Mesenchymal stem cell secretome: A promising therapeutic strategy for erectile dysfunction?

Objective: The secretome, comprising bioactive chemicals released by mesenchymal stem cells (MSCs), holds therapeutic promise in regenerative medicine. This review aimed to explore the therapeutic potential of the MSC secretome in regenerative urology, particularly for treating erectile dysfunction (ED), and to provide an overview of preclinical and clinical research on MSCs in ED treatment and subsequently to highlight the rationales, mechanisms, preclinical investigations, and therapeutic potential of the MSC secretome in this context. Methods: The review incorporated an analysis of preclinical and clinical research involving MSCs in the treatment of ED. Subsequently, it delved into the existing knowledge regarding the MSC secretome, exploring its therapeutic potential. The methods included a comprehensive examination of relevant literature to discern the processes underlying the therapeutic efficacy of the MSC secretome. Results: Preclinical research indicated the effectiveness of the MSC secretome in treating various models of ED. However, the precise mechanisms of its therapeutic efficacy remain unknown. The review provided insights into the anti-inflammatory, pro-angiogenic, and trophic properties of the MSC secretome. It also discussed potential advantages, such as avoiding issues related to cellular therapy, including immunogenicity, neoplastic transformation, and cost. Conclusion: This review underscores the significant therapeutic potential of the MSC secretome in regenerative urology, particularly for ED treatment. While preclinical studies demonstrate promising outcomes, further research is essential to elucidate the specific mechanisms underlying the therapeutic efficacy before clinical application. The review concludes by discussing future perspectives and highlighting the challenges associated with the clinical translation of the MSC secretome in regenerative urology.

Examination of ejaculate fructose levels on male infertility patients at various times and centrifugation using semiautomatic method.

OBJECTIVE: Various factors, such as obstructive azoospermia, cause infertility in men. Biochemical examination of ejaculate, especially measurement of fructose, can be an additional investigation that can be used for this diagnosis in reproductive health. Examination of fructose is carried out after routine ejaculate analysis, resulting in prolonging the examination time so that it will affect the measurement of fructose level in the ejaculate and the accuracy of the diagnosis. This study aims to determine the best timing and procedure for measurement of fructose using a semiautomatic method. METHODS: This research is an analytic observational study conducted at Dr. Soetomo General Hospital, Surabaya. A total of 13 ejaculate samples from infertile male patients who met the inclusion criteria were evaluated. Each ejaculate was divided into eight aliquots that were examined for fructose using a semiautomated method after different intervals of time and centrifugation modalities. RESULTS: This study showed a significant difference in fructose levels when aliquots were centrifuged and examined immediately or after different interval of time (p=0.036). In addition, aliquots left standing for more than 60 minutes (p=0.012) and 120 minutes (p<0.001) before centrifugation, showed significantly lower levels compared to aliquots that were centrifuged and then immediately examined. CONCLUSIONS: We suggest that measuring fructose immediately after centrifugation is more reliable than measuring fructose left standing before or after centrifugation. Leaving the ejaculate standing will reduce the fructose level so that it does not resemble its real level.

The Prevalence, Etiology and Treatment of Gastroduodenal Ulcers and Perforation: A Systematic Review.

(1) Background: Gastroduodenal perforation (GDP) is a life-threatening condition caused by a spontaneous or traumatic event. Treatment should be based on the mechanism of damage, timing, location, extent of the injury, and the patient's clinical condition. We aimed to examine several etiologic factors associated with gastroduodenal perforation and to search for the best method(s) for its prevention and treatment. (2) Methods: We conducted extensive literature reviews by searching numerous studies obtained from PubMed, Science Direct, and Cochrane for the following keywords: gastroduodenal perforation, Helicobacter pylori, NSAIDs' use, side effects of GDP, laparoscopy, and surgery. The primary outcome was the reported occurrence of GDP. (3) Results: Using keywords, 883 articles were identified. After applying the inclusion and exclusion criteria, 53 studies were eligible for the current analyses, with a total number of 34,692 gastroduodenal perforation cases. Even though the risk factors of gastroduodenal perforation are various, the prevalence of H. pylori among patients with perforation is considerably high. As technology develops, the treatment for gastric perforation will also improve, with laparoscopic surgery having a lower mortality and complication rate compared to open surgery for GDP treatment. (4) Conclusions: H. pylori infection plays the most significant role in GDP, more than NSAIDs, surgery, chemotherapy, or transplantation. Treatment of H. pylori infection is essential to decrease the prevalence of GDP and speed up its recovery. However, urgent cases require immediate intervention, such as laparoscopic or open surgery.

Effect of machine-washing semen-stained fabrics on the persistence of human spermatozoa DNA: A systematic review of five articles.

Biological evidence of sexual violence, such as semen, can change due to fabric washing. This can be due to attempts by the perpetrator to eliminate evidence or because the victim feels ashamed of sexual violence. While much research on this topic has been conducted, no systematic review has been attempted. This systematic review explores the effect of fabric machine-washing on the persistence of human spermatozoa deoxyribonucleic acid (DNA). This systematic review seeks in vitro experiments in which semen-stained fabrics were washed by washing machines, published in English, and matched with keywords in PubMed, Europe PMC, ScienceDirect, and Google Scholar. We then assessed the obtained articles with the Joanna Briggs Institute quasi-experimental checklist. This systematic review used the narrative synthesis method. Our search yielded five articles. These articles observe the effect of machine-washing factors on the persistence of human spermatozoa DNA, such as water temperature, washing duration, detergent type, washing repetition, and duration of fabric storage before washing. This systematic review shows that fabric washing insignificantly affects spermatozoa DNA persistence, and DNA might persist after multiple washes. However, variations in the articles indicate that future studies on this topic need to account for more variables and be reported in more detail to reduce bias.

Effect of MTHFR A1298C Gene Polymorphism on Acute Coronary Syndrome.

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Acute coronary syndrome is a manifestation of CVD. In Indonesia, limited studies have been conducted on genetics as a potential risk factor for acute coronary syndrome (ACS). Consequently, this study aimed to examine the effect of the methylenetetrahydrofolate reductase (MTHFR) A1298C gene polymorphism on the incidence of ACS. METHOD: The study employed a case-control design. Outpatients from the cardiology and internal medicine clinics at the University of Airlangga (UNAIR) Hospital in Surabaya, Indonesia, constituted the study population. The case group comprised 60 patients with a history of ACS, while the control group consisted of 30 patients without a history of cardiovascular complaints. MTHFR A12980C gene polymorphism examination was performed using the polymerase chain reaction-restriction fragment length polymorphism (PCR RFLP) method at the Tropical Disease Center UNAIR Laboratory. RESULTS: Among the ACS group, 29 (48.1%), 13 (21.7%), and 18 (30%) of the individuals had AA, AC, and CC genotype patterns, respectively. In the control group, 16 individuals had AA (53.3%), 6 AC (20%), and 8 CC (26.7%). The C allele variant was identified in 41% of the ACS group and 37% of the control group. The odds ratio (OR) for the incidence of ACS was 1.195 (95% confidence interval [CI]; 0.381-3.752), 1.241 (95% CI; 0.481-3.486), and 1.222 (95% CI; 0.381-3.752). Chi-square analysis revealed no association between MTHFR A1298C gene polymorphism and the incidence of ACS (P > 0.05). CONCLUSIONS: MTHFR A1298C gene polymorphism did not significantly affect ACS incidence.

Analysis of gastric microbiota and Helicobacter pylori infection in gastroesophageal reflux disease.

BACKGROUND: We evaluated the microbiota in the stomach of Gastroesophageal Reflux Disease (GERD) patients. We compared Erosive Reflux Disease (ERD) to gastritis and Non-erosive Reflux Disease (NERD) subjects by 16S rRNA approach on gastric biopsy specimens. A total of 197 subjects were included consisting of gastritis (68; 34.52%), ERD (55; 27.92%), and NERD (74; 37.56%). After quality filtering, 187 samples were included for OTU analysis using Qiime2. RESULTS: We observed a significant difference in alpha diversity (Shannon and Simpson indexes were P = 0.0016 and P = 0.017, respectively). A significant decrease in alpha diversity index was observed in NERD with Helicobacter pylori (H. pylori)-positive subjects than in gastritis (Simpson index P = 0.022; Shannon index P = 0.029), indicating a significant influence of H. pylori on the diversity in the stomach despite the diseases. In H. pylori-negative samples, alpha diversity measurement by the abundance coverage estimates (ACE) and Fisher Test revealed that ERD had significantly lower richness than gastritis and NERD groups (P = 0.00012 and P = 0.00043, respectively). Anaerobacillus sp. could only be found in ERD patients by LEFse analysis. CONCLUSIONS: The presence of ERD could alter microbiome diversity. A negative correlation between H. pylori and ERD is shown in this microbiome study but not in NERD.

Experimental and natural infections of severe acute respiratory syndrome-related coronavirus 2 in pets and wild and farm animals.

The severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) has spread globally and has led to extremely high mortality rates. In addition to infecting humans, this virus also has infected animals. Experimental studies and natural infections showed that dogs have a low susceptibility to SARS-CoV-2 infection, whereas domesticated cats and other animals in the family Felidae, such as lions, tigers, snow leopards, and cougars, have a high susceptibility to viral infections. In addition, wild white-tailed deer, gorillas, and otters have been found to be infected by SARS-CoV-2. Furry farm animals, such as minks, have a high susceptibility to SARS-CoV-2 infection. The virus appears to spread among minks and generate several new mutations, resulting in increased viral virulence. Furthermore, livestock animals, such as cattle, sheep, and pigs, were found to have low susceptibility to the virus, whereas chicken, ducks, turkeys, quail, and geese did not show susceptibility to SARS-CoV-2 infection. This knowledge can provide insights for the development of SARS-CoV-2 mitigation strategies in animals and humans. Therefore, this review focuses on experimental (both replication and transmission) in vitro, ex vivo, and in vivo studies of SARS-CoV-2 infections in pets and in wild and farm animals, and to provide details on the mechanism associated with natural infection.

Urease Levels and Gastritis Stage in Dyspeptic Patients.

BACKGROUND: Dyspepsia is a frequent main symptom of inpatients and outpatients scenario in Indonesia. However, the number of endoscopy facilities are still low, thus the use of non-invasive method to detect gastritis is necessary. We measured the relationship between urease levels and the stage of gastritis in dyspeptic adult patients. METHODS: A cross-sectional study included outpatient dyspepsia patient from November 2018 to February 2019. We examined 14C-Urea Breath Test (UBT) and determined the stage of gastritis based on the Updated Sydney System classification. RESULTS: The urease level of acute and chronic gastritis positive patients were higher than negative patients (p = 0.001, r = 0.353; p <0.0001, r = 0.433, respectively). The AUC value of 14C-UBT to detect acute, chronic, and atrophic gastritis are 0.889, 0.632 and 0.544, respectively. The best cut-off points of 14C-UBT to predict acute gastritis was ≥26.50δ‰ with sensitivity and specificity being 88.89% and 63.95%, respectively. Whereas the best cut-off points for chronic gastritis was ≥34.50δ‰ with 82.89% sensitivity, 63.16% specificity. As for atrophic gastritis, it showed very low AUC value, hence it is not a sufficient test modality to predict atrophic gastritis cases. CONCLUSION: 14C-UBT is sufficient for predicting acute or chronic gastritis but not for atrophic gastritis.

The Roles of IL-17, IL-21, and IL-23 in the Helicobacter pylori Infection and Gastrointestinal Inflammation: A Review.

Although millions of people have been infected by Helicobacter pylori (H. pylori), only a small proportion of infected individuals will develop adverse outcomes, ranging from chronic gastritis to gastric cancer. Advanced development of the disease has been well-linked with chronic inflammation, which is significantly impacted by the adaptive and humoral immunity response. From the perspective of cellular immunity, this review aims to clarify the intricate axis between IL-17, IL-21, and IL-23 in H. pylori-related diseases and the pathogenesis of inflammatory gastrointestinal diseases. CD4+ helper T (Th)-17 cells, with the hallmark pleiotropic cytokine IL-17, can affect antimicrobial activity and the pathogenic immune response in the gut environment. These circumstances cannot be separated, as the existence of affiliated cytokines, including IL-21 and IL-23, help maintain Th17 and accommodate humoral immune cells. Comprehensive understanding of the dynamic interaction between molecular host responses in H. pylori-related diseases and the inflammation process may facilitate further development of immune-based therapy.

The validation of the Helicobacter pylori CagA typing by immunohistochemistry: nationwide application in Indonesia.

We aimed to validate 2 types of antibodies, anti-CagA antibody and anti-East Asian CagA specific antibody (α-EAS antibody) for the determination of CagA status in Indonesia. We also confirmed the performance of α-EAS antibody for the detection of East Asian-type CagA H. pylori. Immunohistochemistry was performed using anti-CagA antibody and α-EAS antibody on gastric biopsy specimens from a total of 967 Indonesian patients. Diagnostic values of immunohistochemistry were evaluated with PCR-based sequencing as gold standard. Anti-CagA antibody had high sensitivity, specificity, and accuracy (87.0 %, 100 %, and 98.8 %, respectively) for determining CagA status. The α-EAS antibody was not suitable for the purpose of CagA status determination, as it had a low sensitivity (23.9 %). High specificity (97.6 %) but low sensitivity (41.2 %) and accuracy (66.3 %) was observed in α-EAS antibody to detect East Asian-type CagA. Patients with positive result of immunohistochemistry using anti-CagA antibody had significantly higher monocyte infiltration score in antrum (P < 0.001) and corpus (P = 0.009). In conclusion, the anti-CagA antibody is still suitable to be used in Indonesia for determining the CagA status, whilst the α-EAS antibody was not appropriate to discriminate between East Asian-type and non-East Asian-type CagA in Indonesia.

The signal transduction of xanthone as a protector on 2-methoxyethanol-induced cardiac cell damage in mice.

This research aims at investigating the role of antioxidant of xanthone on 2-methoxyethanol (2-ME)-induced cardiac cell damage in mice. Forty mice were grouped into: (1) The control group (mice were given with distilled water), (2) the ME group (mice were given with 2-ME 200 mg/kg BW orally), and (3) the treatment group (mice were given of xanthone with doses 60 mg, 120 mg, 240 mg/kg BW orally and were also given 2-ME 200 mg/kg BW). Their blood samples were taken to measure the level of lactate dehydrogenase (LDH) and creatinine kinase-MB (CK-MB). Heart tissues were also taken to determine the malondialdehyde (MDA), histological findings of heart damage, and the immunohistochemical of the expression of superoxide dismutase (SOD) and glutathione peroxidase (GPx). The administration of 2-ME resulted in a significant increase level of the LDH, CK-MB, MDA, and a decrease in SOD and GPx expression were compared with the control group. The 2-ME also induced loss of the normal structure of heart cells and necrosis. However, treatment with the xanthone, only dose 240 mg/kg BW significantly decrease the level of LDH, CK-MB, MDA, and increase SOD, GPx expression. The xanthone 240 mg/kg BW also demonstrated significantly improved heart cell damage. From the results, it is concluded that the xanthone are a potent antioxidant in against 2-ME-induced cardiac toxicity in mice, through increasing SOD and GPx expression, and also inhibiting LDH, CK-MB and MDA.