Document Type : Original Article


1 Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran

2 Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran

3 Graduate Student, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran


Testicular torsion is a consequence of spermatic cord twisting which causes progressive damage to the structure of the testis and reduces sperm quality and usually results in infertility. In the present study, with the assumption of the protective effects of L-carnitine and betamethasone against ischemia-reperfusion (IR) injuries, their effects on twisted testicles were evaluated and compared. Twenty Wistar rats were randomly divided into four groups and used in this study. Except for the Sham (S) group, testicular IR was induced surgically in three other groups, including Control (C), Betamethasone (BM), and L-carnitine (LC) groups. Betamethasone and L-carnitine were injected before detorsion in the BM and LC groups, respectively. After twelve hours of reperfusion, the testicles were detached, and prepared for sperm parameters evaluation such as sperm count, motility, viability, morphology, and chromatin quality, and histopathologic evaluations, including mean seminiferous tubular diameter (MSTD), germinal epithelial cell thickness (GECT), and Johnsen’s mean testicular biopsy scoring (MTBS). The MSTD, GECT, and healthy sperms in the C group were significantly lower than the other groups, while the BM and LC groups were significantly different from others in MTBS. The number of sperms and sperm motility in the BM group was significantly higher than the C group. Sperm viability in the BM and LC groups were significantly higher than the C group. The results of this study showed that both L-carnitine and betamethasone similarly can be effective in treating testicular IR injuries.


Main Subjects

  1. Minutoli L, Irrera N, Squadrito F, et al. Effects of ischaemic post conditioning on the early and late testicular damage after experimental testis ischaemia–reperfusion. Andrology 2013; 2(1): 76-82.
  2. Dokmeci D, Kanter M, Inan M, et al. Protective effects of ibuprofen on testicular torsion/detorsion-induced ischemia/reperfusion injury in rats. Arch Toxicol 2007; 81(9): 655-663.
  3. Kim HJ, Lee JW, Hwang BR, et al. Protective effect of pterostilbene on testicular ischemia/reperfusion injury in rats. J Pediatr Surg 2016; 51(7):1192-1196.
  4. Yurtcu M, Abasiyanik A, Avunduk MC, et al. Effects of melatonin on spermatogenesis and testicular ischemia-reperfusion injury after unilateral testicular torsion-detorsion. J Pediatr Surg 2008; 43(10): 1873-1878.
  5. Ergur BU, Kiray M, Pekcetin C, et al. Protective effect of erythropoietin pretreatment in testicular ischemia-reperfusion injury in rats. J Pediatr Surg 2008; 43(4): 722-728.
  6. Tunckıran A, Cayan S, Bozlu M, et al. Protective effect of vascular endothelial growth factor on histologic changes in testicular ischemia–reperfusion injury. Fertil Steril 2005; 84(2): 468-473.
  7. Aktas BK, Bulut S, Bulut S, et al. The effects of N-acetylcysteine on testicular damage in experimental testicular ischemia/reperfusion injury. Pediatr Surg Int 2010; 26(3): 293-298.
  8. Ozokutan BH, Kucukaydın M, Muhtaroglu S, et al. The role of nitric oxide in testicular ischemia-reperfusion injury. J Pediatr Surg 2000; 35(1): 101-103.
  9. Auphan N, DiDonato JA, Rosette C, et al. Immunosuppression by glucocorticoids: Inhibition of NF-kappa B activity through induction of I kappa B synthesis. Science 1995; 270(5234): 286-290
  10. Wang M, Shen F, Shi LH, et al. Protective effect of prednisolone on ischemia-induced liver injury in rats. World J Gastroenterol 2008; 14(27): 4332-4337
  11. Hasturk AE, Harman F, Arca T, et al. Neuroprotective effect of magnesium sulfate and dexamethasone on intrauterine ischemia in the fetal rat brain: ultrastructural evaluation. Turk Neurosurg 2013; 23(5): 666-671.
  12. Takahira R, Yonemura K, Fujise Y, et al. Dexamethasone attenuates neutrophil infiltration in the rat kidney in ischemia/reperfusion injury: the possible role of nitroxyl. Free Radic Biol Med 2001; 31(6): 809-815.
  13. Dokmeci D, Inan M, Basaran UN, et al. Protective effect of L-carnitine on testicular ischaemia–reperfusion injury in rats. Cell Biochem Funct 2007; 25(6): 611-618.
  14. Kanter M, Topcu-Tarladacalisir Y, Parlar S. Antiapoptotic effect of L-carnitine on testicular irradiation in rats. J Mol Histol 2010; 41(2-3): 121-128.
  15. Mogilner JG, Elenberg Y, Lurie M, et al. Effect of dexamethasone on germ cell apoptosis in the contralateral testis after testicular ischemia-reperfusion injury in the rat. Fertil Steril 2006; 85(1): 1111-1117
  16. Yurtcu M, Abasiyanik A, Bicer S, et al. Efficacy of antioxidant treatment in the prevention of testicular atrophy in experimental testicular torsion. J Pediatr Surg 2009; 44(9): 1754-1758.
  17. Coskun N, Hatipoglu MT, Ozogul C, et al. The protective effects of acetyl L-carnitine on testis gonadotoxicity induced by cisplatin in rats. Balkan Med J 2013; 30(2): 235-241.
  18. Kanter M. Protective effects of melatonin on testicular torsion/detorsion-induced ischemia–reperfusion injury in rats. Exp Mol Pathol 2010; 89(3): 314-320
  19. Ozturk A, Baltaci AK, Mogulkoc R, et al. The effect of prophylactic melatonin administration on reperfusion damage in experimental testis ischemia-reperfusion. Neuro Endocrinol Lett 2003; 24(3-4): 170-172.
  20. Akpinar S, Hersekli MA, Demirors H, et al. Effects of methylprednisolone and betamethasone injections on the rotator cuff: An experimental study in rats. Adv Ther 2002; 19(4): 194-201.
  21. Scheepens A, Waarenburg M, Hove D, et al. A single course of prenatal betamethasone in the rat alters postnatal brain cell proliferation but not apoptosis. J Physiol 2003; 552(1): 163-175.
  22. Johnsen SG. Testicular biopsy score count—a method for registration of spermatogenesis in human testes: normal values and results in 335 hypogonadal males. Hormones. 1970;1(1):2-25.
  23. World Health Organization. Laboratory manual for the examination and processing of human semen. 5th ed. World Health Organization 2010; 11-102.
  24. Turner TT, Brown KJ. Spermatic cord torsion: loss of spermatogenesis despite return of blood flow. Biol Reprod 1993; 49(2): 401-407.
  25. Parlaktas BS, Atilgan D, Ozyurt H, et al. The biochemical effects of ischemia-reperfusion injury in the ipsilateral and contralateral testes of rats and the protective role of melatonin. Asian J Androl 2014; 16(2): 314-318.
  26. Sekmenli T, Gunduz M, Ozturk B, et al. The effects of melatonin and colchicine on ischemia–reperfusion injury in experimental rat testicular torsion model. J Pediatr Surg 2017; 52(4): 582-586.
  27. Sener TE, Yuksel M, Ozyılmaz-Yay N, et al. Apocynin attenuates testicular ischemia–reperfusion injury in rats. J Pediatr Surg 2015; 50(8): 1382-1387.
  28. Agarwal A, Said TM. Oxidative stress, DNA damage and apoptosis in male infertility: a clinical approach. BJU Int 2005; 95(4): 503–507.
  29. Camhi SL, Lee P, Choi AM. The oxidative stress response. New Horiz 1995; 3(2): 170-182.
  30. Ng CM, Blackman MR, Wang C, et al. The role of car­nitine in the male reproductive system. Ann N Y Acad Sci 2004; 1033: 177-188.
  31. Matalliotakis I, Koumantaki Y, Evageliou A, et al. L-carnitine levels in the seminal plasma of fertile and infertile men: correlation with sperm quality. Int J Fertil Womens Med 2000; 45(3): 236-240.
  32. Agarwal A, Said TM. Carnitine and male infertility. Reprod Biomed Online 2004; 8(4): 376-384.
  33. Izgut-Uysal VN, Agac A, Derin N. Effect of L-carnitine on carrageenan-induced inflammation in aged rats. Gerontology 2003; 49(5): 287-292.
  34. Onem G, Aral E, Enli Y, et al. Neuroprotective effects of L-carnitine and vitamin E alone or in combination against. J Surg Res 2006; 131(1): 124-130.
  35. Moretti S, Famularo G, Marcellini S, et al. L-carnitine reduces lymphocyte apoptosis and oxidant stress in HIV-1-infected subjects treated with zidovudine and didanosine. Antioxid Redox Signal 2002; 4(3): 391-403.
  36. Ishii T, Shimpo Y, Matsuoka Y, et al. Anti-apoptotic effect of acetyl-L-carnitine and L-carnitine in primary cultured neurons. Jpn J Pharmacol 2000; 83(2): 119-124.
  37. Lenzi A, Sgro P, Salacone P, et al. A placebo-controlled double blind randomized trial of the use of combined L-carnitine and L-acetyl-carnitine treatment in men with asthenozoospermia. Fertil Steril 2004; 81(6): 1578-1584.
  38. Arockia Rani PJ, Panneerselvam C. Carnitine as a free radical scavenger in aging. Exp Gerontol 2001; 36(10): 1713-1726.
  39. Cetinkaya A, Bulbuloglu E, Kantarceken B, et al. Effects of L-carnitine on oxidant/antioxidant status in acetic acid-induced colitis. Dig Dis Sci 2006; 51(3): 488-494.
  40. Calo LA, Pagnin E, Davis PA, et al. Antioxidant effect of L-carnitine and its short chain esters: relevance for the protection from oxidative stress related cardio­vascular damage. Int J Cardiol 2006; 107(1): 54-60.
  41. Jeulin C, Lewin LM. Role of free L-carnitine and acetyl-L-carnitine in post-gonadal maturation of mammalian spermatozoa. Hum Reprod Update 1996; 2(2): 87-102.
  42. Deliktas H, Gedik A, Nergiz Y, et al. The effect of L-carnitine on testicular ischemia-reperfusion injury due to testicular torsion in rats. Eur J Gen Med 2012; 9(3): 192-196.
  43. Gruver-Yates A, Cidlowski JA. Tissue-specific action of glucocorticoids on apoptosis: A double-edged sword. Cells 2013; 2(2): 202-223.
  44. Herr I, Gassler N, Friess H, et al. Regulation of differential pro- and anti-apoptotic signaling by glucocorticoids. Apoptosis 2007; 12(2): 271-291.
  45. Hammer S, Sauer B, Spika I, et al. Glucocorticoids mediate differential anti-apoptotic effects in human fibroblasts and keratinocytes via sphingosine-1-phosphate formation. J Cell Biochem 2004; 91(4): 840-851.
  46. Mertoglu C, Senel U, Cayli S, et al. Protective role of methylprednisolone and heparin in ischemic-reperfusion injury of the rat testicle. Andrologia 2016; 48(7): 737-744.
  47. Taati M, Moghadasi M, Dezfoulian O, et al. Effects of ghrelin on testicular ischemia/reperfusion-induced injury. Acta Med Iran 2016; 54(1): 32-38.