotidine on ischemia–reperfusion injury following testicular torsion in rats

Published:September 28, 2020DOI:https://doi.org/10.1016/j.jpurol.2020.09.019

      Summary

      Introduction

      In testicular torsion, testicular blood flow is impaired, resulting in ischemic changes. Torsion must be corrected urgently with surgical treatment. Detorsioning and restoration of blood supply to the testis cause reperfusion injury.

      Objective

      In this experimental study, we aimed to investigate the effect of famotidine on ischemia–reperfusion injury in a rat model of testicular torsion.

      Study design

      The rats were randomly divided into three groups; Group I (control, no torsion) (n = 8), Group II (torsion + detorsion) (n = 8), Group III (torsion + detorsion + famotidine) (n = 8). Levels of oxidative stress markers, such as malondialdehyde (MDA) and nitric oxide (NO), and antioxidants, such as superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), were measured for biochemical analysis. Testicular tissues were assessed by Johnsen Scoring for spermatogenic evaluation. Tissues were also examined with TUNEL staining to determine the extent of apoptosis.

      Results

      Average MDA level was higher in Group II than Groups I and III. The difference was only significant between Group I and II (p = 0.03). Average NO level was significantly higher in Group II than Groups I and III (p = 0.03; p = 0.04; respectively). Conversely, average SOD level was lower in Group II than Groups I and III. The difference was only significant between Group II and III (p < 0.001). Average GSH-Px level was lower in Group II than Groups I and III, but the differences were not significant (p = 0.37; p = 0.35; respectively). The average Johnsen score in Group II was significantly lower than the scores in Groups I and III (p < 0.001; p < 0.001; respectively). The apoptotic index of Group II was significantly higher than those of Groups I and III (p < 0.001; p < 0.001; respectively).

      Discussion

      Famotidine prevented increases in oxidative stress markers and reductions of antioxidants during ischemia–reperfusion injury in our study. Spermatogenesis was less affected and DNA injury was reduced in rats treated with famotidine. The antioxidant characteristics of famotidine and its protective effects have been shown in our study.

      Conclusion

      Summary Figure
      Graphical AbstractHistological images of testicular tissues. Johnsen scores were calculated by histological and spermatogenic evaluation of testicular tissues. PAS Staining; Group I (left), Group II (middle), Group III (right).

      Keywords

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      Linked Article

      • Preclinical studies of testicular ischemia-reperfusion treatment
        Journal of Pediatric UrologyVol. 17Issue 2
        • Preview
          Testicular torsion occurs annually in appr. 3.8/100.000 under the age of 18 years The condition has a bimodal incidence pattern with peaks in infancy and early adolescence [1]. If retorsion is performed within the first few hours, there might be a chance of preservation of testicular function, but when the time period from onset of symptoms exceeds 12 h, the testicular function is lost. So acute surgery is mandatory, but could it be possible to get a higher success rate with supplementary measures? This is the topic of the preclinical study by [2] where they explore the effect of famotidine, a competitive inhibitor of histamine H2 receptors, normally used to reduce gastric acid, to counteract the reperfusion damages to the testicular tissue?
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