Uloga oksidativnog stresa u muškoj neplodnosti: veza sa skraćivanjem telomera spermatozoida i generalnim oštećenjem DNK
Sažetak
Muška neplodnost pogađa oko 20% muškaraca, pri čemu je 30–40% slučajeva povezano sa problemima kod oba partnera. Iako spermatogeneza može biti normalna, određeni faktori mogu da dovedu do oštećenja DNK u spermatozoidima i uslove pojavu neplodnosti. Oksidativni stres dovodi do oštećenja različitih biomolekula, kao što su fragmentacija DNK, peroksidacija lipida i oksidacija proteina, što sve može narušiti fertilizaciju jajne ćelije i razvoj embriona. Povišeni nivoi reaktivnih kiseonikovih jedinjenja (ROS) u semenoj tečnosti su povezani sa lošim kvalitetom spermatozoida, smanjenim potencijalom oplodnje i povećanom fragmentacijom DNK. Pored toga, kraće telomere u semenoj tečnosti koreliraju sa smanjenom vitalnošću i funkcijom spermatozoida. Oksidativni stres ubrzava skraćivanje telomera spermatozoida izazivanjem oštećenja DNK, što ugrožava sposobnost oplodnje. Oštećenje DNK može nastati u različitim fazama spermatogeneze i oplodnje. Ako oštećenje premašuje sposobnost popravke oocita, može doći do neplodnosti. Dostupni su različiti testovi za procenu oštećenja DNK spermatozoida, pri čemu je test fragmentacije DNK spermatozoida (SDF) jedan od najperspektivnijih. Oštećenje DNK se kvantifikuje kao indeks fragmentacije DNK (DFI), koji predstavlja procenat spermatozoida sa fragmentovanom DNK. Iako referentni intervali za DFI mogu da variraju u zavisnosti od korišćene metode, DFI ≤ 15% se generalno smatra normalnim, 15–30% se smatra prosečnim, a DFI ≥ 30% ukazuje na loš integritet DNK, što može negativno uticati na ishod trudnoće.
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