GERM CELL APOPTOSIS and SURVIVAL in TESTICULAR INFLAMMATION

THEAS, MARÍA SUSANA

ANDROLOGIA

WILEY-BLACKWELL PUBLISHING, INC

Año: 2018 vol. 50 p. 13083 - 13091

0303-4569

Male infertility is due to genetics, hormonal, or environmental causes, or is idiopathic. Azoospermia is linked to local testicular microenvironment deregulation, with inflammatory cells present in the 15% of testicular biopsies of infertile patients. As widely reported, spermatogenesis and steroidogenesis are controled by local immunoregulatory agents produced by immune and non-immune cells. Moreover IL-6R, TNFR1, Fas, and IL-1R are expressed on germ cells, indicating a direct action of pro-inflammatory agents on these cells. Beyond the known function of cytokines and nitric oxide on testicular function at the stable levels present in the normal testis, this review focalizes on the effect of pro-inflammatory factors on germ cell survival and death when inflammatory conditions are established in the testis. Since no cure for male infertility has been found up to the present, intra-cytoplasmic sperm injection is the therapeutic option for azoospermic patients who wish to achieve genetic parenthood. Therapies with anti-oxidant and anti-inflammatory agents in experimental models of testicular damage have been successful. However, clinical implementation is uncertain in cases with a prolonged inflammatory state of the testis. Therapies offering multiple approaches to treat infertility by restoring the spermatogonial stem cell niche and protecting germ cells from apoptosis should be considered.