Seminal Tumour necrosis factor‐related apoptosis‐inducing ligand and its relationship to infertility in Egyptian patients with varicocele

Germ cell apoptosis has been proposed as one of the mechanisms by which varicocele can influence fertility. The aim of this study was to investigate the relationship between seminal tumour necrosis factor (TNF)‐related apoptosis‐inducing ligand (TRAIL) levels and male infertility in patients with varicocele. This study included 112 males: 30 fertile males with varicocele, 44 infertile males with varicocele and 38 healthy fertile control subjects without varicocele. Semen analysis was performed, and serum levels of reproductive hormones were measured. Seminal TRAIL levels in the infertile varicocele group were significantly higher than in the fertile varicocele and the control groups (P = 0.014). A significant negative correlation was found between seminal TRAIL and progressive (P < 0.001) and total motility scores (P < 0.001) in the infertile varicocele group. A significant negative correlation was also detected between seminal TRAIL levels and normal sperm morphology in the fertile varicocele (P = 0.007) and infertile varicocele patients (P = 0.047). Seminal TRAIL was significantly correlated with varicocele grade whether the patients were fertile (P = 0.001) or infertile (P = 0.035). Seminal TRAIL may thus have a potential role in varicocele‐associated male infertility through its negative effect on sperm motility and morphology.     

人重组TNF相关凋亡诱导配体联合塞来昔布诱导胆囊癌细胞凋亡的作用研究

目的于体外实验观察人重组肿瘤坏死因子相关凋亡诱导配体(rhTRAIL)联合环氧化酶-2选择性抑制剂塞来昔布对胆囊癌的疗效,初步探讨产生疗效的机制.方法用western-blot法检测塞来昔布作用于胆囊癌细胞株后,抗凋亡蛋白c-FLIP和死亡受体DR4、DR5表达状况.rhTRAIL联合塞来昔布作用于胆囊癌细胞株SGC-996后,采用3种方法检测细胞凋亡状况:(1)细胞的相差显微镜观察;(2)caspase 3、7活性检测;(3)Annexin染色后凋亡细胞流式细胞仪检测.结果塞来昔布可下调SGC-996细胞c-FLIPs的表达,上调DR5的表达,且呈浓度、时间依赖性.rhTRAIL联合塞来昔布作用于胆囊癌细胞后,细胞凋亡水平明显高于单独用药组和对照组.结论塞来昔布可通过下调c-FLIPs表达和上调DR5表达,显著增强rhTRAIL诱导胆囊癌SGC-996细胞凋亡的作用.     

TRAIL真核表达质粒的构建及抑制肝癌生长的实验研究

目的构建TNF相关凋亡诱导配体(TRAIL)基因的真核表达质粒，观察其对BALB／c裸鼠肝癌细胞皮下移植瘤模型的抑瘤作用。方法提取U937细胞总RNA．用RT-PCR方法扩增出胞外区(114—281aa)，连入溶菌酶信号肽序列，构建分泌型TRAIL重组质粒；建立裸鼠7402肝癌细胞皮下移植瘤模型，纯化后的质粒DNA与脂质体聚乙烯胺混合后经肌肉注射进行基因转染，体内验证重组蛋白的抑瘤活性，采用TUNEL法进行肿瘤组织细胞凋亡检测。结果肿瘤体积测定结果显示．TRAIL对肝癌细胞生长有抑制作用；凋亡检测光镜下可见有棕褐色凋亡细胞，细胞凋亡指数增高。结论重组TRAIL质粒能引起肿瘤细胞的凋亡，抑制7402肝癌细胞的生长。     

TRAIL及其受体在肾脏疾病的研究进展

肿瘤坏死因子(TNF)相关的凋亡诱导配体(TRAIL)是肿瘤坏死因子超家族中重要的促凋亡细胞因子。TRAIL通过与死亡受体(DR)结合发挥促凋亡效应,同时该效应受诱骗受体(DcR)的调节,进而发挥抗凋亡、促增殖等作用。TRAIL同各类受体结合所致的病理损伤效应参与糖尿病肾病(DN)、狼疮肾炎(LN)、移植性肾病等肾脏疾病进展,并与其预后密切相关。本文将简要介绍TRAIL、TRAIL受体的结构与功能及其在肾脏疾病中的作用。     

Role of testicular tissue telomerase assay for the prediction of the presence of testicular spermatozoa in azoospermic men with varicoceles, pre- and post-varicocelectomy

We evaluated the reproductive potential of frozen/thawed testicular spermatozoa of azoospermic men with left varicocele. The role of testicular tissue telomerase assay (TTA) in the prediction of the presence of testicular spermatozoa pre- and post-varicocelectomy was investigated, as well. Therapeutic testicular biopsy and TTA were performed in 82 nonobstructed azoospermic (NOA) men with varicoceles. Testicular spermatozoa were found in 33 men and processed for cryopreservation. Oocytes were later recovered from the spouses of the latter azoospermic men with varicoceles and injected with frozen/thawed testicular spermatozoa. Among the 49 men who were negative for testicular spermatozoa, 22 men underwent subsequently subinguinal microsurgical varicocelectomy. A total of 198 mature oocytes were successfully injected and 101 were normally fertilized and subsequently cleaved. Transfer of these 101 embryos in 26 women resulted in nine full-term pregnancies. Thirteen healthy babies were delivered. A cut-off value of TTA of 39 TPG U microg(-1) protein had an overall diagnostic accuracy equal to 90.2% to predict the presence of testicular spermatozoa pre-varicocelectomy. Within the group of men who were negative for testicular spermatozoa a cut-off value of TTA equal to 28 TPG U microg(-1) protein (pre-varicocelectomy) had a 84.2 % diagnostic accuracy to recognize the men who would become positive for either ejaculated or testicular spermatozoa post-varicocelectomy. Testicular spermatozoa can be found in 40% of NOA men with left varicocele. Ooplasmic injections with frozen/thawed testicular spermatozoa have a role in the therapeutic management of non-obstructive azoospermia associated with varicocele. Pre-varicocelectomy, a TTA cut-off value equal to 39 TPG U microg(-1) protein has a 90.2% diagnostic accuracy to indicate the men positive/negative for testicular spermatozoa. In addition, pre-varicocelectomy, a cut-off value equal to 28 TPG U microg(-1) protein has a 84.2% diagnostic accuracy to identify those men with varicoceles without testicular spermatozoa, who will become positive/negative for spermatozoa (either ejaculated or testicular) post-varicocelectomy.     

不育男性双侧Ⅰ度精索静脉曲张对睾丸体积和生殖激素水平的影响

目的 评价不育男性双侧I度精索静脉曲张对睾丸体积和生殖激素水平的影响.方法 185例不育男性双侧I度精索静脉曲张(A组)和149例正常生育男性(B组),比较其睾丸体积、卵泡刺激素(FSH)、黄体生成素(LH)和睾酮(T)水平.结果 A组患者两侧睾丸体积均小于B组,但睾丸体积绝对差异和睾丸体积相对差异与B组比较,无统计学意义.A组患者血清FSH水平高于B组,而LH、T与B组相比,差异无统计学意义.结论 不育男性双侧I度精索静脉曲张可导致患者双侧睾丸体积减小,血清FSH水平升高.     

Targeted RNA interference of PI3K pathway components sensitizes colon cancer cells to TNF-related apoptosis-inducing ligand (TRAIL)

BACKGROUND: The phosphoinositide 3-kinase (PI3K/Akt) pathway transduces signals initiated from growth factors. Previously, we identified an important role for PI3K/Akt in colon cancer progression. The purpose of this study was to determine (1) whether short interfering RNA (siRNA) directed to PI3K/Akt components can render colon cancer cells sensitive to treatment with tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and (2) the cellular mechanisms contributing to the enhanced sensitivity. METHODS: Human colon cancer cells KM20 and KM12C (both TRAIL resistant) were transfected with siRNA directed against the PI3K p85alpha regulatory subunit Akt1 or nontargeting control sequence and then treated with TRAIL (100 ng/mL) or vehicle. A ribonuclease protection assay was performed to assess changes in TRAIL receptor expression. Protein was extracted and analyzed by Western blot for expression of cleavage of TRAIL receptors (death receptor (DR) 4 and 5), caspase-3, caspase-8, and BID. Apoptosis was measured by enzyme-linked immunosorbent assay of DNA fragmentation. RESULTS: Combination treatment with p85alpha or Akt1 siRNA and TRAIL increased apoptosis in KM20 and KM12C cells, compared with TRAIL alone; these results were corroborated further by complete inhibition of apoptosis by Z-acetyl-Asp-Glu-Val-Asp-(DEVD)-fmk, a caspase-3 inhibitor. Furthermore, siRNA-mediated PI3K pathway inhibition resulted in increased expression of the TRAIL death receptors 4 and 5. CONCLUSIONS: Inhibition of PI3K/Akt by RNA interference sensitizes resistant colon cancer cells to TRAIL-induced cell death through the induction of TRAIL receptors and activation of caspase-3 and caspase-8. Agents that selectively target the PI3K/Akt pathway may enhance the effects of chemotherapeutic agents and provide novel adjuvant treatment for selected colon cancers.     

Caspase-8 activation is necessary but not sufficient for tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-mediated apoptosis in the prostatic carcinoma cell line LNCaP

BACKGROUND: The differential sensitivity of tumor cells to TRAIL-induced apoptosis may be mediated by different intracellular inhibitors of apoptosis, and only a few reports have described the pathway(s) that are activated in response to TRAIL in prostate cells. METHODS: LNCaP was transfected with a dominant-negative form of FADD (FADD-DN) and cells were selected in the presence of hygromycin. Cell viability was estimated by calcein assay. Apoptosis was estimated by caspase activation using both fluorogenic substrates and Western blot analysis of activated caspases. To detect cytochrome c release, mitochondria-free cytosol was prepared and Western blot analysis was performed. RESULTS: LNCaP is resistant to TRAIL but TRAIL transiently induces DEVDase activity and activation of caspase-8; caspase-2, -3, -7, and -9 were not activated. Wortmannin, an inhibitor of the PI3K/Akt pathway, converted the phenotype of LNCaP from TRAIL-resistant to -sensitive. In the presence of wortmannin TRAIL induced activation of caspase-2, -3, -7, -8, and -9, as well as dissipation of mitochondrial transmembrane potential and release of cyto-chrome c from mitochondria into the cytosol. In addition, combined TRAIL and wortmannin treatment resulted in cleavage of several proteins: PARP, Akt, p21/WAF1, and MDM2 as well as dephosphorylation of Akt. The proteolysis of p21/WAFI and Akt, which are known survival factors, presumably amplify the apoptotic cascade in LNCaP. Transfection of FADD-DN in LNCaP resulted in inhibition of caspase activation as well as in resistance to combined treatment with TRAIL and wortmannin. CONCLUSIONS: These results suggest that caspase-8 activation is necessary but not sufficient for TRAIL-mediated apoptosis and is presumably blocked downstream of caspase-8 by the PI3K/Akt pathway.     

Obstruction of the tubuli recti and ductuli efferentes by dilated veins in the testes of men with varicocele and its possible role in causing atrophy of the seminiferous tubules

Hormone measurements, spermiograms and testicular biopsies studies were performed in young with varicocele. In addition, the testes and epididymides of 27 adults with varicocele were obtained from autopsies. Light and electron microscopic examination of biopsy and autopsy specimens revealed two types of lesions in testes with varicocele: 1) a diffuse lesion consisting of abnormal spermatozoa and spermatid morphology and sloughing of immature spermatozoa and spermatid; 2) focal lesion, distributed irregularly throughout the testicular parenchyma, affecting several small groups of seminiferous tubules. Each of these groups corresponded to a testicular lobule and showed different degrees of tubular atrophy, so that the focal lesions were distributed in a mosaic pattern. The testicular interstitium showed dilated veins and venules, and progressive collagenization. Some testes showed dilated veins in the rete testis, which compressed several tubuli recti and caused tubular atrophy in the seminiferous tubules opening into these tubuli recti. Other testes showed dilated young veins among the ductuli efferentes, and the rete testis channels appeared to be dilated. Among the different etiological mechanisms which have been suggested to for testicular lesions in varicocele, tubular obstruction at the level of either the tubuli recti or the ductuli efferentes might be responsible for lesions leading to testicular atrophy.     

南京地区汉族人群TRAIL基因多态性与前列腺癌的易感性研究

目的:探讨南京地区汉族人群中肿瘤坏死因子相关凋亡诱导配体(TRAIL)基因多态性与前列腺癌(PCa)易感性的关系。方法:采用病例对照研究,提取187例PCa患者和237例非PCa健康人(对照组)外周血基因组DNA,应用聚合酶链反应-连接酶特异检测技术(PCR-LDR)分析186例PCa患者和237例对照组TRAIL基因-716位点的多态性,比较不同基因型与PCa易感性的关系。结果:TRAIL基因启动子区存在一个SNP位点(-716A/G),基因型分别为AA型、AG型和GG型;Logistic回归分析显示,携带AG、GG和AG+GG基因型的个体与PCa发病风险之间无明显相关性(OR=0.89,95%CI=0.54～1.47;OR=0.94,95%CI=0.69～1.27;OR=0.87,95%CI=0.54～1.41)。结论:中国南京地区汉族人群中TRAIL基因-716位点基因多态性对PCa易感性无明显影响。     

肿瘤坏死因子相关凋亡诱导配体对Omi/HtrA2不同表达水平前列腺癌细胞的促凋亡作用

目的 观察肿瘤坏死因子相关凋亡诱导配体(TRAIL)对前列腺癌细胞(PC-3M)不同丝氨酸蛋白酶Omi/HtrA2表达水平的促凋亡作用.方法 构建其小分子干扰RNA(siRNA)表达载体,辅助设计Omi/HtrA2特异性siRNA序列.合成后克隆入真核表达载体psiRNA-hH1neo.脂质体法转染psiRNA-Omi/HtrA2载体至PC-3M中,检测Omi/HtrA2在PC-3M细胞中的表达及psiRNA-Omi/HtrA2对Omi/HtrA2沉默效应后的转录和表达.用原位末端转移酶标记技术检测Omi/HtrA2基因沉默后,计算不同浓度TRAIL(50、100、200、500 μg/L)下PC-3M细胞凋亡指数(AI).结果 Omi/HtrA2在PC-3M细胞中高表达.酶切和DNA测序证实siRNA基因序列正确,且准确克隆入psiR-NA-hH1neo载体中.psiRNA-Omi/HtrA2载体可特异性抑制PC-3M细胞中Omi/HtrA2的表达.不同浓度TRAIL(50、100、200、500 μg/L)对转染psiRNA-Omi/HtrA2载体后PC-3M细胞AI分别为7.23、14.87、22.65、31.78.而未转染组分别为15.28、24.17、36.33、47.76.两组之间差异有统计学意义(P<0.05).结论 Omi/HtrA2在前列腺癌细胞凋亡过程中起重要作用,TRAIL促进前列腺癌细胞的凋亡,其效果与TRAIL浓度及Omi/HtrA2表达水平相关.     

男性不育患者精索静脉曲张的超声诊断研究

目的:探讨高频超声诊断男性不育患者精索静脉曲张(varicocele,VC)的检测指标及其VC导致睾丸体积改变情况。方法:采用高频超声方法对46例正常对照者的精索静脉及178例男性不育患者左侧曲张的精索静脉进行了检测。根据临床及超声检查结果将178例VC患者分为4组,其中亚临床型VC(SVC)组45例,临床型VCⅠ级(VCⅠ)组44例,Ⅱ级(VCⅡ)组48例,Ⅲ级(VCⅢ)组41例。结果:①对照组双侧平静呼吸时精索静脉最大内径(DR)、Valsalva试验时精索静脉最大内径(DV)、最大返流速度(Vmax)、返流持续时间(TR)及睾丸体积差别均无显著性(P>0.05);②VC组与对照组及各级VC组DR、DV、Vmax、TR比较的差别具有显著性(P<0.001);③各VC组左侧睾丸体积小于右侧(P<0.01),VCⅡ、VCⅢ组右侧睾丸体积小于对照组(P<0.05),VCⅢ组左侧睾丸体积小于SVC组(P<0.05)。结论:①高频超声可为男性不育VC患者提供精确的精索静脉内径、血流动力学及睾丸大小等客观指标,有助于男性不育病因的筛选;②单侧VC可引起双侧睾丸体积变小,尤以左侧为甚,亚临床型及临床型VC均可导致患侧睾丸体积缩小,且VC愈严重,睾丸体积愈小。     

肿瘤坏死因子相关诱导配体受体在前列腺癌组织中的表达

目的：研究肿瘤坏死因子相关诱导配体受体在前列腺癌组织中的表达情况。方法：应用RT—PCR检测20例良性前列腺增生和20例前列腺癌组织中的死亡受体DR4、DR5、假受体DcRl、DcR2的mRNA表达。结果：良性前列腺增生组织中DR4、DR5、DcR1均为85％(17／20);DcR2为75％(15／20)。前列腺癌组织中死亡受体DR41、DR5为80％(16／20);DcR1阳性表达率为15％(3／20);假受体DcR2于前列腺癌组织中未见表达。结论：前列腺癌组织中的DcR1、DcR2受体缺乏表达,DcR1、DcR2在前列腺癌的凋亡调控途径中可能有重要作用。     

Inter-observer variation in the results of the clinical andrological examination including estimation of testicular size

Inter-observer variation in andrological examination by 10 clinical investigators from five Nordic and Baltic countries was investigated. In addition, information on intra-observer variation was obtained for six of the 10 investigators. Testicular size was measured using Prader's orchidometer and one of the investigators also performed an ultrasound estimate of testicular size. A highly significant difference (p < 0.001) between observers was found with an inter-observer error of 16% in estimating testicular size in 23 young men. The difference in the estimate tended to increase with increasing testicular size. There was no significant intra-observer difference in two measurements performed on consecutive days. Only differences in median testis size, which were greater than 31% between measurements by two investigators, were found to be significant at the 5% level. The ultrasound estimate of testicular size was significantly lower than the orchidometer estimate, with a mean difference of 3.6 mL for the left testis and 4.3 mL for the right testis. Tanner staging of genitalia and diagnosis of a varicocele was subject to great inter-observer variation, and for the diagnosis of varicocele only one-third of the investigators was able to reproduce their results on a second examination. In conclusion, it was found that the clinical andrological examination of young men is subject to great inter-observer variation. This should be kept in mind when results from different studies are compared as well as in daily clinical practice.     

The role of testicular biopsy in the modern management of male infertility.

PURPOSE: We evaluate the traditional role of isolated testicular biopsy as a diagnostic tool, as opposed to the value as a therapeutic procedure for azoospermic men. MATERIALS AND METHODS: The medical records of azoospermic patients who were evaluated, and treated between 1995 and 2000 were retrospectively analyzed for history, physical examination findings, endocrine profiles, testicular histology and sperm retrieval rates. Based on these parameters, cases were placed into diagnostic categories that included obstructive or nonobstructive azoospermia. Diagnostic parameters used to distinguish obstructive from nonobstructive azoospermia were subjected to statistical analysis with the t-test, analysis of variance and receiver operating characteristics curve. RESULTS: A total of 153 azoospermic men were included in our analysis. Of men with obstructive azoospermia 96% had follicle-stimulating hormone (FSH) 7.6 mIU/ml. or less, or testicular long axis greater than 4.6 cm. Conversely, 89% of men with nonobstructive azoospermia had FSH greater than 7.6 mIU/ml., or testicular long axis 4.6 cm. or less. Receiver operating characteristics analysis revealed that FSH, testicular long axis, and luteinizing hormone were the best individual diagnostic predictors, with areas 0.87, 0.83 and 0.79, respectively. CONCLUSIONS: In the vast majority of patients obstructive azoospermia may be distinguished clinically from nonobstructive azoospermia with a thorough analysis of diagnostic parameters. Based on this result, we believe that the isolated diagnostic testicular biopsy is rarely if ever indicated. Men with FSH 7.6 mIU/ml. or greater, or testicular long axis 4.6 cm. or less may be considered to have nonobstructive azoospermia and counseled accordingly. These men are best treated with therapeutic testicular biopsy and sperm extraction, with processing and cryopreservation for usage in in vitro fertilization and intracytoplasmic sperm injection if they accept advanced reproductive treatment. Diagnostic biopsy is of no other value in this group. Men with FSH 7.6 mIU/ml. or less, or testicular long axis greater than 4.6 cm. may elect to undergo reconstructive surgery with or without testicular biopsy and sperm extraction, or testicular biopsy and sperm extraction alone depending on their reproductive goals.     

移植物浸润T淋巴细胞肿瘤坏死因子相关凋亡诱导配体及受体DR4和DR5表达与大鼠小肠移植急性排斥反应的相关性

目的 探讨浸润T淋巴细胞七的DR4、DR5表达同小肠移植急性排斥反应的关系.方法 将2种近交系大鼠(SD、Wistar)54只按随机配对法分为A、B、C3组.A组大鼠为对照组(18只)行虚拟手术;B组(18只)大鼠行同系小肠移植;C组(18只)大鼠行不同品系小肠移植.各组大鼠于术后5 d取移植肠样本分别做HE染色和免疫荧光双标记染色.采用免疫荧光染色、激光共聚焦技术测定各组标本浸润T淋巴细胞肿瘤坏死因相关凋亡诱导配体及DR4、DR5的表达情况.结果 A组大鼠小肠黏膜正常,B组大鼠小肠表现为免疫耐受,C组大鼠表现为急性排斥反应.C组大鼠高T淋巴细胞表达肿瘤坏死因子相关凋亡诱导配体与A、B组大鼠比较差异有统计学意义(P < 0.01);A、B组大鼠浸润T淋巴细胞DR4、DR5均呈高表达,C组大鼠呈低表达,C组大鼠与A、B组比较差异有统计学意义(P < 0.01);A、B组大鼠比较差异无统计学意义(P > 0.05).结论 急性排斥反应的发生可能与浸润T淋巴细胞DR的低表达有关.减少浸润淋巴细胞DR表达的下调,或者上调DR将有助于控制急性排斥反应,诱导免疫耐受.