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Показники анкет Mіжнародного індексу еректильної функції-5 (МІЕФ-5) чоловіків, постраждалих внаслідок бойових дій

 616.69-008.6(079.5)

Сучасне наукове розуміння еректильної дисфункції вказує на переважну вторинність сексуальних розладів стосовно захворювань, що їх спричиняють. Це значною мірою стосується чоловіків, постраждалих внаслідок бойових дій. Основою роботи стали результати анкетування 298 чоловіків, постраждалих внаслідок бойових дій (осколкові та кульові поранення) з використанням анкет Міжнародного індексу еректильної функції-5 (МІЕФ-5). Дослідна група була розділена на дві: чоловіки віком 20–39 років (група 1) і чоловіки віком 40–53 роки (група 2). До контрольної групи увійшли 48 практично здорових чоловіків без скарг на сексуальну дисфункцію чи кардіологічну, неврологічну або ж ендокринологічну патологію. Серед чоловіків контрольної групи – 30 чоловіків віком 20–39 років (група 3) і 18 чоловіків віком 40–60 років (група 4). Показано, що у 196 чоловіків 1-ї групи віком 20–39 років спостерігається легка форма ЕД – сумарний бал – 19,57 ± 0,44. У 102 чоловіків 2-ї групи віком 40–53 роки теж наявна легка форма ЕД, однак сумарний бал значно нижчий – 17,94 ± 0,41. Показники окремих 5 компонентів статевої функції чоловіків і шкала твердості ерекції також були нижчими в пацієнтів 2-ї групи. Найбільш показово знижується домен ЕД-МІЕФ-5 зі ступенем тяжкості ЕД. Усі домени МІЕФ достовірно знижуються при ЕД порівняно зі здоровою групою респондентів, проте диференціація за тяжкістю ЕД відсутня. Тобто, при ЕД будь-якої вираженості одночасно страждають всі інші сексуальні функції – сексуальне бажання, впевненість в ерекції, твердість та підтримання ерекції, задоволення від статевого акту та статевого життя.

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Parameters of oxidative, nitrasive and anti-oxidative status in men with erectile dysfunction due to combat trauma

The development of oxidative and nitrative stress and the processes of free radical oxidation are associated with many pathological processes. Damage of any origin leads to the activation of free radical processes not only in the place of damage, but also in the whole organism. The aim of the study is to assess the state of lipid peroxidation, content of GSH and GSSG and the activity of NO-synthase and arginase in lymphocytes and peripheral blood serum in men with erectile dysfunction due to combat trauma. The research was conducted on peripheral blood lymphocytes of men injured as a result of combat operations (shrapnel and bullet wounds) in the Russian-Ukrainian war, and who were treated at the Military Medical Clinical Center of the Western Region (Lviv, Ukraine). The research group of men with combat injuries was divided into two age groups: men aged 20–39 years and men aged 40–53 years. The MDA content in the blood serum of patients of both age groups was 1.35 times higher than in the control group. In peripheral blood lymphocytes, the MDA content in patients of the young age group was 1.27, and in patients of the middle age group in 1.39 times higher than in the control group. Simultaneously, no significant changes in the concentration of oxidized glutathione in blood serum and blood lymphocytes were found between men with erectile dysfunction due to combat trauma and healthy men. GSH content in blood serum in patients of both age groups was significantly lower than in the control group. The arginase/NOS ratio in blood serum was 9.75 times lower in the young age group and in 20.45 times lower in the middle age group compared to healthy men. It was established that in the blood serum and blood lymphocytes of men with erectile dysfunction due to combat trauma, processes of lipid peroxidation were intensified and the GSH level was reduced. The GSH/GSSG ratio was reduced only in blood serum. It was found that the oxidative stress is associated with development of nitrative stress. The arginase/NOS ratio was shifted towards increased NOS activity. Activation of iNOS was accompanied by significant inhibition of cNOS. Further study of biochemical mechanisms is important to understand the triggers of erectile dysfunction due to combat
trauma.
Keywords: trauma; erectile dysfunction;MDA content; glutathione;NO-synthase; arginase. 

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DIAGNOSTIC SENSITIVITY AND SPECIFICITY OF INDICATORS OF GLUTATHIONE ANTIOXIDANT SYSTEM IN SPERMATOZOA OF INFERTILE MEN WITH DIFFERENT FORMS OF PATHOSPERMIA

UDC: 612.616.2:612.015.1]-07

Background. One of the most important antioxidant defence mechanism in spermatozoa is the gluthatione system which includes glutathione peroxidase (GPx), glutathione reductase (GR), glutathione S-transferase (GST) and reduced glutathione (GSH). It is promising to use ROC analysis, which allows to assessing the diagnostic sensitivity and specificity of indicators.
Materials and methods. Infertile men were divided into 3 groups: patients with oligozoospermia (n = 30), asthenozoospermia (n = 34), and oligoasthenozoospermia (n = 22). To assess the diagnostic sensitivity and specificity of indicators, the values of the biomarkers were tested using the receiver operating characteristic (ROC) curve, and the area under it (AUC), the standard error (SE) and the 95% confidence interval (CI 95%) were calculated.
Results. The ROC analysis showed that GP activity was characterized by excellent diagnostic significance for diagnosing both oligozoospermia and asthenozoospermia (the sensitivity was 100%, and specificity – 100%). The GR activity has moderate diagnostic significance, since the AUC is 0.654 (95% CI from 0.503 to 0.785, P = 0.0645) for oligozoospermic, the AUC is 0.612 (95% CI from 0.454 to 0.7555, P = 0.1979) for asthenozoospermic men. The analysis of the ROC curve revealed a good diagnostic value of GsT activity in sperm samples for the diagnosis of pathospermia (sensitivity of 75% and specificity of 80%). Simultaneously, it was shown that GSH content could not serve as valuable biomarkers for distinguishing patients with pathospermia from healthy controls, with an AUC of 0.615, corresponding to moderate diagnostic significance for oligozoospermia.
Conclusion. The results of this study show that the cut-off points for the biomar­kers glutathione peroxidase and glutathione-S-transferase can be used to distinguish between patients with pathospermia and normozoospermia, and the parameters themselves can serve as valuable diagnostic biomarkers to distinguish patients with pathospermia from healthy controls, regardless of the causes of pathospermia. The value of these indicators below the cut-off point indicates the probable presence of pathology. Indicators of GR activity and GSH content have a low diagnostic value, which makes them unsuitable for use as laboratory tests for the diagnosis of male infertility.

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IMBALANCE OF SUBSTANCES IN UTERINE-VAGINAL MUCUS IN THE EARLY DAYS OF THE ESTROUS CYCLE

Abstract


Background. The macroscopic evaluation of the color and consistency of cow uterine-vaginal mucus (UVM) samples revealed that during days 1–3 of the estrous cycle, 45.4 % of the animals in the studied sample (n = 11) had a clear-glassy color, 27.3 % had blood impurities, 18.2 %, and 9.1 % – altered coloring. Additionally, 36.4 % of the samples had thick-viscous, liquid consistency, while 63.6 % had liquid texture.
Materials and methods. Mucus was collected from experimental animals at 7–8 a.m. on days 1–3 of the estrous cycle. The volume (cm3) was measured and the color and consistency of the secretion were evaluated. Indicators of mass (g) and content (%) of water (H2O), organic substances (OS), and inorganic substances (IS) were determined gravimetrically.
Results. The analysis of the volume and mass indicators of native UVM samples indicates a high (˃95 %) error rate in the registered changes of H2O. However, the error in the sum of the masses OS and IS samples of dry residue (DR) components is completely different. This indicator tends to change on days 1 and 2 (Р ˂0.05), but its stable probability is detected on days 2 and 3, as well as 1 and 3 (Р ˂0.001). Stable changes in the mass OS were detected on days 2 and 3 (Р ˂0.01), while the masses of IS changed on days 1 and 2 (P ˂0.01) and 2 and 3 (P ˂0.001). In all other cases, the error exceeds 95 %.
The mass percentages of H2O, OS, and IS indicate a tendency (Р ˂0.05) for changes in H2O and OS content on days 1 and 3; IS content changes on days 1 and 2, as well as 2 and 3, but the changes on days 1 and 3 are highly stable (Р ˂0.001). Stable changes in the mass of DR components were only observed on days 2 and 3.
The analysis of homeostasis changes in the mass of native samples indicates that the limit of mean values of UVM:Н2О (1.02–1.04:1) ˂ Н2О:OS (67–77:1) ˂ Н2О:IS (82–439:1), but the OS:IS ratios (1.2–5.5:1) of UVM sample align with the OS:IS ratios (1.2–5.5:1) of DR samples.
The limit of Сv for UVM:Н2О, Н2О:OS, Н2О:IS ratio is 0.8–5.3; 19–27; 46–93 % respectively. The OS:IS ratios of native UVM and its DR samples are the same (49; 63; 31 %). The indicators of UVM:Н2О, Н2О:IS, and OS:IS ratios suggest a tendency for change (Р ˂0.05) on days 1 and 3. Their stable changes (Р ˂0.01–0.001) were observed on days 1 and 2, as well as 2 and 3 for Н2О:IS and OS:IS ratios.
Conclusion. Given the above, there is a need for further thorough investigation of the characteristics of the imbalance in the components’ mass of UVM during days 1–3 of the estrous cycle, as well as the response of secretory cells of the mucous membrane of the reproductive organs to the effects of pathological factors. This research will be applied in the development of new methods of prevention, diagnosis, and treatment of reproductive tract diseases in female animals.

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