Response to Letter to the Editor re ‘The effect of astaxanthin on testicular torsion-detorsion injury in rats - Detailed morphometric evaluation of histological sections’

  • Marko Bašković
    Correspondence
    Correspondence to: Marko Bašković, Department of Pediatric Urology, Children's Hospital Zagreb, Klaićeva 16, Zagreb 10000, Croatia, Tel.: +385 1 3636 379
    Affiliations
    Department of Pediatric Urology, Children's Hospital Zagreb, Klaićeva 16, Zagreb 10000, Croatia
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  • Davor Ježek
    Affiliations
    Department of Histology and Embriology, University of Zagreb, School of Medicine, Šalata 3, Zagreb 10000, Croatia
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Published:October 28, 2021DOI:https://doi.org/10.1016/j.jpurol.2021.10.018
      We are glad to see that our article entitled “The effect of astaxanthin on testicular torsion-detorsion injury in rats - detailed morphometric evaluation of histological sections” [
      • Bašković M.
      • Bojanac A.K.
      • Sinčić N.
      • Perić M.H.
      • Krsnik D.
      • Ježek D.
      The effect of astaxanthin on testicular torsion-detorsion injury in rats - detailed morphometric evaluation of histological sections.
      ] has attracted the attention of colleagues from Canada. Even though the human body has defence mechanisms in the fight against free oxygen radicals, we are witnessing that at some point, they become insufficient. This upsets the balance between prooxidants and antioxidants favouring prooxidants (a state of oxidative stress). Cell damage is reversible to one point, but cells are subject to irreversible damage under intense and prolonged stress. The biological response of a cell to free oxygen radicals depends on cell type, type of free oxygen radicals, the ability of the cell to remove oxygen free radicals, length of exposure to free oxygen radicals, and concentration of free oxygen radicals. It has generally been shown that low concentrations of free oxygen radicals induce apoptosis, while high ones result in necrosis. To help the body strengthen pre-existing defence mechanisms, researchers around the world are looking for new antioxidants. Astaxanthin has a unique molecular structure that allows it to remain both inside and outside the cell membrane. Structural features such as size, shape, and polarity are critical determinants of astaxanthin's ability to properly blend into its molecular environment for maximum action [
      • Britton G.
      Structure and properties of carotenoids in relation to function.
      ]. Astaxanthin enhances the phosphorylation of Bcl-xL/Bcl-2 linked cell death mediator (BAD), regulates cytochrome c and caspase 3 and 9 activations through p38-MAPK protein regulation. It also activates the PI3K/Akt survival pathway, leading to reduced apoptosis [
      • Wu H.
      • Niu H.
      • Shao A.
      • Wu C.
      • Dixon B.J.
      • Zhang J.
      • et al.
      Astaxanthin as a potential neuroprotective agent for neurological diseases.
      ].
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      Linked Article

      • Astaxanthin for testicular torsion
        Journal of Pediatric Urology
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          We read with interest the recent article of Dr. Baskovic on the use of astaxanthin for the ischemic process that occurs following the testicular torsion [1]. Testicular viability in neonatal torsion is indeed generally poor. My experience at the Children's Hospital of Eastern Ontario (Ottawa, ON, Canada), and previously at the Stollery Children's Hospital (Edmonton, AB, Canada) mirrors the literature review. A survey of 18 case series with 284 patients found a salvage rate of less than 10% [2]. In addition, testicular torsion is associated often with hemorrhagic necrosis of the testis (Fig. 1).
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