Hemorrhagic Fever with Renal Syndrome Complicated by Orchitis

Hemorrhagic fever with renal syndrome (HFRS) is a disease caused by viruses of the family Bunyaviridae,genus Hantavirus.HFRS from Dobrava virus (DOBV) is a seldom reported disease in Albania.Clinically HFRS is manifested as mild,moderate,or severe.Therefore,the number of cases of Hantavirus' infection may be underestimated,and should be included in the differential diagnosis of many acute infections,hematologic diseases,acute abdominal diseases and renal diseases complicated by acute renal failure.We report here an atypical presentation of HFRS from Dobrava virus complicated by orchitis with a positive outcome.

Serum Hormone and Cellular Proliferation Changes of Testis in Rats with Experimental Orchitis Induced by Lipopolysaccharide

Objective To explore the changes of serum male hormone, androgen binding protein （ABP） expression as well as the proliferation of testicular cells in rats with experimental orchitis induced by bacterial lipoplysaccharide （LPS） in vivo and to elucidate the putative mechanism of LPS on spermatogenesis of testis. Methods The serum testosterone （T）, luteinizing hormone （LH） levels were detected with magnetic enzyme immunoassay. The expression of proliferating cell nuclear antigen （PCNA） and ABP expression at mRNA level of testis were studied with immunohistochemical staining and in situ hybrydization respectively. Results The serum T level in rats with experimental orchitis was significantly higher than that in the rats of control （P〈0.05） and ABP mRNA expression in Sertoli cells of testis was significantly increased （P〈0.05） while PCNA expression in seminiferous epithelium in experimental rats significantly was decreased as compared with that of the control （P〈0.05）. No significant change in serum LH level was seen between experimental orchitis and control groups （P〉0. 05）. Conclusion The serum level of T and ABP expression significantly increased in rats with experimental aspecific orchitis induced by LPS, and at the same time inhibition of cellular proliferation of seminiferous epithelium can be detected, which may be the possible mechanism of male infertility in inflammatory process.

Isolated Autoimmune Orchitis Due to IgG4 Hypersecretion Presenting as Tumor-Like Mass: Case Report and Review of Literature

Background: IgG4-related disease is a rare autoimmune condition that presents with lymphoplasmacytic infiltrate and fibrosis in the organ affected. Isolated testicle involvement is uncommon and there are only a few cases reported in the literature. Case Presentation: We report a case of isolated chronic orchitis due to IgG4 hypersecretion in a 61-year-old patient that evolved with asymptomatic tumor-like mass growth and was treated with left orchiectomy. Histopathological study revealed orchitis related to IgG4 hypersecretion disease. Conclusion: IgG4-related disease can be manifested as a multi or single-organ disorder. Most diagnoses are made after surgery with histopathological analysis. Most of the cases in literature stand out the difficulty in diagnosis and necessity of high suspicion due to this condition’s similarity with neoplasm presentation.

Testicular exosomes disturb the immunosuppressive phenotype of testicular macrophages mediated by miR-155-5p in uropathogenic Escherichia coli-induced orchitis

Male reproductive infections are known to shape the immunological homeostasis of the testes,leading to male infertility.However,the specific pathogenesis of these changes remains poorly understood.Exosomes released in the inflammatory microenvironment are important in communication between the local microenvironment and recipient cells.Here,we aim to identify the immunomodulatory properties of inflammatory testes-derived exosomes(IT-exos)and explore their underlying mechanisms in orchitis.IT-exos were isolated using a uropathogenic Escherichia coli(UPEC)-induced orchitis model and confirmed that IT-exos promoted proinflammatory M1 activation with increasing expression of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)in vitro.We further used small RNA sequencing to identify the differential miRNA profiles in exosomes and primary testicular macrophages(TMs)from normal and UPEC-infected testes,respectively,and identified that miR-155-5p was highly enriched in IT-exos and TMs from inflammatory testes.Further study of bone marrow derived macrophages(BMDMs)transfected with miR-155-5p mimic showed that macrophages polarized to proinflammatory phenotype.In addition,the mice that were administrated IT-exos showed remarkable activation of TM1-like macrophages;however,IT-exos with silencing miR-155-5p showed a decrease in proinflammatory responses.Overall,we demonstrate that miR-155-5p delivered by IT-exos plays an important role in the activation of TM1 in UPEC-induced orchitis.Our study provides a new perspective on the immunological mechanisms underlying inflammation-related male infertility.

Effect of ketotifen fumarate on experimental autoimmune orchitis and torsion of the spermatic cord

The aim of this work was to study effects of ketotifen fumarate(KF)on prevention of tissue damage in testes of rats with experimental autoimmune orchitis(EAO)and on the contralateral testis in a model of prolonged testicular cord torsion(TCT).Rats with EAO or TCT were injected intraperitoneally once daily with KF or saline solution(vehicle group).Incidence and severity of testicular damage were evaluated by histopathology using an EAO score or a Johnsen score.Mast cells(MC)were identified by histochemistry and quantified.In EAO model,KF significantly reduced severity of histopathological testicular damage compared to rats in the vehicle group.KF also reduced the number of testicular MC compared to vehicle group.Similarly,in TCT model,multifocal damage of the contralateral testis was observed 30 days after testicular torsion characterized by sloughing of the germinal epithelium,seminiferous tubule atrophy,and interstitial edema.Focal signs of inflammation and fibrosis of seminiferous tubular walls were also observed.In contrast,sections of contralateral testis of rats injected with KF and killed 30 days after surgery showed normal histological features.A significant decrease in the number of MC was observed in rats treated with KF compared to untreated animals.In conclusion,we demonstrated that treatment with KF reduced testicular inflammatory process and MC infiltrates in both EAO and TCT models.The results suggest a promising treatment for infertile male patients with testicular pathologies associated with inflammation and germ cell loss.

Treatment of 18 Orchitis Cases by Wrist- ankle Acupuncture

Needle embedding at the first region of ankle acupuncture plus fomentation was used to treat 18 orchitis cases. The curative rate was 100%. Key Words Acupuncture Therapy - Ankle Acupuncture - Orchitis Author: BAI Shu-xiang (1955-), male, attending physicianTranslator: HUANG Guo-qi

Transcription factor Dmrt1 triggers the SPRY1-NF-κB pathway to maintain testicular immune homeostasis and male fertility

Bacterial or viral infections,such as Brucella,mumps virus,herpes simplex virus,and Zika virus,destroy immune homeostasis of the testes,leading to spermatogenesis disorder and infertility.Of note,recent research shows that SARS-CoV-2 can infect male gonads and destroy Sertoli and Leydig cells,leading to male reproductive dysfunction.Due to the many side effects associated with antibiotic therapy,finding alternative treatments for inflammatory injury remains critical.Here,we found that Dmrt1 plays an important role in regulating testicular immune homeostasis.Knockdown of Dmrt1 in male mice inhibited spermatogenesis with a broad inflammatory response in seminiferous tubules and led to the loss of spermatogenic epithelial cells.Chromatin immunoprecipitation sequencing(ChIP-seq)and RNA sequencing(RNA-seq)revealed that Dmrt1 positively regulated the expression of Spry1,an inhibitory protein of the receptor tyrosine kinase(RTK)signaling pathway.Furthermore,immunoprecipitation-mass spectrometry(IP-MS)and co-immunoprecipitation(Co-IP)analysis indicated that SPRY1 binds to nuclear factor kappa B1(NF-κB1)to prevent nuclear translocation of p65,inhibit activation of NF-κB signaling,prevent excessive inflammatory reaction in the testis,and protect the integrity of the blood-testis barrier.In view of this newly identified Dmrt1-Spry1-NF-κB axis mechanism in the regulation of testicular immune homeostasis,our study opens new avenues for the prevention and treatment of male reproductive diseases in humans and livestock.

Comparative study of chloroquine and quinine on malaria rodents and their effects on the mouse testis

Objective:To evaluate the effects of quinine and chloroquine against mole mice infected with Plasmodium berghei and their adverse effects on the mice testes.Methods:In this study,48 adult male mice,(20-23 g).aged 8 to 12 weeks were divided into four groups.This study was carried out from December 2009 until May 2010 in the School of Public Health,Tehran University of Medical Sciences.Results:The results showed that 58.33%of mice treated with chloroquine were completely recovered.Parasitemia was 4%on day 8 when compared to that on day 0,whereas it was 9%on day 9.There was no orchitis found in this group.The mortality of mice after exposing to quinine on day 5 was 8.3%,whereas from day 10 to day 14 it was 91.7%.We found 73%orchitis occurred in quinine treated group.There was a significant difference between quinine and chloroquine effects on the parasite and also mice testes(P<0.05).Conclusions:In this study,It can be concluded that male mice have full resistance to the quinine.Quinine does not only make male mice recover completely,but also cause inflammation on mice testicles tissue.

A scoping review of SARS-CoV-2 and male infertility: Concerns and future prospects

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has been detected in the blood,urine,facial/anal swabs,semen,and vaginal discharge;all have been shown to contain SARSCoV-2 RNA.Recent findings have highlighted the prospect of SARS-CoV-2 invading the genital system in addition to other tissues,which might give rise to reproductive concerns.This investigation sheds light on male reproductive tract vulnerability to invasion by SARS-CoV-2 and provides a foundation for further researches into male fertility.Males are infected with COVID-19 at a higher rate than females.As a result,some data suggest that this viral infection might affect the male reproductive system.The probable causes for male genital tract abnormalities in COVID19 are:(1)high expression of angiotensin-converting enzyme 2 in the testes;(2)SARS-CoV-2 infection indirectly induces immune response in the testes;(3)SARS-CoV-2 directly damages male genital cells by virus-receptor binding activity;(4)fever in SARSCoV-2 infected males may cause damages to testicular cells;(5)testosterone level decreased in SAR-CoV-2 infected males;(6)males are more susceptible to COVID-19 than females,which may be due to differences in the physiology of the genital tract.This review seeks to offer some insights into the potential causes of COVID-19 that affect the male reproductive system,as well as future prospect on this issue.

Infectious Pathology of the Scrotum in Abidjan: Ultrasound Features of 80 Cases

Objectives: The aim of this study was to determine the epidemiological-clinical profile of patients with scrotal infectious pathology in Abidjan and describe the ultrasound features of this scrotal infectious pathology. Methods: This was a prospective study of 80 cases of scrotal infectious pathology objectified by ultrasound at Yopougon University Hospital from 1 January 2015 to 31 December 2015. Ultrasounds were performed using a high-frequency linear probe in B and Color Doppler modes by senior radiologists. The epidemiological-clinical data were recorded from the ultrasound request form and the interrogation of the patient. Results: The average age was 23 years with extreme ranging from 16 to 40 years. Soldiers were the most concerned (40%) followed by students (30%). The painful large bursa was the quasi constant presenting feature (95% of cases) and fever was associated in less than half of the cases (45% of cases). The scrotal involvement was most often unilateral (85% of cases) and the left side was involved in 70% of the cases. Epididymitis was the most frequent pathology (60%) followed by orchiepididymitis (30%) and orchitis (10%). The most commonly encountered accompanying ultrasound findings were envelope thickening (100%), intravaginal fluid effusion (60%), and Doppler Hypervascularization (30%). Conclusion: In Abidjan Scrotal infectious pathology is most often encountered among young soldiers or students most often with a ± febrile large bursa. The most common pathology is left unilateral epididymitis.

Coccidioidomycosis of the Testis and Epididymis

This report describes an unusual presentation of a man with a testicular mass who presented in diabetic ketoacidosis to the emergency department. Initial diagnosis was a suspected testicular malignancy based on history, physical exam, and available laboratory and radiological imaging. Due to the possibility of a testicular malignancy, the patient was taken for immediate orchiectomy. Histology revealed coccidioido-mycosis of the left testicle and epididymis. Treatment with the appropriate antifungals was initiated. Despite aggressive multi-disciplinary therapy the patient continued to deteriorate and eventually expired as a result of the massive systemic infection. Literature review revealed the presentation of disseminated genitourinary coccidioidomycosis is rare and seldom reported.

Seminal plasma S100A8/A9 as a potential biomarker of genital tract inflammation

Infections and inflammatory reactions in the male genital tract are the leading causes of male infertility with a prevalence of 6%-10%,primarily affecting testicular and epididymal function and ultimately compromising sperm quality.However,most infertile patients with genital infection/inflammation are asymptomatic and easily overlooked.Traditional indicators,including white blood cells,elastase,and other components in semen,can reflect inflammation of the genital tract,but there is still a lack of a uniform standard method of detection.Therefore,it is necessary to explore reliable markers in semen that reflect the inflammatory status of the genital tract.Using the experimental autoimmune orchitis(EAO)model to simulate noninfectious chronic orchitis,we successfully collected ejaculated seminal fluid from EAO rats using optimized electrical stimulation devices.Proteomic analysis was performed using isobaric tags for relative and absolute quantification(iTRAQ).Compared to the control group,55 upregulated and 105 downregulated proteins were identified in seminal plasma samples from the EAO group.In a preliminary screening,the inflammation-related protein S100A8/A9 was upregulated.We further verified that S100A8/A9 was increased in seminal plasma and highly expressed in testicular macrophages of the EAO model.In patients with oligoasthenospermia and genital tract infections,we also found that S100A8/A9 levels were remarkably increased in seminal plasma and testicular macrophages.S100A8/A9 in semen may be a potential biomarker for chronic genital inflammation.Our study provides a new potential biomarker for early diagnosis and further understanding of male infertility caused by genital inflammation.