A comparison of the effects of N-acetylcysteine and ethyl pyruvate on experimental testicular ischemia-reperfusion injury

This study was intended to compare the effects of NAC and EP on experimental testicular I/R injury. The NAC therapy may be regarded as a relatively more effective treatment than EP.

Suha Turkmen, M.D., Ahmet Mentese, Ph.D., Ersagun Karaguzel, M.D., Yunus Karaca, M.D., Adem Kucuk, M.D., Aysegul Uzun, Ph.D., Esin Yulug, M.D., Suleyman Turedi, M.D.

Volume 98, Issue 3, Pages 626-631, September 2012


To compare the effects of NAC and EP on experimental testicular ischemia reperfusion (I/R) injury.

Randomized, controlled, experimental study

University hospital

Animal (s):
Twenty-four mature male Wistar rats

Intervention (s):
Rats were divided into four groups; control, torsion-detorsion (T/D) group, ethyl pyruvate (EP) group and N-acetylcysteine (NAC) group. In the pretreatment of the NAC and EP groups, 20 mg/kg NAC and 50 mg/kg EP were given intraperitoneally 30 min before detorsion.

Main Outcome Measure(s):
Serum ischemia modified albumin (IMA), tissue and serum malondialdehyde (MDA) and myeloperoxidase (MPO) activity levels and histopathological damage scores were then compared.

Result (s):
Ethyl pyruvate and N-acetylcysteine exhibited a protective effect against I/R injury. Of the biochemical parameters evaluated as a result of testicular I/R, only IMA levels were significantly elevated. There was a strong and significant correlation between serum IMA levels and histopathological injury scores, and the increase in serum IMA level exhibited a strong parallel with the rise in histopathological injury. In the EP group, although histopathological injury score was similar to that of the control group, serum IMA levels were significantly elevated.

Conclusion (s):
Both NAC and EP, the effects of which on I/R injury are evaluated here, reduce such injury in testicular T/D. Comparing their effects on IMA levels, NAC may be regarded as a relatively more effective treatment than EP.

  • Ananda Suzuki

    What was the NAC concetration used? 100mg/mL? Thank you.

  • Was hydration status in these animals taken into account? I ask because we use mannitol routinely for ischemia repurfusion injuries in both partial nephrectomies and for kidney transplants. While mannitol is thought to work mainly through a free radical scavenging mechanism, it also helps pull fluid into the intravascular space. Might be interesting to examine the role of hydration status and/or mannitol as another comparison group to NAC.

  • eykko

    Will be very interested to see how this data can be translated into human applications. May potentially be useful to help blunt reperfusion injury after surgical detorsion. This also brings up the question if any other antioxidants or free radical scavengers can be applied to this scenario as well to protect the testes from further injury after the ischemic insult.

  • José Martínez-Jabaloyas

    Interesting study. Testicular torsion is a frequent
    urological emergency and an important cause of testicular damage. Do the
    authors think that n-acetylcysteine can be useful in clinical practice? I think
    that the first problem is to prove that it is beneficial in humans because it
    is very difficult to design adequate clinical trials for this pathology.

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