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Evaluation of the Protective Effect of Co-administration of Hydroalcoholic Extract of Lemongrass (Cymbopogon citratus) and Vitamin E on Ultrasound Indices, Oxidative Stress, and Testosterone Level in a Model of Testicular Ischemia-Reperfusion in Rats
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Kambiz Yousefi    , Mahdi Farid , Elham Moghtadaei Khorasgani * , Mehrdad Yadegari |
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Abstract: (4 Views) |
Introduction:
Testicular torsion is a urological emergency that interrupts blood flow to the testis, causing ischemia and severe tissue damage. Reperfusion itself exacerbates injury by inducing oxidative stress. This study aimed to evaluate the combined effect of hydroalcoholic extract of Cymbopogon citratus (lemongrass) and vitamin E on ultrasound indices, oxidative stress, and testosterone levels in a rat model of testicular ischemia-reperfusion. The importance of this research lies in the potential to find effective protective interventions that can mitigate testicular damage and preserve reproductive function following torsion-detorsion events.
Materials and Methods:
In this experimental study, 30 adult male Wistar rats (weighing 250±30g) were randomly divided into five groups (n=6): negative control, positive control (torsion-detorsion without treatment), lemongrass extract-treated group (400 mg/kg/day, intraperitoneal), vitamin E-treated group (160 mg/kg/day, intramuscular), and a combination group receiving both compounds. Testicular ischemia was induced by rotating the left testis 720 degrees counterclockwise for 3 hours, followed by detorsion. Ultrasound indices including echogenicity, resistive index (RI), and testicular size were assessed on days 1 and 21. Serum levels of malondialdehyde (MDA), total antioxidant capacity (TAC), gamma-glutamyl transferase (GGT), and testosterone were analyzed. Additionally, gene expression of superoxide dismutase (SOD) and catalase (CAT) was evaluated using Real-Time PCR. Statistical analysis was performed using One-Way ANOVA followed by Tukey's test, with significance set at P<0.05.
Results:
Co-administration of lemongrass extract and vitamin E significantly improved ultrasound indices compared to the positive control group (P<0.001). On day 21, the combination group showed testicular size (122.95±2.39 mm) significantly larger than the positive control group (77.32±3.41 mm) and closer to the negative control group (128.33±3.43 mm). The resistive index in the combination group (0.58±0.01) was significantly lower than the positive control (0.86±0.01) and similar to the negative control (0.57±0.02). Echogenicity scores were significantly better in the combination group (0.63±2.00) compared to the positive control (3.00±0.00). Biochemical analysis revealed that MDA levels were significantly reduced in the combination group (2.122±0.211 nmol/mg protein) compared to the positive control (4.852±0.283 nmol/mg protein). TAC levels were significantly increased in the combination group (0.475±0.027 mmol/L) compared to the positive control (0.175±0.071 mmol/L). GGT levels were significantly lower in the combination group (0.010±0.510 U/mg protein) compared to the positive control (1.157±0.650 U/mg protein). Testosterone levels were significantly higher in the combination group (0.948±0.025 ng/mL) compared to the positive control (0.433±0.075 ng/mL). Gene expression analysis showed significant upregulation of both SOD and CAT in the combination group compared to the positive control.
Discussion:
The findings of this study demonstrate that co-administration of lemongrass extract and vitamin E provides synergistic protective effects against testicular ischemia-reperfusion injury. The improvement in ultrasound parameters indicates better preservation of testicular structure and blood flow. The reduction in MDA and increase in TAC suggest enhanced antioxidant defense mechanisms. The decrease in GGT levels indicates reduced cellular damage, particularly to Sertoli cells. The preservation of testosterone levels suggests maintained Leydig cell function. The upregulation of SOD and CAT gene expression provides a molecular mechanism for the observed antioxidant effects. These findings are consistent with previous studies on the antioxidant properties of lemongrass and vitamin E, but this is the first study to demonstrate their synergistic effects in a testicular ischemia-reperfusion model using both ultrasound and biochemical parameters.
Conclusion:
Concurrent use of hydroalcoholic lemongrass extract and vitamin E can serve as an effective protective strategy to mitigate testicular ischemia-reperfusion complications, preventing tissue damage and functional impairments. The combination therapy showed superior effects compared to individual treatments, suggesting a synergistic interaction. This approach has potential clinical applications in veterinary medicine for managing testicular torsion and improving outcomes after surgical detorsion. Further studies are needed to determine optimal dosing and evaluate long-term effects on fertility.
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| Keywords: Lemongrass, Vitamin E, Testicular torsion, Oxidative stress, Resistive index, Echogenicity, Testosterone, Ultrasound, MDA, TAC |
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Type of Study: Research |
Subject:
medicine, paraclinic
Received: 2025/09/18 | Revised: 2025/12/9 | Accepted: 2025/12/9
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