精索静脉曲张致男性生育力低下的机理研究新进展
Recent Advances in the Mechanisms of Varicocele-Induced Male Infertility
DOI: 10.12677/acm.2024.1482204, PDF,   
作者: 庞浩峰, 梁子龙*:西安医学院研究生工作部,陕西 西安
关键词: 精索静脉曲张不育发病机理Varicocele Infertility Pathogenesis
摘要: 精索静脉曲张(varicocele, VC)是泌尿生殖系统常见的疾病,也是引起男性不育的主要原因之一,因此是世界范围内一个重要的临床问题。目前人们对于精索静脉曲张致男性生育力低下的研究已经相当深入,其可能的机制包括睾丸微循环障碍、肾和肾上腺代谢物回流、氧化应激、免疫因素、缺氧、NO、凋亡等,但是对于其具体发病机制并未完全阐明。本文根据国内外研究现状,对精索静脉曲张致男性生育力低下的机理研究做一综述。
Abstract: Varicocele (VC) is a common disorder of the genitourinary system and a major cause of male infertility, making it a significant clinical issue worldwide. Research into how varicocele impairs male fertility has advanced considerably, exploring mechanisms such as testicular microcirculatory disturbances, reflux of metabolites from the kidney and adrenal glands, oxidative stress, immune factors, hypoxia, nitric oxide, apoptosis, among others. However, the exact pathophysiology remains incompletely understood. This article provides a comprehensive review of current domestic and international research on the mechanisms by which varicocele contributes to reduced male fertility.
文章引用:庞浩峰, 梁子龙. 精索静脉曲张致男性生育力低下的机理研究新进展[J]. 临床医学进展, 2024, 14(8): 223-228. https://doi.org/10.12677/acm.2024.1482204

参考文献

[1] Sasson, D.C. and Kashanian, J.A. (2020) Varicoceles. JAMA, 323, 2210. [Google Scholar] [CrossRef] [PubMed]
[2] Zini, A., Alsaikhan, B., Alrabeeah, K. and Delouya, G. (2016) Epidemiology of Varicocele. Asian Journal of Andrology, 18, 179-181. [Google Scholar] [CrossRef] [PubMed]
[3] Kang, C., Punjani, N., Lee, R.K., Li, P.S. and Goldstein, M. (2022) Effect of Varicoceles on Spermatogenesis. Seminars in Cell & Developmental Biology, 121, 114-124. [Google Scholar] [CrossRef] [PubMed]
[4] Green, K.F., Turner, T.T. and Howards, S.S. (1984) Varicocele: Reversal of the Testicular Blood Flow and Temperature Effects by Varicocele Repair. Journal of Urology, 131, 1208-1211. [Google Scholar] [CrossRef] [PubMed]
[5] 顾磊, 金保方, 张新东. 睾丸微循环结构及功能调控的研究进展[J]. 微循环学杂志, 2014, 24(3): 65-67.
[6] Naughton, C.K. (2001) Varicocele and Male Infertility: Part II: Pathophysiology of Varicoceles in Male Infertility. Human Reproduction Update, 7, 473-481. [Google Scholar] [CrossRef] [PubMed]
[7] 宁金卓, 程帆, 余伟民. 精索静脉曲张与男性不育的研究进展[J]. 中国医药导报, 2017, 14(13): 38-41.
[8] Devoto, C.E., Madariaga, A.M. and Lioi, C.X. (2000) Factores causales de infertilidad masculina: Contribución del factor endocrino. Revista Médica de Chile, 128, 184-192. [Google Scholar] [CrossRef
[9] Camoglio, F.S., Zampieri, N., Corroppolo, M., Chironi, C., Dipaola, G., Giacomello, L., et al. (2004) Varicocele and Retrograde Adrenal Metabolites Flow. An Experimental Study on Rats. Urologia Internationalis, 73, 337-342. [Google Scholar] [CrossRef] [PubMed]
[10] Pizzino, G., Irrera, N., Cucinotta, M., Pallio, G., Mannino, F., Arcoraci, V., et al. (2017) Oxidative Stress: Harms and Benefits for Human Health. Oxidative Medicine and Cellular Longevity, 2017, Article ID: 8416763. [Google Scholar] [CrossRef] [PubMed]
[11] Barati, E., Nikzad, H. and Karimian, M. (2019) Oxidative Stress and Male Infertility: Current Knowledge of Pathophysiology and Role of Antioxidant Therapy in Disease Management. Cellular and Molecular Life Sciences, 77, 93-113. [Google Scholar] [CrossRef] [PubMed]
[12] Wang, K., Gao, Y., Wang, C., Liang, M., Liao, Y. and Hu, K. (2022) Role of Oxidative Stress in Varicocele. Frontiers in Genetics, 13, Article ID: 850114. [Google Scholar] [CrossRef] [PubMed]
[13] Wang, K., Gao, Y., Wang, C., Liu, Z., Liang, M., Liao, Y., et al. (2022) Is Parthanatos Involved in Varicocele? DNA and Cell Biology, 41, 861-870. [Google Scholar] [CrossRef] [PubMed]
[14] Wood, G.J.A., Cardoso, J.P.G., Paluello, D.V., Nunes, T.F. and Cocuzza, M. (2021) Varicocele-Associated Infertility and the Role of Oxidative Stress on Sperm DNA Fragmentation. Frontiers in Reproductive Health, 3, Article ID: 695992. [Google Scholar] [CrossRef] [PubMed]
[15] Fleisher, T.A. (1997) Apoptosis. Annals of Allergy, Asthma & Immunology, 78, 245-250. [Google Scholar] [CrossRef] [PubMed]
[16] 秦文波, 王淑秋, 王淑湘. 精索静脉曲张大鼠睾丸细胞线粒体钙、Bcl-2/Bax蛋白表达和细胞凋亡的研究[J]. 中国病理生理杂志, 2006(3): 597-599.
[17] 闫涛, 俞建军, 徐月敏. 精索静脉曲张致男性不育的研究进展[J]. 现代泌尿外科杂志, 2010, 15(4): 324-327.
[18] Hassanin, A.M., Ahmed, H.H. and Kaddah, A.N. (2018) A Global View of the Pathophysiology of Varicocele. Andrology, 6, 654-661. [Google Scholar] [CrossRef] [PubMed]
[19] Jankovic Velickovic, L. and Stefanovic, V. (2013) Hypoxia and Spermatogenesis. International Urology and Nephrology, 46, 887-894. [Google Scholar] [CrossRef] [PubMed]
[20] Ke, Q. and Costa, M. (2006) Hypoxia-Inducible Factor-1 (HIF-1). Molecular Pharmacology, 70, 1469-1480. [Google Scholar] [CrossRef] [PubMed]
[21] Zhu, S., Rao, T., Yang, X., Ning, J., Yu, W., Ruan, Y., et al. (2017) Autophagy May Play an Important Role in Varicocele. Molecular Medicine Reports, 16, 5471-5479. [Google Scholar] [CrossRef] [PubMed]
[22] Ghandehari-Alavijeh, R., Tavalaee, M., Zohrabi, D., Foroozan-Broojeni, S., Abbasi, H. and Nasr-Esfahani, M.H. (2018) Hypoxia Pathway Has More Impact than Inflammation Pathway on Etiology of Infertile Men with Varicocele. Andrologia, 51, e13189. [Google Scholar] [CrossRef] [PubMed]
[23] Zhao, W., Liu, J., Wang, D., Wang, Y., Zhang, F., Jin, G., et al. (2019) Effect of Silencing HIF-1α Gene on Testicle Spermatogenesis Function in Varicocele Rats. Cell and Tissue Research, 378, 543-554. [Google Scholar] [CrossRef] [PubMed]
[24] Wu, G., Meininger, C.J., McNeal, C.J., Bazer, F.W. and Rhoads, J.M. (2021) Role of L-Arginine in Nitric Oxide Synthesis and Health in Humans. In: Advances in Experimental Medicine and Biology, Springer International Publishing, Berlin, 167-187. [Google Scholar] [CrossRef] [PubMed]
[25] Perera, D.M.D., Katz, M., Heenbanda, S.R. and Marchant, S. (1996) Nitric Oxide Synthase Inhibitor Ng-Monomethyl-L-Arginine Preserves Sperm Motility after Swim-Up. Fertility and Sterility, 66, 830-833. [Google Scholar] [CrossRef] [PubMed]
[26] Karthikeyan, V., Vickram, A.S. and Manian, R. (2020) Estimation of Varicocele Associated Human ARG2 and NOS1 Proteins and Computational Analysis on the Effect of Its nsSNPs. International Journal of Biological Macromolecules, 164, 735-747. [Google Scholar] [CrossRef] [PubMed]
[27] Shiraishi, K. and Naito, K. (2007) Nitric Oxide Produced in the Testis Is Involved in Dilatation of the Internal Spermatic Vein That Compromises Spermatogenesis in Infertile Men with Varicocele. BJU International, 99, 1086-1090. [Google Scholar] [CrossRef] [PubMed]
[28] Chen, Q., Deng, T. and Han, D. (2016) Testicular Immunoregulation and Spermatogenesis. Seminars in Cell & Developmental Biology, 59, 157-165. [Google Scholar] [CrossRef] [PubMed]
[29] Mongioì, L.M., Alamo, A., Calogero, A.E., Compagnone, M., Giacone, F., Cannarella, R., et al. (2020) Evaluation of Seminal Fluid Leukocyte Subpopulations in Patients with Varicocele. International Journal of Immunopathology and Pharmacology, 34, 1-6. [Google Scholar] [CrossRef] [PubMed]
[30] Fang, Y., Su, Y., Xu, J., Hu, Z., Zhao, K., Liu, C., et al. (2021) Varicocele-Mediated Male Infertility: From the Perspective of Testicular Immunity and Inflammation. Frontiers in Immunology, 12, Article ID: 729539. [Google Scholar] [CrossRef] [PubMed]
[31] Bozhedomov, V.A., Lipatova, N.A., Rokhlikov, I.M., Alexeev, R.A., Ushakova, I.V. and Sukhikh, G.T. (2013) Male Fertility and Varicocoele: Role of Immune Factors. Andrology, 2, 51-58. [Google Scholar] [CrossRef] [PubMed]
[32] Zhang, H., Yin, Y., Wang, G., Liu, Z., Liu, L. and Sun, F. (2014) Interleukin-6 Disrupts Blood-Testis Barrier through Inhibiting Protein Degradation or Activating Phosphorylated ERK in Sertoli Cells. Scientific Reports, 4, Article No. 4260. [Google Scholar] [CrossRef] [PubMed]
[33] Pan, J., Zhu, Z., Xu, G., Niu, L., Yu, L., Luo, Z., et al. (2018) Expression of Claudin-11 in a Rat Model of Varicocele and Its Effects on the Blood-Testis Barrier. Molecular Medicine Reports, 18, 5647-5651. [Google Scholar] [CrossRef] [PubMed]
[34] Zhang, H., Li, Y., Zhou, T., Su, Y., Hu, Z., Wei, J., et al. (2020) Prokineticin 2 Overexpression Induces Spermatocyte Apoptosis in Varicocele in Rats. Asian Journal of Andrology, 22, 500-506. [Google Scholar] [CrossRef] [PubMed]