Remote limb ischemic postconditioning attenuates myocardial dysfunction induced by testicular torsion/detorsion in rats

Torsion of the spermatic cord is a urological emergency that must be treated immediately with surgery, yet detorsion of the tes-tis can cause testicular tissue damage because of ischemia-reperfusion (I/R) injury. I/R injury is a complex pathophysiological pro-cess that may affect the functions of distant organs. Here, we examined whether testicular torsion/detorsion (TT) causes myocardial dysfunction. We next investigated the potential beneficial effect and underlying mechanisms of remote ischemic post -conditioning (RIPost) on cardiac function after testicular torsion/detorsion. Male Sprague-Dawley rats were assigned to three dif-ferent sets of experimental groups. Testicular I/R was induced by rotating the right testis to 1080 degrees clockwise for 3 h followed by 3 h of detorsion. RIPost was induced at the onset of testicular detorsion by four cycles of 5-min bilateral femoral artery occlusion with 5-min reperfusion. Cardiac function was determined postdetorsion, and the cardioprotective effect of RIPost was examined. Testicular torsion/detorsion-treated rats had reduced serum testosterone levels, impaired systemic hemodynamics, elevated sys-temic inflammatory responses, and increased serum levels of lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB), a-hydroxybutyrate dehydrogenase (a-HBDH), and cardiac troponin I (cTnI). However, RIPost attenuated remote heart dysfunction induced by testicular torsion/detorsion. Furthermore, RIPost enhanced the phosphorylation of ventricular signal transducer and activator of transcription (STAT)-3, which is a key component of the survivor activating factor enhancement (SAFE) signaling path-ways. Inhibition of STAT-3 with Ag490 abolished the RIPost-induced cardioprotection and STAT-3 phosphorylation. Testicular tor-sion followed by detorsion may cause impaired cardiac function in rats. RIPost effectively attenuates this remote cardiac dysfunction. RIPost-induced protective effects may be mediated by the STAT-3 signaling pathway.

Automated summary

Testicular torsion is a urological emergency that requires immediate surgery, but detorsion can lead to testicular tissue damage. This study investigated whether testicular torsion/detorsion affects myocardial function and examined the potential cardioprotective effect of remote ischemic post-conditioning (RIPost). The results showed that testicular torsion/detorsion led to impaired cardiac function and increased serum markers of cardiac injury. However, RIPost attenuated the remote cardiac dysfunction induced by testicular torsion/detorsion and enhanced the phosphorylation of ventricular STAT-3, a key component of the SAFE signaling pathway. These findings suggest that testicular torsion/detorsion can cause cardiac dysfunction, but RIPost may protect against it through the activation of STAT-3 signaling.