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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:   (10 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) groupEchinophora 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: 2026/07/13 | Accepted: 2026/07/13
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