THE EFFECTS OF UNILATERAL TESTICULAR TORSION UPON IMMUNITY MODULATION AND APOPTOSIS OF GERMINAL CELLS IN THE CONTRALATERAL TESTIS: An Experimental Study in Rats
ABSTRACT: Since the report of
Krarup in 1978, deteriorating effects of unilateral testicular torsion to the
contralateral testis are generally accepted, but the mechanism of the damage
remains controversial. This study aims to explain the mechanism of
spermatogenesis disorder of the contralateral testis after unilateral
testicular torsion that underlies infertility. This study used 40 Wistar strain
Rattus norwegicus white rats divided into 4 groups of 10 rats each with a post
test control group design. Two groups of white rats were subjected to left
sided testicular torsion three times counter-clockwise for 4 hours and 24 hours
respectively, and two other groups, which served as control, were subjected to
sham operation. Subsequently, the determination of serum testosterone was
carried out using radioimmunoassay and investigations on the proportion of
apoptosis of the germinal epithelial cells, the percentage of IL-4 producing
lymphocytes and the IgG-producing plasma cells in the contralateral testis was
performed by means of an immunohistochemical method. The results of
multivariate analysis showed that unilateral torsion in white rats for 4 hours
induced significant increase in the percentage of IL-4 producing lymphocytes in
the contralateral testis, but no significant change was demonstrated in serum
testosterone level, the percentage of IgG-producing plasma cells, or the proportion
of apoptotic germinal epithelial cells in the contralateral testis. Unilateral
testicular torsion for 24 hours could induce significant decrease in serum
testosterone level along with significant proportional increase of apoptosis of
the germinal epithelial cells in the contralateral testis. No significant
change in the percentage of IL-4 producing lymphocyte and the IgG-producing plasma
cells in the contralateral testis could be measured. It can be concluded that
the mechanism of spermatogenesis disorder post-unilateral testicular torsion
can be explained by the immunopathobiology paradigm. Immunity modulation was
found in the rats subjected to testicular torsion for 4 hours, as reflected by
an increase in the percentage of IL-4 producing lymphocytes and pathobiological
modulation occurred in rats subjected to testicular torsion for 24 hours as
reflected by the reduction in serum testosterone level along with an increase
in the proportion of apoptosis of the germinal epithelial cells in the contralateral
testis.
Author: Sunaryo Hardjowijoto
Journal Code: jpkedokterangg050048
