Testicular torsion: its effect on autoimmunisation, pituitary–testis axis and correlation with primary gonadal dysfunction in boys

Abstract

Background Torsion of the testis is an urgent surgical condition that endangers the viability of the gonad and the fertility of the patient. Our aim was to assess potential autoimmune processes and hormonal abnormalities in boys operated on due to that illness. Methods The authors evaluated the levels of antibodies against sperm and Leydig cells, concentrations of follicle-stimulating, luteinizing and anti-Müllerian hormone, testosterone, oestradiol and vascular endothelial growth factor in the serum in 28 boys operated on due to torsion of the testis. Patients’ sexual maturity was assessed according the Tanner scale (group G1, G4 and G5). Results No antibodies against sperm or Leydig cells were found in the serum. Statistically significant differences in follicle-stimulating and anti-Müllerian hormone concentrations were observed in the G1, and they were higher in the study than in the control group. There were no statistically significant differences in luteinizing hormone, testosterone, oestradiol and vascular endothelial growth factor concentrations in the study group or control group. Testosterone concentration was unrelated to total testicular volume. Conclusions Results did not confirm the autoimmune process in boys with torsion of the testis. The pituitary–testis axis seems to have sufficient compensation capabilities. However, study results suggest that primary gonadal dysfunction may predispose to torsion. Impact Significant differences exist between the literature data and own results on the formation of antibodies and hormonal changes due to testicular torsion in boys. It is a novel, prospective study on antibodies against sperms and Leydig cells in the serum and on hormonal processes occurring as a result of the testicular torsion from the prenatal period to the adolescence with division into pubertal groups. The study has revealed sufficient compensation capabilities of the pituitary–testis axis and no autoimmune process in boys with torsion of the testis.

Vitamin D3 Prevents the Deleterious Effects of Testicular Torsion on Testis by Targeting miRNA-145 and ADAM17: In Silico and In Vivo Study

“…Our histomorphometry analysis results demonstrated that the decrease in the weight could be related to the decrease in the mean diameter of seminiferous tubules, and the mean thickness of germinal epithelium in the testicular T/D group which caused a decrease in the ATW and RTW. These results are in agreement with the study from Osemlak et al which showed that exposure to testicular torsion caused a significant loss to the testicular weight due to a decrease in Sertoli cell number [59]. Moreover, our histological results showed that the normal architecture of the seminiferous tubules was lost together with distortion and reduction of the thickness of the epithelial lining with sloughing of the spermatogenic cells.…”

“…Early arrest of spermatogenesis or a diminution of germ cells have been reported to lower the concentration of this hormone [68]. Recently, it was noticed that TT resulted in the reduction of inhibin B hormone which was associated with destruction of Sertoli cells [59]. Furthermore, Fu et al suggested that the increase in serum inhibin B could indicate the degree of testicular injury [69].…”

Varicocele and testicular cord torsion: immune testicular microenvironment imbalance

“…Anti-lymphocyte IgG and splenectomy or corticoids before detorsion also prevent damaging of the contralateral testis ( Nagler and White, 1982 ; Pakyz et al, 1990 ; Mogilner et al, 2006 ). However, Jacobsen et al (2020) suggest that contralateral testis damage results from multifactorial processes that also include pre-existing congenital testicular dysgenesis (a maldeveloped male urogenital tract) that may predispose to TCT ( Laor et al, 1990 ; Osemlak et al, 2021 ) and/or contralateral hypoxia following ipsilateral torsion.…”

Low-Grade Injury following Testicular Torsion: A Multicenter Study Confirming a Disturbing Possibility

“…Several hypotheses on how the damage occurs were suggested as a reduction in contralateral blood flow in response to an afferent input [10], reperfusion injury [11], or an autoimmune reaction against the damaged testis [13]. There are also studies showing no contralateral damage or absence of antisperm antibodies following orchidopexy [14][15][16][17]. Hensen's population-based cross-sectional study with 7,876 young Danish men found no differences in semen parameters between TT patients and healthy controls, and when they cross-matched the findings according to the type of treatment, they showed the superiority of orchiopexy over orchiectomy [18].…”