Некоторые патофизиологические механизмы нарушения сперматогенеза у пациентов с варикоцеле. Часть 1
https://doi.org/10.63769/2070-9781-2025-25-4-84-92
Аннотация
Несмотря на противоречивые взгляды о связи варикоцеле и патоспермии, многочисленные исследования доказали отрицательное воздействие варикоцеле на показатели сперматогенеза и ультраструктурные характеристики сперматозоидов. Исследования, проведенные в последние десятилетия, несколько изменили общий взгляд на патофизиологию развития патоспермии при варикоцеле и раскрыли роль взаимосвязанных процессов: теплового стресса, оксидативного стресса (ОС), апоптоза, генетических, воспалительных и других факторов, которые способствуют индукции патофизиологических проявлений.
Ключевые слова
Об авторах
З. А. КадыровРоссия
Зиератшо Абдуллоевич Кадыров, доктор медицинских наук, профессор, заведующий кафедрой
МИ; ФНМО; кафедра эндоскопической урологии и ультразвуковой диагностики
Москва
Author ID: 6602093282
В. C. Степанов
Россия
Владимир Сергеевич Степанов, ассистент
МИ; ФНМО; кафедра эндоскопической урологии и ультразвуковой диагностики
Москва
М. В. Фаниев
Россия
Михаил Владимирович Фаниев, канд. мед. наук, доцент
МИ; ФНМО; кафедра эндоскопической урологии и ультразвуковой диагностики
Москва
Author ID: 1056145
В. А. Мирзонов
Россия
Владислав Александрович Мирзонов, главный врач
Химки
Г. А. Варич
Россия
Георгий Александрович Варич, заместитель главного врача по хирургии
Химки
А. А. Алексеев
Россия
Артем Александрович Алексеев, аспирант, врач-уролог
МИ; ФНМО; кафедра эндоскопической урологии и ультразвуковой диагностики
Москва
В. В. Папсуев
Россия
Вадим Витальевич Папсуев, врач-уролог
МИ; ФНМО; кафедра эндоскопической урологии и ультразвуковой диагностики; медицинский холдинг
Москва
В. И. Беспрозванный
Россия
Владимир Игоревич Беспрозванный, врач–уролог-андролог
медицинский холдинг
Москва
Список литературы
1. Iommiello V.M., Albani E., Di Rosa A. et al. Ejaculate oxidative stress is related with sperm DNA fragmentation and round cells / Int J Endocrinol Metab. – 2015. – No. 23. – 2015.
2. dos Santos Hamilton T.R., de Castro L.S. et al. Included lipid peroxidation in ram sperm: semen profile, DNA fragmentation and antioxidant status / Reproduction. – 2016 – No. 151. – P. 379–390.
3. Shiraishi K., Matsuyama H., Takihara H. Pathophysiology of varicocele in male infertility in the era of assisted reproductive technology / Int J Urol. – 2012. – No. 19. – P. 538–550.
4. Kimura M., Nagao K. Role of varicocele repair for male infertility in the era of assisted reproductive technologies / Reprod Med Biol. – 2014. – No. 13. – P. 185–192.
5. Щеплев П.А., Нестеров С.Н., Кухаркин С.А., Таневский В.Э. Лечение варикоцеле с использованием микрохирургического лигирования вен семенного канатика из субингвинального минидоступа // Андрология и генитальная хирургия 2001. N 1. (приложение). С. 93–94.
6. Hassanin A.M., Ahmed H.H., Kaddah A.N. A global view of the pathophysiology of varicocele / Andrology. – 2018. – No. 6. – P. 654–661.
7. Wang L.Y., Zheng L., Jiang T. Research advances in inflammation and oxidative stress in varicocele-induced male infertility : a narrative review/ Asian Journal of Andrology.2025 Mar 1;27(2):177-184. DOI: 10.4103/aja202488.
8. Ko E.Y., Sabanegh E.S.The Role of Over-the-Counter Supplements for the Treatment of Male Infertility – Fact or Fiction? / J. Androl. – 2012. – No. 33. – P. 292–308. [Google Scholar] [CrossRef]
9. Erfani Majd N., Sadeghi N., Tavalaee M. et al. Evaluation of oxidative stress in testis and sperm of rat following induced varicocele / Urol J. – 2019. – No. 16. – P. 300–306.
10. Tawadrous, G.A., Azizт A.A., Mostafa T. Seminal soluble fas relationship with oxidative stress in infertile men with varicocele / Urology. – 2013. – No. 82. – P. 820–823.
11. Smith R., Kaune H., Parodi D. et al. Extent of sperm DNA damage in spermatozoa from men examined for infertility. Relationship with oxidative stress / Rev Med Chil. – 2007. – No. 135. – P. 279–286.
12. Mieusset R., Grandjean H., Mansat A., Pontonnier F. Inhibiting effect of artificial cryptorchidism on spermatogenesis / Fertil Steril. – 1985 – No. 43. – P. 589–594.
13. Garolla A., Torino M., Miola P. et al. Twenty-four-hour monitoring of scrotal temperature in obese men and men with a varicocele as a mirror of spermatogenic function / Hum Reprod. – 2015. – No. 30. – P. 1006–1013.
14. Lima S.B., Cenedeze M.A., Bertolla R.P. et al. Expression of the HSPA2 gene in ejaculated spermatozoa from adolescents with and without varicocele / – Fertil Steril. – 2006. – No. 86. – P. 1659–1663.
15. Paul C., Teng S., Saunders P.T. A single, mild, transient scrotal heat stress causes hypoxia and oxidative stress in mouse testes, which induces germ cell death / Biol Reprod. – 2009. – No. 80. – P. 913–919.
16. Shiraishi K.,Takihara H., Matsuyama H. Elevated scrotal temperature, but not varicocele grade, reflects testicular oxidative stress-mediated apoptosis / K. Shiraishi, H. Takihara, H. Matsuyama. – Text : unmediated // World J Urol. – 2010. – No. 28. – P. 359–364.
17. Gat Y., Bachar G.N., Everaert K. et al. Induction of spermatogenesis in azoospermic men after internal spermatic vein embolization for the treatment of varicocele / Hum Reprod. – 2005. – No. 20. – P. 1013–1017.
18. Rao M., Zhao X.L., Yang J. et al. Effect of transient scrotal hyperthermia on sperm parameters, seminal plasma biochemical markers, and oxidative stress in men / Asian J Androl 2015. V. 17. – P. 668–675.
19. Jung A., Eberl M., Schill W.B. Improvement of semen quality by nocturnal scrotal cooling and moderate behavioural change to reduce genital heat stress in men with oligoasthenoteratozoospermia / Reproduction. – 2001. – No. 121. – P. 595–603.
20. Zini A., Buckspan M., Berardinucci D., Jarvi K.. Loss of left testicular volume in men with clinical left varicocele: correlation with grade of varicocele / Arch Androl. – 1998. – No. 41. – P. 37–41.
21. Feder M.E., Hofmann G.E. – Heat-shock proteins, molecular chaperones, and the stress response:evolutionary and ecological physiology / Annu Rev Physiol. – 1999. – No. 61. – P. 243–282.
22. Ferlin A., Speltra E., Patassini C. et al. Heat shock protein and heat shock factor expression in sperm:relation to oligozoospermia and varicocele / // J Urol. – 2010. – No. 183. – P. 1248–1252.
23. Panner Selvam M.K. Agarwal A. Proteomic profiling of seminal plasma proteins in varicocele patients / World J Mens Health. – 2021. – No. 39. – P. 90–98.
24. Yeşilli C., Mungan G., Seçkiner I. et al. Effect of varicocelectomy on sperm creatine kinase, HspA2 chaperone protein (creatine kinase-M type), LDH, LDH-X, and lipid peroxidation product levels in infertile men with varicocele / Urology. – 2005. – No. 66. – P. 610–615.
25. Lima S.B., Cenedeze M.A., Bertolla R.P. et al. Expression of the HSPA2 gene in ejaculated spermatozoa from adolescents with and without varicocele / Fertil Steril. – 2006. – No. 86. – P. 1659–1663.
26. Gual-Frau J., Abad C., Amengual M.J. et al. Oral antioxidant treatment partly improves integrity of human sperm DNA in infertile grade I varicocele patients / Hum Fertil (Camb). – 2015. – No. 18. – P. 225–229.
27. Ahmadi S., Bashiri R., Ghadiri-Anari A., Nadjarzadeh A.. Antioxidant supplements and semen parameters : an evidence based review / Int J Reprod BioMed. – 2016. – No. 14. – P. 729–736.
28. Chen S.S., Huang W.J., Chang L.S., Wei Y.H. Attenuation of oxidative stress after varicocelectomy in subfertile patients with varicocele / J Urol. – 2008. – Vol. 179. – P. 639–642.
29. Sakamoto Y., Ishikawa T., Kondo Y. et al. The assessment of oxidative stress in infertile patients with varicocele / BJU Int. – 2008. – No. 101. – P. 1547–1552.
30. Liu X.Y., Zhang S.X., Zhang N. et al. Effects of apigenin on scrotal heat-induced damage in the mice testis / Int J Clin Exp Med. – 2016. – No. 9. – P. 6342–6347.
31. Мазо Е.Б. Новое в лечении мужского бесплодия при варикоцеле / Е.Б. Мазо, М.В. Корякин. – Москва: Медицина, 1992. – 170 с. – Текст : непосредственный.
32. Comhaire F., Kunnen M. Selective retrograde venography of the internal spermatic vein: a conclusive approach to the diagnosis of varicocele / Andrologia. – 1976. – No. 8. – P. 11–24.
33. Tian R.H., Chen H.X., Zhao L.Y. et al. Efficacy and safety study of microsurgical varicocelectomy in the treatment of non-obstructive azoospermia with varicocele / Zhonghua Yi Xue Za Zhi. – 2018. – No. 98. – P. 3737–3740.
34. Hu W., Zhou P.H., Zhang X.B. et al. Roles of adrenomedullin and hypoxia-inducible factor 1 alpha in patients with varicocele / Andrologia. – 2015. – No. 47. – P. 951–957.
35. Liang M., Wen J., Dong Q. et al. Testicular hypofunction caused by activating p53 expression induced by reactive oxygen species in varicocele rats / Andrologia. – 2015. – No. 47. – P. 1175–1182.
36. Swain N., Samanta L., Agarwal A. et al. Aberrant upregulation of compensatory redox molecular machines may contribute to sperm dysfunction in infertile men with unilateral varicocele: a proteomic insight / Antioxid Redox Signal. – 2020. – No. 32. – P. 504–521.
37. Kilinc F., Kayaselcuk F., Aygun C.E. et al. Experimental varicocele induces hypoxia inducible factor-1a, vascular endothelial growth factor expression and angiogenesis in the rat testis / J Urol. – 2004. – No. 172. – P. 1188–1191.
38. Tek M., Cayan S., Yilmaz N. et al. The effect of vascular endothelial growth factor on spermatogenesis and apoptosis in experimentally varicocele-induced adolescent rats / Fertil Steril. – 2009. – No. 91. – P. 2247–2252.
39. Minutoli L., Arena S., Antonuccio P. et al. Role of inhibitors of apoptosis proteins in testicular function and male fertility: effects of polydeoxyribonucleotide administration in experimental varicocele / – Text: unmediated // Bio Med Res Int. – 2015. – Vol. 2015. – No. 248976.
40. Aitken R.J., Baker M.A., Nixon B. Sperm DNA fragmentation, recurrent implantation failure and recurrent miscarriage / Asian J Androl. – 2015. – No. 17. – P. 633–639.
41. Liu J., Qian S.Y., Guo Q. et al. Cadmium generates reactive oxygen- and carbon-centered radical species in rats: insights from in vivo spin-trapping studies / Free Radic Biol Med. – 2008. – No. 45. – P. 475–481.
42. Yuan Y., Zhang Y., Zhao S. et al. Cadmium-induced apoptosis in neuronal cells is mediated by Fas/FasL-mediated mitochondrial apoptotic signaling pathway / Sci Rep. – 2018. – No. 8. – P. 8837.
43. Morielli T., O’Flaherty C. Oxidative stress impairs function and increases redox protein modifications in human spermatozoa / Reproduction. – 2015. – No. 149. – P. 113–123.
44. Gil-Guzman E., Ollero M., Lopez M.C. et al. Differential production of reactive oxygen species by subsets of human spermatozoa at different stages of maturation / Hum Reprod. – 2001. – No. 16. – P. 1922–1930.
45. Liang M., Wen J., Dong Q. et al. Testicular hypofunction caused by activating p53 expression induced by reactive oxygen species in varicocele rats /Andrologia. – 2015. – No. 47. – P. 1175–1182.
46. Shiraishi K., Naito K. Generation of 4-hydroxy-2-nonenal modified proteins in testes predicts improvement in spermatogenesis after varicocelectomy / Fertil Steril 2006. – No. 86. – P. 233–235.
47. Shiraishi K., Naito K. Nitric oxide produced in the testis is involved in dilatation of the internal spermatic vein that compromises spermatogenesis in infertile men with varicocele / BJU Int. – 2007. – No. 99. – P. 1086–1090.
48. Agarwal B.B., Manish K. Endoscopic varicocelectomy by extraperitoneal route: a novel technique / B.B. Agarwal, – Text : unmediated // Int J Surg. – 2009. – Vol. 7(4). – P. 37781.
49. Altintas R, Ediz C., Celik H. et al. The effect of varicocelectomy on the relationship of oxidative stress in peripheral and internal spermatic vein with semen parameters /Andrology. – 2016. – No. 4. – P. 442–446.
50. Tiseo B.C., Esteves S.C., Cocuzza M.S. Summary evidence on the effects of varicocele treatment to improve natural fertility in subfertile men / Asian J Androl. – 2016. – No. 18. – P. 239.
51. Cho C.L., Esteves S.C., Agarwal B.B. Novel insights into the pathophysiology of varicocele and its association with reactive oxygen species and sperm DNA fragmentation / Asian J Androl. – 2016. – No. 18. – P. 86–93.
52. Agarwal A., Majzoub A., Parekh N., Henkel R. A Schematic Overview of the Current Status of Male Infertility Practice / World J Mens Health. – Published online Jul 19. – 2019. – DOl: 10.5534/wjmh.190068.
53. Smith R., Kaune H., Parodi D. et al. Extent of sperm DNA damage in spermatozoa from men examined for infertility. Relationship with oxidative stress / Rev Med Chil. – 2007. – No. 135. – P. 279–286.
54. Ferramosca A., Albani D., Coppola L., Zara V. Varicocele negatively affects sperm mitochondrial respiration / Urology. – 2015. – No. 86. – P. 735–739.
55. Smit M., Romijn J.C., Wildhagen M.F. et al. Decreased sperm DNA fragmentation after surgical varicocelectomy is associated with increased pregnancy rate / J Urol. – 2010. – No. 183. – P. 270–274.
56. Boitrelle F., Shah R., Saleh R. et al. The Sixth Edition of the WHO Manual for Human Semen Analysis: A Critical Review and SWOT Analysis / Life. – 2021. – No. 11. – P. 1368. [Google Scholar] [CrossRef] [PubMed]
57. Rex A.S., Aagaard J., Fedder J. DNA fragmentation in spermatozoa : a historical review / – Text : unmediated // Andrology. – 2017. – No. 5. – P. 622–630.
Рецензия
Для цитирования:
Кадыров З.А., Степанов В.C., Фаниев М.В., Мирзонов В.А., Варич Г.А., Алексеев А.А., Папсуев В.В., Беспрозванный В.И. Некоторые патофизиологические механизмы нарушения сперматогенеза у пациентов с варикоцеле. Часть 1. Андрология и генитальная хирургия. 2025;25(4):84-92. https://doi.org/10.63769/2070-9781-2025-25-4-84-92
For citation:
Kadyrov Z.A., Stepanov V.S., Faniev M.V., Mirzonov V.A., Varich G.A., Alekseev A.А., Papsuev V.V., Besprozvanni V.I. Some pathophysiological mechanisms of spermatogenesis disorders in patients with varicocele. Part 1. Andrology and Genital Surgery. 2025;25(4):84-92. (In Russ.) https://doi.org/10.63769/2070-9781-2025-25-4-84-92
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