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Testikuläre Ischämie

Verlauf von Zytokinen und Zelladhäsionsmolekülen beim Menschen

Testicular perfusion injury

Cytokines and cell adhesion molecules in humans

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Zusammenfassung

Hintergrund

Durch Ischämie und Reperfusion kommt es zu schädigenden Einflüssen an Geweben. Die Therapie des Hodenhochstands und die Hodentorsion gehen mit Minderperfusionen einher. Dies resultiert in einer Zellaktivierung, die zur Synthese von Entzündungsmediatoren (TNF-α) und Expression von Adhäsionsmolekülen (ICAM und VCAM) auf der Zelloberfläche führt.

Methodik

Die Expression der Zytokine IL-10, TNF-α und der Adhäsionsmoleküle ICAM (intercellular adhesion molecule) und VCAM (vascular cell adhesion meolecule) wurde mittels rt-PCR nach definierter Minderperfusion aus kryokonserviertem Hodengewebe von 9 Patientinnen im Rahmen einer geschlechtsangleichenden Operation von Mann-zu-Frau-Transsexuellen evaluiert. Weiterhin wurde der Laktatwert im Organ und die Tubulusdurchmesser der Hoden bestimmt.

Ergebnisse

Während der Ischämie lassen sich für ICAM, IL-10 und VCAM auf der ischämieexponierten und der kontralateralen Seite ebenso wie für die Tubulusdurchmesser keine statistisch signifikanten Unterschiede nachweisen. Für TNF-α und die Organlaktatwerte waren signifikante Unterschiede nachweisbar.

Diskussion

TNF-α und der Organlaktatwert als Ausdruck der Leuktozytenmigration, Entzündungsreaktion und Immunantwort zeigten statistische Unterschiede. Inwieweit die kontralaterale TNF-α-Expression Ausdruck einer beginnenden immunologischen Reaktion ist, bleibt ungeklärt. Diese Untersuchung stellt erste Grundlagen der immunologischen Ebene bei testikulärer Minderperfusion dar.

Abstract

Background

Ischemia and reperfusion (I/R) lead to cellular damage. A disturbance of testicular perfusion occurs during the therapy of cryptorchidism and in cases of testicular torsion. This results in the activation of mediator cells with an increasing synthesis of mediators of infection like TNF-α and the expression of cell adhesion molecules like ICAM (intercellular adhesion molecule) and VCAM (vascular cell adhesion molecule) at the cellular surface.

Methods

The expression of the cytokines IL-10 and TNF-α and the adhesion molecules ICAM and VCAM after defined testicular I/R injury in nine male transsexuals was evaluated with rt-PCR. Furthermore we examined lactate and the diameter of the testicular tubulus under ischemic conditions.

Results

During ischemia ICAM, IL-10, and VCAM do not show significant changes on the side of testicular ischemia and the contralateral side; the same was seen for the tubulus diameter. TNF-α and the testicular lactate values showed a significant change of the expression pattern.

Discussion

The statistical changes of TNF-α and testicular lactate are the expression of leukocyte migration, infectious reaction, and immune response. To what extent the TNF-α expression represents a severe immunological reaction remains undefined. This human study shows primary results for the immunological understanding of and cellular response to testicular ischemia.

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Authors and Affiliations

  1. Urologische Klinik, Universitätsklinikum, Essen, Deutschland

    H. Sperling, G. Lümmen & H. Rübben

  2. Urologische Klinik, Kliniken Maria Hilf, Viersener Straße 450, 41063, Mönchengladbach, Deutschland

    H. Sperling

  3. Urologische Klinik, Krankenhaus Maria-Hilf, Krefeld, Deutschland

    S. Krege

  4. Urologische Klinik, St. Josef Hospital, Troisdorf, Deutschland

    G. Lümmen

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  1. H. Sperling
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  2. S. Krege
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  3. G. Lümmen
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  4. H. Rübben
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Correspondence to H. Sperling.

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Sperling, H., Krege, S., Lümmen, G. et al. Testikuläre Ischämie. Urologe 46, 1033–1040 (2007). https://doi.org/10.1007/s00120-007-1389-3

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