Amaç: Allopurinol ve oksipurinol tedavisinin testis iskemi-reperfüzyonunda (IR) oksidatif stresi ve germ hücre apoptozunu azaltýp azaltamayacaðýný incelemek.
Yöntemler: Otuz iki erkek sýçan dört gruba ayrýldý: Grup 1 (Sham-Ameliyat, n=8), testis açýða çýkarýldý, ancak torsiyon uygulanmadý; Grup-2 (IR+Salin, n=8), sol testise torsiyon/detorsiyon uygulandý ve 1 ml serum fizyolojik verildi; Grup-3 (IR+Allopurinol, n=8), sol testise torsiyon/detorsiyon uygulandý ve 50 mg/kg allopurinol verildi; Grup 4 (IR+Oksipurinol, n=8), sol testise torsiyon/detorsiyon uygulandý ve 50 mg/kg oksipurinol verildi. Sol testis ameliyat sonrasý 28. günde alýndý ve dokuda TAS, TOS ve OSI düzeyleri ölçüldü. Ayrýca Bax, Bcl-2, eNOS ve VEGF-A gen ekspresyon düzeyleri incelendi.
Bulgular: Allopurinol ve oksipurinol, OSI düzeylerini anlamlý þekilde azalttý (p<0,001). Oksipurinolün oksidatif stresi azaltmada anlamlý þekilde daha etkili olduðu bulundu (p<0,001). Allopurinol ve oksipurinol, Bax gen ekspresyon düzeyini anlamlý þekilde azalttý (p<0,001). Allopurinol (p=0,009) ve oksipurinol (p=0,001) tedavisi Bcl-2 düzeyini anlamlý þekilde artýrdý. Allopurinol ve oksipurinol apoptoz indeksini anlamlý þekilde azalttý (p<0,001). Allopurinol (p1=0,007, p2<0,001) ve oksipurinol (p1,2<0,001) tedavileri, eNOS ve VEGF-A gen ekspresyon seviyelerini anlamlý þekilde artýrmýþtýr.
Sonuçlar: Allopurinol ve oksipurinol, IR sonrasý testiste oksidatif stresi azaltmada etkilidir ve oksipurinol daha güçlü bir antioksidan etkiye sahiptir. Allopurinol ve oksipurinol tedavisi, eNOS ve VEGF-A aracýlý onarým sürecine olumlu katkýda bulunarak apoptozu azaltmada etkilidir. Bu açýlardan, allopurinol ve oksipurinol, testis torsiyonunda klinik uygulamalar için potansiyel ajanlardýr.

Anahtar Kelimeler: Testis torsiyonu, Ýskemi, reperfüzyon, Allopurinol, Oksipurinol

Effect of Allopurinol and Oxypurinol Treatment on Apoptosis in Experimental Testicular Torsion Model

Purpose: To examine whether allopurinol and oxypurinol treatment could mitigate oxidative stress and germ cell apoptosis in testicular ischemia-reperfusion (IR).
Methods: Thirty-two male rats were divided into 4 groups: Group 1 (Sham-Operated, n=8), testicle was exposed but torsion was not performed; Group-2 (IR+Saline, n=8), torsion/detorsion was applied to the left testicle and 1 ml normal saline solution was administered; Group-3 (IR+Allopurinol, n=8), torsion/detorsion was applied to the left testicle and 50 mg/kg allopurinol was administered; Group 4 (IR+Oxypurinol, n=8), torsion/detorsion was applied to the left testicle and 50 mg/kg oxypurinol was administered. The left testicle sample was taken on the 28th postoperative day and TAS, TOS and OSI levels were measured in the tissue; Additionally, Bax, Bcl-2, eNOS and VEGF-A gene expression levels were examined.
Results: Allopurinol and oxypurinol significantly decreased OSI levels (p<0.001). Oxypurinol was found to be significantly more effective in reducing oxidative stress (p<0.001). Allopurinol and oxypurinol significantly reduced the Bax gene expression level (p<0.001). Allopurinol (p=0.009) and oxypurinol (p=0.001) treatment significantly increased Bcl-2 level. Allopurinol and oxypurinol significantly reduced the apoptosis index (p<0.001). Allopurinol (p1=0.007, p2<0.001) and oxypurinol (p1,2<0.001) treatments significantly increased the eNOS and VEGF-A gene expression levels.
Conclusions: Allopurinol and oxypurinol have effects on reducing oxidative stress in the testis after IR, and oxypurinol has a greater antioxidant effect. Allopurinol and oxypurinol treatment have effects on reducing apoptosis by contributing positively to the eNOS and VEGF-A mediated repair process. In these respects, allopurinol and oxypurinol are potential agents for clinical applications in testicular torsion.

Keywords: Testicular torsion, ischemia, reperfusion, allopurinol, oxypurinol