The antioxidant n-acetyl cyste

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Bezug Jannatifar R., Parivar K., Roodbari NH, Nasr-Esfahani MH. Auswirkungen einer N-Acetyl-Cystein-Supplementierung auf die Spermienqualität, die Chromatinintegrität und das Ausmaß des oxidativen Stresses bei unfruchtbaren Männern. (Link entfernt). 2019;17(24). Studienziel Bestimmung der Auswirkungen einer Supplementierung mit dem Antioxidans N-Acetyl-Cystein (NAC) auf die Spermienqualität, die Chromatinintegrität und das Ausmaß des oxidativen Stresses bei unfruchtbaren Männern mit anormalen Samenparametern Entwurf Dreimonatige prospektive, randomisierte, verblindete klinische Studie Teilnehmer Fünfzig Männer im Alter von 25 bis 40 Jahren mit Asthenoteratozoospermie, bestimmt nach WHO-Kriterien. Die Teilnehmer berichteten von keinen früheren Imprägnierungen und hatten Partnerinnen ohne Fruchtbarkeitsprobleme. Patienten mit Erkrankungen und/oder Risikofaktoren, von denen bekannt ist, …
Relation Jannatilar R., Parivar K., Rodbari NH, Nasr-Esfahani Mh. Effects of an N-acetyl cysteine ​​supplementation on sperm quality, chromatin integrity and the extent of oxidative stress in sterile men. (Link away). 2019; 17 (24). Study goal Determination of the effects of supplementation with the antioxidant n-acetyl cyst (NAC) on sperm quality, chromatin integrity and the extent of oxidative stress in sterile men with abnormal seed parameters draft three-month prospective, randomized, blinded clinical studies. Asthenoteratozoospermia, determined according to WHO criteria. The participants did not report any earlier impregnations and had partners without fertility problems. Patients with diseases and/or risk factors that are known ... (Symbolbild/natur.wiki)

reference

Jannatilar R., Parivar K., ROODBARI NH, NASR-ESFAHANI MH. Effects of an N-acetyl cysteine ​​supplementation on sperm quality, chromatin integrity and the extent of oxidative stress in sterile men. (Link away). 2019; 17 (24).

Study goal

Determination of the effects of a supplementation with the antioxidant N-acetyl cysteine ​​(NAC) on sperm quality, chromatin integrity and the extent of oxidative stress in sterile men with abnormal seed parameters

draft

Three -month prospective, randomized, blinded clinical study

participant

Fifty men aged 25 to 40 years with asthenoteratozoospermia, determined according to WHO criteria. The participants reported no earlier impregnations and had partners without fertility problems.

Patients with diseases and/or risk factors that are known to affect fertility (hormonal anomalies, clinefelter syndrome, varicocele, cryptorchism, vasectomy, leukospermia, sperm antibodies, anatomical diseases, crab, abnormal liver function, cigarette smoking, alcohol consumption within from 90 days after seed analysis) were excluded.

Intervention

All participants received an oral NAC supplement of 600 mg.

for 3 months

study parameters evaluated

The semen analysis was used to assess the following seed parameters: volume, sperm concentration, overall mobility, progressive mobility, non-progressive mobility, immovable sperm and abnormal morphology. Other recorded data included the DNA fragmenting index, the protamine deficiency values, the total antioxidant capacity (TAC), the content of seminalem malondiahyde (MDA) and hormonal parameters, including the serum level of the follicle-stimulating hormone (FSH), the Luteinizing Hormon (LH), the testosterone and Prolactin. The reviews were carried out at the start of the course and after 3 months.

primary result measurements

The results after 3 months were with them at the beginning of the course.

important knowledge

After 3 months of NAC, significant improvements were found in all evaluated seed parameters: volume ( p = 0.01), sperm concentration ( p = 0.02), overall mobility ( p = 0.01), progressive motility ( p = 0.001), non-progressive ( p = 0.01), immobile sperm ( p = 0.01) and abnormal morphology ( p = 0.001).

There were also significant reductions in the percentages of DNA fragmentation ( p = 0.001) and sperm with protamine deficiency ( p = 0.009). The values ​​of the oxidative stress improved compared to the initial value, as by taking the MDA ( p = 0.01) and an increase in the TAC ( p = 0.01). All hormonal parameters except prolactin showed statistically significant differences with acceptance of FSH ( p = 0.01) and LH ( p = 0.04) and an increase in testosterons ( p = 0.01).

practice implications

Male infertility makes up a significant percentage of infertility cases, with a prevalence that corresponds approximately to female infertility. 1 Several etiologies have been identified, including innate anomalies, genetic inheritance, poor lifestyle, environmental influences and iatrogenic conditions. If no cause is recognizable, the diagnosis of an unexplained or idiopathic infertility is made. 2 While the terms are used "unexplained" and "idiopathic", there is an important difference. Patients with real unexplained infertility are presented with a normal examination, including seed analysis. In contrast, those with idiopathic infertility have a normal processing, with the exception of suboptimal sperm analysis findings. 3 The participants of this study were classified as the latter, since poor movement and morphology were determined (asthenoteratozoospermia).

After 3 months of NAC, significant improvements were found in all evaluated seed parameters.

idiopathic male infertility is a current topic of interest among researchers, with a special focus on the connection between oxidative stress and abnormal seed parameters. Oxidative stress occurs when there is an excess of reactive oxygen species (ROS) with inadequate antioxidant storage. are. 5 If ROS is in excess, they affect the spermatogenesis and threaten the general sperm quality. 6 male idiopathic infertility often has deviations in both ROS and antioxidants, which indicates that these people have greater stress due to oxidative stress Wear. 4.7

In the present study, Malondiadhyde (MDA) and the entire antioxidant capacity (TAC) served as a biomarker for oxidative stress. MDA is produced when Ros initiates the lipid peroxidation of polyunsaturated fatty acids (PUFAS). Since the plasma membranes of spermatozoen pufas contain, the MDA levels serve as an indicator of the lipid peroxidation. 8 Several studies have shown higher MDA levels in sterile men compared to fertile men. The subsequent oxidative stress contribute to the seed anomalies associated with idiopathic male infertility.

During the mechanism, by which oxidative stress changes the normal sperm physiology, unknown, recent research has shown that it affects DNA integrity. The DNA fragmentation index and the protaming content are considered promising markers for DNA damage. They seem to predict fertility results better than a seed analysis. 11 in 2019 Borges et al. Statistically significant correlations between a high degree of sperm-DNA fragmentation and poor embryo development, a low implantation rate and a high miscarriage rate. 12 The participants of this study originally assumed that they suffered from unexplained infertility. In almost 10 %, however, sperm anomalies were found in the form of DNA fragmentation. These results indicate that DNA fragmentation is a valuable marker for sperm anomalies for some men and could be used in combination with a sperm analysis to strengthen the diagnostic processing of male infertility.

The connection between oxidative stress, DNA damage and poor sperm quality seems to be well documented. It is less clear whether oxidative stress causes the DNA damage connected to seed anomalies. The present study showed remarkable improvements in oxidative stress, DNA integrity and sperm quality with antioxidant supplementation in the form of NAC. Other studies on antioxidant therapy for male infertility have reported similar results. However, strict studies that show clear clinical results are limited, and most of the research results come to the conclusion that further investigations are justified. 14 In the meantime it seems sensible to target oxidative stress in the treatment of male idiopathic infertility, be it by supplementing with antioxidants or in any other way. The current options for providers are extensive, with a growing list of antioxidant nutritional supplements, including selenium, L-carnitine, acetyl-l-carnitine, coenzyme Q10, zinc, folic acid, myo-inositol, vitamin C, docosahexaenoic acid (DHA). , Eicosapentaenic acid (EPA) and now nac. 15-20

  1. Kumar N., Singh Ak. Trends of male infertility, an important cause of infertility: a literature overview. j Hum Reprod Sci . 2015; 8 (4): 191–196.
  2. Anawalt B, page S. Causes of male infertility. (Link away). Literature overview currently until June 2019. Access on July 14, 2019.
  3. Kothandaraman N., Agarwal A., Abu-Elmagd M., Al-Quatani Mh. Pathogenic landscape of idiopathic male infertility: new insights into their regulatory networks. npj Genommed . 2016; 1: 16023.
  4. Wagner H, Cheng JW, Ko Ey. Role of reactive oxygen species in male infertility: an updated literature overview. arab j urol . 2018; 16 (1): 35–43.
  5. human sperm and interactions with oxidative stress. In: Toor JS, Sikka Sc. oxidants, antioxidants and influence of oxidative status on male reproduction . Elsevier; 2019. Accessed on July 14th, 2019.
  6. Dutta S, Majzoub A, Agarwal A. Oxidative stress and sperm function: A systematic review of evaluation and management. arab j urol . 2019; 17 (2): 87-97.
  7. Alkan I, Simsek F, HACH, Kervancioğlu e, Ozveri H, Yalçin S. Production of reactive oxygen species through the sperm of patients with idiopathic infertility: relationship with seed plasma antioxidants. J urol. 1997; 157: 140–143.
  8. agarwal A, Prabakaran SA. Mechanism, measurement and prevention of oxidative stress in male reproductive physiology. Indian J Exp Biol . 2005; 43 (11): 963-974.
  9. oladosu ow, biliaminu sa, abdulazeeez im, nwadike vu, yusuff jo, okesina. Evaluation of the groundbreaking biomarker of lipid peroxidation in male partners of sterile couples at the teaching hospital of the University of Ilorin in Nigeria. Niger Postgrad Med J . 2018; 25 (2): 94-99.
  10. Subramanian V, Ravichandran A, Thiagarajan N, Govindarajan M, Dhandayuthapani S, Suresh S. Seminal Reactive oxygen species and total antioxidant capacity: correlations with sperm parameters and effects on male infertility. Clin Exp. Reprod. Med . 2018 jun; 45 (2): 88-93.
  11. Wright C, Milne S, Leeson H. Spermia DNA damage through oxidative stress: Modifiable clinical, lifestyle and nutritional factors in male infertility. Reproduction of biomed online . 2014 Jun; 28 (6): 684-703.
  12. Borges e JR, Zanetti Bf, Setti as, Braga DPAF, Provenza RR, Iaconelli a Jr. Spermia-DNA fragmentation correlated with poor embryonic development, lower implantation rate and higher miscarriages in reproduction cycles of infertility through non-male factors. fertile sterile . 2019; 112 (3): 483-490.
  13. Keshteli SH, Farsi MM, Khafri S. should we carry out semen-analyzes, DNA fragmentation and hypoosmotic swelling tests together? int. J. Mol. Cell. Med . 2016; 5 (4): 246–254.
  14. Showell MG, Mackenzie-Proctor R., Brown J., Yazdani A., Stankiewicz Mt, Hart RJ. Antioxidants for male subfertility. Cochrane Database Syst Rev . 2014; (12): CD007411.
  15. Buhling K, Schumacher A, Eulenburg CZ, Laakmann E. Influence of oral vitamin and mineral supplements on male infertility: a meta-analysis and systematic review. Reproduction of biomed online . 2019; 39 (2): 269-279.
  16. b. Hosseini, M. Näurmohamadi, S. Hajipour et al. The effect of omega-3 fatty acids, EPA and/or DHA on male infertility: a systematic review and meta-analysis. j Diet-Suppl . 2019; 16 (2): 245-256.
  17. Busetto GM, Agarwal A, Virmani a, et al. Effect of a metabolic and antioxidant supplementation on sperm parameters in oligo-astheno-teratozoospermia, with and without varicocele: a double-blind, placebo-controlled study. Andrology . 2018; 50 (3).
  18. Cheng JB, ZHU J, Ni F, Jiang H. L-Carnitin combined with Coenzyme Q10 in idiopathic oligoastenozozoospermia: a double-blind, randomized, controlled study. zhonghua nan ke xue . 2018; 24 (1): 33-38.
  19. condorelli ra, La vignera s, Mongioì lm, et al. Myo-Inositol as a male fertility molecule: accelerate them! EUR. Rev. med. Pharmacol. Sci . 2017; 21 (2 Suppl): 30-35.
  20. Kumalic Si, Pinter B. Review of Clinical Trials on effects of oral antioxidants on basic sperm and other parameters in idiopathic oligoastenoteratozoospermia. biomed res int . 2014; 2014: 426951.