title: Inflammation and oxidative stress in testicular torsion: do they deserve intensive treatment to save both guilty and innocent testes?
abstract: OBJECTIVE
  To investigate at the molecular level, whether the combined use of an antioxidant (L-carnitine) and a selective cyclooxygenase-2 (COX-2) inhibitor (meloxicam) is effective in the treatment of cellular damage caused by testicular torsion.
  
  
  METHODS
  A total of 30 male Wistar rats were randomly divided into 5 groups. The control group underwent a sham operation, and the second group underwent torsion/detorsion for 90 minutes. Groups 3 and 4 received L-carnitine (500 mg/kg/d) and meloxicam (3 mg/kg/d), respectively. Group 5 also received these 2 agents, in addition to the same torsion/detorsion procedure. Bilateral orchiectomy was performed 96 hours after the operation in all groups. cDNA was synthesized after isolation of total RNA from the tissues. The relative expression of interleukin (IL)-1a, COX-2, and β-actin genes was measured by real-time polymerase chain reaction.
  
  
  RESULTS
  The COX-2 and IL-1a mRNA levels had significantly decreased in groups 3, 4, and 5 compared with group 2 (P<.05). COX-2 and IL-1a mRNA levels were significantly great in the torsion/detorsion group (P=.007). The COX-2 and IL-1a mRNA levels significantly decreased in the torsion/detorsion testis after maximal treatment (P<.001).
  
  
  CONCLUSIONS
  Meloxicam seems to exert its inhibitory effect on the expression of specific genes of inflammation, as well as the combination therapy. Because the effects of these inflammatory genes are still evident 4 days after detorsion, combination therapy using these agents could be administered until late postoperative period to prevent the initiation of autoimmune activity against sperm cells and protect the innocent contralateral testis from the insult of antisperm antibodies.
authors.affiliation: Department of Urology, Gazi University School of Medicine, Ankara, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Gürocak
authors.forename: Akin
authors.initials: A
authors.lastname: Yilmaz
authors.forename: Ebru
authors.initials: E
authors.lastname: Alp
authors.forename: Iyimser
authors.initials: I
authors.lastname: Üre
authors.forename: Sinan
authors.initials: S
authors.lastname: Sözen
authors.forename: Sevda
authors.initials: S
authors.lastname: Menevşe
authors.forename: Adnan
authors.initials: A
authors.lastname: Menevşe
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Bozkirli
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000627:therapeutic use*; D002331:Carnitine / Q000627:therapeutic use*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D007249:Inflammation / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D000077239:Meloxicam; D018384:Oxidative Stress; D051381:Rats; D017208:Rats, Wistar; D013086:Spermatic Cord Torsion / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D013843:Thiazines / Q000627:therapeutic use*; D013844:Thiazoles / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D016861:Cyclooxygenase Inhibitors; D013843:Thiazines; D013844:Thiazoles; D002331:Carnitine; D000077239:Meloxicam