Synergistic Protective Effects of Hydroalcoholic Extract of Echinophora Platyloba and Vitamin E on Testicular Ischemia-Reperfusion Injury: Evaluation of Oxidative Stress, Antioxidant Gene Expression, and Doppler Ultrasound Findings

Sadeghi, Ashkan; Farid, Mehdi; Moghtadaei-Khorasgani, Elham; Yadegari, Mehrdad; Javdani, Moosa

[Home ] [Archive]

[ فارسی ]

Main Menu

Home

Journal Information

Indexing Sources

Guide for Authors

Online Submission

Ethics

Articles archive

For Reviewers

Contact us

Basic and Clinical Biochemistry and Nutrition

DOAJ

CINAHL

EBSCO

IMEMR

ISC

Search in website

Receive site information

enamad

Back to the articles list

Back to browse issues page

Synergistic Protective Effects of Hydroalcoholic Extract of Echinophora Platyloba and Vitamin E on Testicular Ischemia-Reperfusion Injury: Evaluation of Oxidative Stress, Antioxidant Gene Expression, and Doppler Ultrasound Findings

Ashkan Sadeghi

, Mehdi Farid

, Elham Moghtadaei-Khorasgani ^*

, Mehrdad Yadegari

, Moosa Javdani

Department of Pathobiology, ShK.C., Islamic Azad University, ShahreKord, Iran , Moghtadaiee@gmail.com

Abstract: (244 Views)

Background:
Testicular ischemia-reperfusion (I/R) injury is one of the major urological emergencies. Following acute interruption of blood flow and sudden restoration of perfusion, it leads to excessive production of reactive oxygen species (ROS), activation of inflammatory pathways, downregulation of antioxidant genes such as SOD and CAT, and structural damage to testicular tissue. This process not only impairs germ cell function but also reduces sperm count and quality, ultimately diminishing fertility potential. Therefore, identifying natural agents capable of modulating oxidative stress and improving testicular function holds significant clinical importance. Accordingly, this study aimed to evaluate the synergistic effects of hydroalcoholic extract of Echinophora platyloba and vitamin E on testicular sonographic parameters, oxidative stress indices, antioxidant gene expression, sperm count, and testosterone levels in an animal model of testicular ischemia-reperfusion injury.
Materials and Methods:
In this experimental study, 30 adult male Wistar rats were randomly divided into five groups: sham, testicular torsion-detorsion (T/R) group, Echinophora platyloba extract-treated group, vitamin E-treated group, and combination group. Sonographic parameters including echogenicity, resistance index (RI), and testicular volume were assessed using color Doppler ultrasound (Medison SA-8000) on days 1 and 21. Biochemical parameters including malondialdehyde (MDA), total antioxidant capacity (TAC), catalase (CAT) activity, superoxide dismutase (SOD) activity, and testosterone levels were measured using spectrophotometric, enzymatic, and ELISA methods. Additionally, the expression of SOD and CAT genes was evaluated using real-time PCR.
Results:
Concurrent administration of hydroalcoholic extract of Echinophora platyloba and vitamin E significantly improved sonographic parameters. The resistance index (RI) decreased from 0.88 ± 0.01 to 0.59 ± 0.01. Echogenicity decreased from 2.61 ± 0.14 to 1.00 ± 0.25, and testicular volume significantly increased from 72.705 ± 5.742 mm³ to 131.658 ± 9.831 mm³ (P < 0.0001). In the group receiving the combination of Echinophora extract and vitamin E, the relative expression levels of SOD and CAT genes showed significant increases of 1.7-fold and 4.7-fold, respectively, compared to the torsion-detorsion (T/D) group. Sperm count increased from 20.300 ± 1.300 × 10⁶ sperm/mL to 100.200 ± 1.638 × 10⁶ sperm/mL (P < 0.001). Furthermore, tissue malondialdehyde (MDA) levels significantly decreased, while total antioxidant capacity (TAC) and testosterone levels showed significant increases (P < 0.001).
Conclusion:
The findings of this study indicate that concurrent administration of hydroalcoholic extract of Echinophora platyloba and vitamin E possesses considerable protective capacity against testicular ischemia-reperfusion-induced damage. It appears that this combination plays an effective role in preventing tissue damage and preserving physiological testicular function by attenuating oxidative stress, modulating inflammatory processes, and upregulating the expression of genes related to the antioxidant system.

Keywords: Echinophora platyloba, Vitamin E, Testicular torsion, Sperm, Oxidative stress

Type of Study: Research | Subject: medicine, paraclinic
Received: 2026/05/27 | Revised: 2026/08/19 | Accepted: 2026/07/13

References

1. Leys CM, Gatti JM. The Acute Scrotum. In: Holcomb GW, Murphy JP, Ostlie DJ, editors. Ashcraft's Pediatric Surgery. 5th ed. Philadelphia: Saunders; 2010. p. 687-91. doi:10.1016/B978-1-4160-6127-4.00053-7

2. Ashraf-Talesh SS, Amniattalab A. Histopathologic Evaluation of Intraperitoneal Administration of Cerium Oxide Nanoparticles on Ischemia Reperfusion Injury in Rat Testicular Torsion and Detorsion Model. Iran J Vet Surg. 2021;16(2):84-90.

3. Aitken RJ, Roman SD. Antioxidant systems and oxidative stress in the testes. Adv Exp Med Biol. 2008; 636:154-71. doi:10.1007/978-0-387-09597-4_9 PMid:19856167

4. Aktaş BK, Bulut S, Bulut S, Baykam MM, Özden C, Senes M, et al. The effects of N-acetylcysteine on testicular damage in experimental testicular ischemia/reperfusion injury. Pediatr Surg Int. 2010;26(3):293-8. doi:10.1007/s00383-009-2538-0 PMid:19911182

5. Kazak F, Akcakavak G, Alakus I, Alakus H, Kirgiz O, Karatas O, et al. Proanthocyanidin alleviates testicular torsion/detorsion-induced ischemia/reperfusion injury in rats. Tissue Cell. 2024;89:102459. doi:10.1016/j.tice.2024.102459 PMid:39002290

6. Aitken RJ, Smith TB, Jobling MS, Baker MA, De Iuliis GN. Oxidative stress and male reproductive health. Asian J Androl. 2014;16(1):31-8. doi:10.4103/1008-682X.122203 PMid:24369131 PMCid:PMC3901879

7. Gong Y, Han XD. Nonylphenol-induced oxidative stress and cytotoxicity in testicular Sertoli cells. Reprod Toxicol. 2006;22(4):623-30. doi:10.1016/j.reprotox.2006.04.019 PMid:16777376

8. Tan BL, Norhaizan ME, Liew WP, Sulaiman Rahman H. Antioxidant and Oxidative Stress: A Mutual Interplay in Age-Related Diseases. Front Pharmacol. 2018;9:1162. doi:10.3389/fphar.2018.01162 PMid:30405405 PMCid:PMC6204759

9. Yousefi K, Farid M, Moghtadaei Khorasgani E, Yadegari M. Therapeutic Potential of Cymbopogon citratus Hydroalcoholic Extract and Vitamin E Coadministration in Alleviating Complications From Testicular Ischemia-Reperfusion-Induced Injury in Rats. Andrologia. 2025;2025(1):4028767. doi:10.1155/and/4028767

10. Aziz N, Saleh RA, Sharma RK, Lewis-Jones I, Esfandiari N, Thomas AJ Jr, et al. Novel association between sperm reactive oxygen species production, sperm morphological defects, and the sperm deformity index. Fertil Steril. 2004;81(2):349-54. doi:10.1016/j.fertnstert.2003.06.026 PMid:14967372

11. Jiang Q. Natural forms of vitamin E: metabolism, antioxidant, and anti-inflammatory activities and their role in disease prevention and therapy. Free Radic Biol Med. 2014;72:76-90. doi:10.1016/j.freeradbiomed.2014.03.035 PMid:24704972 PMCid:PMC4120831

12. Sajjadi SE, Ghannadi A. Composition of the essential oil of Echinophora cinerea (Boiss.) Hedge et Lamond. J Essent Oil Res. 2002;14(2):114-5. doi:10.1080/10412905.2002.9699788

13. Delazar A, Nazemiyeh H, Babaei H, Talebpour AH, Nahar L, Sarker SD. Chemical composition and antimicrobial activity of the essential oil of Echinophora platyloba DC. from Iran. Food Control. 2006;17(7):577-80.

14. Pas M, Rashidipour M, Talei G, Doosty B. Chemical compositions, antibacterial and antioxidant properties of Echinophora cinerea essential oil. J Med Herb. 2012;3(2):67-74.

15. Zarie A, Changizi-Ashtiyani S, Sokhandani M, Farrokhi Z, Rassekh F, Amini S, et al. The effects of extracts of aerial sections of Echinophora platyloba on function tests of Liver, kidney, and fat profiles of diabetic male rats induced by Streptozocin. Feyz Med Sci J. 2021;25(2):823. 10.48307/FMSJ.2021.25.2.823

16. Mirghazanfari SM, Hosseinzadeh L, Shokoohinia Y, Aslany M, Kamali-Nejad M. Acute and subchronic toxicological evaluation of Echinophora platyloba DC (Apiaceae) total extract in Wistar rats. Clinics (Sao Paulo). 2012;67(5):497-502. doi:10.6061/clinics/2012(05)15

17. Maleki-Saghooni N, Karimi FZ, Behboodi Moghadam Z, Mirzaii Najmabadi K. The effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome: A systematic review. Avicenna J Phytomed. 2018; 8(2):96-113.

18. Pietta PG. Flavonoids as antioxidants. J Nat Prod. 2000;63(7):1035-42. doi:10.1021/np9904509 PMid:10924197

19. Cory H, Passarelli S, Szeto J, Tamez M, Mattei J. The Role of Polyphenols in Human Health and Food Systems: A Mini-Review. Front Nutr. 2018; 5:87. doi:10.3389/fnut.2018.00087 PMid:30298133 PMCid:PMC6160559

20. Yousefi K, Farid M, Moghtadaei Khorasgani E, Yadegari M. Evaluation of the Concurrent Protective Effects of Hydroalcoholic Extract of Lemongrass (Cymbopogon citratus) and Vitamin E on Ultrasonographic Indices, Oxidative Stress Parameters, and Antioxidant Gene Expression (SOD and CAT) in a Testicular Ischemia-Reperfusion Model in Rats. KAUMS J. 2026;30(1):28.

21. Traber MG, Stevens JF. Vitamins C and E: Beneficial effects from a mechanistic perspective. Free Radic Biol Med. 2011;51(5):1000-13. doi:10.1016/j.freeradbiomed.2011.05.017 PMid:21664268 PMCid:PMC3156342

22. Kwon JW, Kim WS, Cheon JE, Kim CJ, Kim IO, Yeon KM. Evaluation of testicular viability by power Doppler ultrasonography in experimentally induced acute testicular torsion. Invest Radiol. 2005; 40(10):682-7. doi:10.1097/01.rli.0000178837.68891.f2 PMid:16189438

23. Romeo C, Antonuccio P, Esposito M, Marini H, Impellizzeri P, Turiaco N, et al. Raxofelast, a hydrophilic vitamin E-like antioxidant, reduces testicular ischemia-reperfusion injury. Urol Res. 2004;32(5):367-71. doi:10.1007/s00240-004-0436-4 PMid:15316698

24. Akhigbe RE, Odetayo AF, Akhigbe TM, Hamed MA, Ashonibare PJ. Pathophysiology and management of testicular ischemia/reperfusion injury: Lessons from animal models. Heliyon. 2024;10(9):e27760. doi:10.1016/j.heliyon.2024.e27760 PMid:38694115 PMCid:PMC11058307

25. Alnajem A, Al-Maghrebi M. The Regulatory Effects of JAK2/STAT3 on Spermatogenesis and the Redox Keap1/Nrf2 Axis in an Animal Model of Testicular Ischemia Reperfusion Injury. Cells. 2023; 12(18). doi:10.3390/cells12182292 PMid:37759514 PMCid:PMC10528395

26. Saba M, Morales CR, De Lamirande E, Gagnon C. Morphological and biochemical changes following acute unilateral testicular torsion in prepubertal rats. J Urol. 1997;157(3):1149-54. doi:10.1016/S0022-5347(01)65158-9 PMid:9072560

27. Wei SM, Huang YM. Effect of sulforaphane on testicular ischemia-reperfusion injury induced by testicular torsion-detorsion in rats. Sci Rep. 2024;14(1):23420. doi:10.1038/s41598-024-74756-z PMid:39379457 PMCid:PMC11461801

28. Raisi A, Kheradmand A, Farjanikish G, Davoodi F, Taheri S. Nitroglycerin ameliorates sperm parameters, oxidative stress and testicular injury following testicular torsion/detorsion in male rats. Exp Mol Pathol. 2020;117:104563. doi:10.1016/j.yexmp.2020.104563 PMid:33147433

29. Khorsand K, Najafpour A, Valilou M, Soleimanzadeh A. Naringin attenuates testicular ischemia/reperfusion injury in a mouse torsion/detorsion model via intraperitoneal administration. Pediatr Surg Int. 2026;42(1):59. doi:10.1007/s00383-025-06286-2 PMid:41492007

30. Azarabadi M, Heidari F, Khaki AA, Kaka G, Ghadian A. Minocycline attenuates testicular damage in a rat model of ischaemia/reperfusion (I/R) injury. Andrologia. 2020;52(9):e13704. doi:10.1111/and.13704 PMid:32542686

31. Ranade AV, Tripathi Y, Rajalakshmi R, Vinodini NA, Soubhagya RN, Nayanatara AK, et al. Effect of vitamin E administration on histopathological changes in rat testes following torsion and detorsion. Singapore Med J. 2011;52(10):742-6.

32. Eisa EFM, Ezzeldein SAM, Mohammed HA, Abdallah AA, Ghonimi WAM, Abd El Raouf M. Comparison of the therapeutic effect of platelet-rich plasma and injectable platelet-rich fibrin on testicular torsion/detorsion injury in rats. Sci Rep. 2024;14(1):18045. doi:10.1038/s41598-024-67704-4 PMid:39103420 PMCid:PMC11300838

33. Minas A, Mahmoudabadi S, Gamchi NS, Antoniassi MP, Alizadeh A, Bertolla RP. Testicular torsion in vivo models: Mechanisms and treatments. Andrology. 2023;11(7):1267-85. doi:10.1111/andr.13418 PMid:36825607

34. Evans WC. Trease and Evans' Pharmacognosy. 16th ed. Saunders/Elsevier; 2009.

35. Harborne JB. Phytochemical methods: a guide to modern techniques of plant analysis. 3rd ed. London: Chapman & Hall; 1998.

36. World Health Organization. Quality control methods for herbal materials. Updated ed. Geneva: WHO Press; 2011.

37. Taheri S, Davoodi F, Raisi A, Zakian A, Rajabzadeh A, Hablolvarid MH, et al. Co-administration of Salvia miltiorrhiza and verapamil inhibits detrimental effects of torsion/detorsion on testicular tissue in rats. Andrologia. 2021; 53(6): e14049. doi:10.1111/and.14049 PMid:33733509

38. Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Anal Biochem. 1979;95(2):351-8. doi:10.1016/0003-2697(79)90738-3 PMid:36810 PMCid:PMC8374294

39. Benzie IF, Strain JJ. The ferric reducing ability of plasma (FRAP) as a measure of "antioxidant power": the FRAP assay. Anal Biochem. 1996; 239(1):70-6. doi:10.1006/abio.1996.0292 PMid:8660627

40. Janero DR. Malondialdehyde and thiobarbituric acid-reactivity as diagnostic indices of lipid peroxidation and peroxidative tissue injury. Free Radic Biol Med. 1990;9(6):515-40. doi:10.1016/0891-5849(90)90131-2 PMid:2079232

41. Uz E, Söğüt S, Şahin Ş, Özyurt H, Güleç M, Var A, et al. The protective role of caffeic acid phenethyl ester (CAPE) on testicular tissue after testicular torsion and detorsion. World J Urol. 2002; 20(5): 264-70. doi:10.1007/s00345-002-0259-2 PMid:12215859

42. Atik E, Görür S, Kiper AN. The effect of caffeic acid phenethyl ester (CAPE) on histopathological changes in testicular ischemia-reperfusion injury. Pharmacol Res. 2006;54(4):293-7. doi:10.1016/j.phrs.2006.06.005 PMid:16887363

43. Herek D, Çakmak V, Çomut E, Herek Ö. The value of multimodal ultrasonography in the evaluation of late-presenting testicular torsion in a rat experimental model. Br J Radiol. 2024;97(1154):377-85. doi:10.1093/bjr/tqad059 PMid:38302083

44. Li ZM. Role of antioxidants in preventing testicular ischemia‑reperfusion injury: a narrative review. Eur Rev Med Pharmacol Sci. 2022;26(24):9126-43.

45. Dejban P, Rahimi N, Takzare N, Jahansouz M, Haddadi NS, Dehpour AR. Beneficial effects of dapsone on ischemia/reperfusion injury following torsion/detorsion in ipsilateral and contralateral testes in rats. Theriogenology. 2019;140:136-42. doi:10.1016/j.theriogenology.2019.08.021 PMid:31473496

46. Shokoohi M, Shoorei H, Soltani M, Abtahi-Eivari SH, Salimnejad R, Moghimian M. Protective effects of the hydroalcoholic extract of Fumaria parviflora on testicular injury induced by torsion/detorsion in adult rats. Andrologia. 2018; 50(7): e13047. doi:10.1111/and.13047 PMid:29770471

47. Abdel-Kader MS, Abdel-Rahman RF, Althurwi HN, Soliman GA, Ogaly HA, Albaqami FF. Samarcandin protects against testicular ischemia/reperfusion injury in rats via activation of Nrf2/HO-1-mediated antioxidant responses. Saudi Pharm J. 2023;31(7):1186-96. doi:10.1016/j.jsps.2023.05.007 PMid:37273262 PMCid:PMC10236372

48. Mohamed MZ, Morsy MA, Mohamed HH, Hafez HM. Paeonol protects against testicular ischaemia-reperfusion injury in rats through inhibition of oxidative stress and inflammation. Andrologia. 2020;52(6):e13599. doi:10.1111/and.13599

49. Ogunleye OD, Afolabi OA, Saka WA, Olusola BO, Ajike RA, Oladokun OO, et al. Possible role of vitamins C and E co-administration in the prevention of testicular ischemia-reperfusion injury following surgical repair of torsion of the testis. Front Nutr. 2025;12:1660240. doi:10.3389/fnut.2025.1660240 PMid:41256933 PMCid:PMC12621144

50. Agarwal A, Virk G, Ong C, du Plessis SS. Effect of oxidative stress on male reproduction. World J Mens Health. 2014;32(1):1-17. doi:10.5534/wjmh.2014.32.1.1 PMid:24872947 PMCid:PMC4026229

51. Agarwal A, Parekh N, Panner Selvam MK, Henkel R, Shah R, Homa ST, et al. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. World J Mens Health. 2019;37(3):296-312. doi:10.5534/wjmh.190055 PMid:31081299 PMCid:PMC6704307

Send email to the article author

Add your comments about this article

Ethics code: IR.IAU.SHK.REC.1402.093

This open access journal is licensed under a Creative Commons Attribution-NonCommercial ۴.۰ International License. CC BY-NC ۴. Design and publishing by Kashan University of Medical Sciences.
Copyright ۲۰۲۳© Feyz Medical Sciences Journal. All rights reserved.

Back to the articles list

Back to browse issues page

Persian site map - English site map - Created in 0.2 seconds with 46 queries by YEKTAWEB 4772