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Browsing by Author "Leisegang, Kristian"

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Alternative medicine and herbal remedies in the treatment of erectile dysfunction: A systematic review
(Informa UK Limited, trading as Taylor & Francis Group., 2021) Leisegang, Kristian; Finelli, Renata
Objectives: To systematically review and discuss the current evidence from placebo-controlled clinical trials that investigated the use of alternative medicines and herbal remedies in the management of erectile dysfunction (ED). Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)- based systematic review using specific keyword combinations was conducted on the PubMed and Scopus databases. Randomised controlled trials investigating herbal medicine in at least one group and using the International Index of Erectile Function (IIEF) as an outcome in patients primarily diagnosed with ED were included for review. Results: Following the literature search, screening and eligibility analysis, a total of 42 articles were included. The 42 articles were categorised as single herb extractions (n = 14), combination herbal formula (n = 5), combination of herbal formula and non-herbal nutraceuticals (n = 7), non-herbal nutraceuticals (n = 5), acupuncture and moxibustion (n = 2), diet and nutrition (n = 3), exercise (n = 5), and topical treatments (n = 1). Based on the results, Korean ginseng, Pygnogenol and Prelox, Tribulus terrestris, Lepidium meyenii, L-arginine, acupuncture and lifestyle interventions were the more predominantly investigated treatments interventions for ED. Conclusions: Panax ginseng, Pygnogenol, Prelox and Tribulus terrestris have promising evidence as herbal products, alongside L-arginine as a nutritional supplement, for ED based on IIEF outcomes, and warrant further clinical investigation. The mechanisms of action remain unclear, but each of these appears to in part increase nitric oxide synthesis. Importantly, improved diet and exercise should be considered, particularly in patients with obesity or diabetes mellitus.
A comparison between the anthropological and modern day uses of this indigenous herb
(Conference: SA Medical Research Council 6th Annual Research Conference, 2012) Leisegang, Kristian; Campbell, James; Ma, X; De Beer, Sanien
Sceletium tortuosum (Fig. 1) is a scrambling succulent ground cover indigenous to the Western and Eastern Cape. It has probably been used for centuries as a mood-altering drug, especially by the Khoisan hunters and Nama shepherds, where it was often smoked or used as snuff. It also has hallucinogenic properties and high dosages were often used during trance dances. These properties have been associated with alkaloids such as mesembrine. The San people used it prior to hunting to sharpen their senses, and to diminish hunger and thirst. Even in excessive dosages its initial euphoric effect seems to be replaced with feelings of serene sedation. It was more often used for enjoyment and not primarily for medicine. Modern day medical and commercial use of Sceletium spp is primary as a mood enhancer, to decrease anxiety, stress, and in addiction therapy. The objectives of this study was to investigate and compare the historical and anthropological se of Sceletium with the modern day and current uses there of.
Do lifestyle practices impede male fertility?
(John Wiley & Sons, Inc, 2020) Leisegang, Kristian; Dutta, Sulagna
Alongside an increasing prevalence of couple and male infertility, evidence suggests there is a global declining trend in male fertility parameters over the past few decades. This may, at least in part, be explained through detrimental lifestyle practices and exposures. These include alcohol and tobacco consumption, use of recreational drugs (e.g., cannabis, opioids and anabolic steroids), poor nutritional habits, obesity and metabolic syndrome, genital heat stress (e.g., radiation exposure through cell phones and laptops, prolonged periods of sitting, tight-fitting underwear and recurrent hot baths or saunas), exposure to endocrine-disrupting chemicals (e.g., pesticide residue, bisphenol A, phthalates and dioxins) and psychological stress. This review discusses these lifestyle practices and the current evidence associated with male infertility. Furthermore, known mechanisms of action are also discussed for each of these. Common mechanisms associated with a reduction in spermatogenesis and/ or steroidogenesis due to unfavourable lifestyle practices include inflammation and oxidative stress locally or systemically. It is recommended that relevant lifestyle practices are investigated in clinical history of male infertility cases, particularly in unexplained or idiopathic male infertility. Appropriate modification of detrimental lifestyle practices is further suggested and recommended in the management of male infertility.
The effect of Nigella sativa oil and metformin on male seminal parameters and testosterone in Wistar rats exposed to an obesogenic diet
(Elsevier, 2021) Leisegang, Kristian; Almaghrawi, Walid; Henkel, Ralf
Obesity is a significant global health and socio-economic challenge, and considered an important risk factor for poor health outcomes including male reproductive dysfunction and infertility. As excess adiposity causes testicular dysfunction and infertility, novel therapeutic strategies require investigation. Nigella sativa (Ns) seed oil and metformin have both demonstrated a potential positive effect on obesity, although both remain poorly investigated in male fertility. Therefore, this study aimed to determine the effect of Ns oil and metformin on total body weight (TBW), mitochondrial membrane potential (MMP), serum testosterone and semen parameters in an obese animal model. Wistar rats (n = 54) were divided into six groups: normal chow (NC), high sugar diet (HSD) only, HSD and saline, HSD and metformin (75 mg/Kg/day), HSD and Ns (200 mg/Kg/day) (NS200), HSD and Ns (400 mg/Kg/day) (NS400). Intervention was force fed for the last 8 weeks of the 14 weeks dietary exposures. Results showed that the HSD increased TBW (P = 0.001) and reduced sperm concentration (P = 0.013) and progressive motility (P = 0.009) compared to the NC group. Metformin, NS200 and NS400 improved TBW (P = 0.035, P = 0.006 and P = 0.005, respectively) and testosterone (P < 0.001) compared to the HSD saline group, where metformin and NS400 improved sperm concentration (P < 0.001 and P = 0.049, respectively) and MMP (P < 0.001). There were no changes in sperm motility and viability for all experimental exposures, although NS400 (P = 0.047) negatively affected sperm viability. Metformin and Ns may be novel treatment options in obesity-induced infertility, although a potential negative impact on viability is cautioned for high dose Ns. These results warrant further investigation of Ns and Metformin for the management of obese infertile males.
The effect of Nigella sativa oil and metformin on male seminal parameters and testosterone in Wistar rats exposed to an obesogenic diet
(Elsevier, 2020) Leisegang, Kristian; Almaghrawi, Walid; Henkel, Ralf
Obesity is a significant global health and socio-economic challenge, and considered an important risk factor for poor health outcomes including male reproductive dysfunction and infertility. As excess adiposity causes testicular dysfunction and infertility, novel therapeutic strategies require investigation. Nigella sativa (Ns) seed oil and metformin have both demonstrated a potential positive effect on obesity, although both remain poorly investigated in male fertility. Therefore, this study aimed to determine the effect of Ns oil and metformin on total body weight (TBW), mitochondrial membrane potential (MMP), serum testosterone and semen parameters in an obese animal model. Wistar rats (n = 54) were divided into six groups: normal chow (NC), high sugar diet (HSD) only, HSD and saline, HSD and metformin (75 mg/Kg/day), HSD and Ns (200 mg/Kg/day) (NS200), HSD and Ns (400 mg/Kg/day) (NS400). Intervention was force fed for the last 8 weeks of the 14 weeks dietary exposures. Results showed that the HSD increased TBW (P = 0.001) and reduced sperm concentration (P = 0.013) and progressive motility (P = 0.009) compared to the NC group. Metformin, NS200 and NS400 improved TBW (P = 0.035, P = 0.006 and P = 0.005, respectively) and testosterone (P < 0.001) compared to the HSD saline group, where metformin and NS400 improved sperm concentration (P < 0.001 and P = 0.049, respectively) and MMP (P < 0.001).
Effect of the metabolic syndrome on male reproductive function: a case-controlled pilot study
(Wiley, 2014) Leisegang, Kristian; Bouic, Patrick J.D.; Henkel, Ralf
The metabolic syndrome (MetS) is a constellation of various risk factors. This study aimed to investigate the effect of MetS on testosterone and progesterone, and semen parameters, in a case-controlled pilot study. Male patients (n = 54) had body mass index, waist-to-hip ratio (WHR) and blood pressure recorded. Blood was analysed for HDL cholesterol, triglycerides and glucose. Saliva was assayed for free testosterone and free progesterone. Ejaculates were analysed for volume, sperm concentration, total sperm count, motility, vitality, mitochondrial membrane potential (MMP), DNA fragmentation and leucocyte concentration. Participants were divided into the control group (n = 28) and the MetS group (n = 26). Differences were found between the groups for body mass index, WHR, blood pressure, high-density lipoprotein (HDL), triglycerides and glucose. The MetS group showed significant reductions in sperm concentration (P = 0.0026), total sperm count (P = 0.0034), total motility (P = 0.0291), sperm vitality (P = 0.002), MMP (P = 0.0039), free testosterone (P = 0.0093) and free progesterone (P = 0.0130), while values for DNA fragmentation increased (P = 0.0287). Results indicate that patients with MetS have compromised sperm parameters in the absence of leucocytospermia. A reduction in free progesterone suggests that steroidogenesis cascades may be compromised. It is hypothesised that a systemic pro-inflammatory state with oxidative stress associated with MetS may provide a novel explanation.
The efficacy of zingiber officinale on dyslipidaemia, blood pressure, and inflammation as cardiovascular risk factors: A systematic review
(Clinical Nutrition ESPEN, 2022) Daniels, Chelsea Courtney; Isaacs, Zaiyaan; Leisegang, Kristian; Finelli, Renata
Background & aims: Hypertension, dyslipidaemia, and chronic inflammation contribute to the development of cardiovascular disease (CVD). Zingiber officinale has been suggested to reduce these CVD risk factors; however, the clinical evidence remains unclear. This systematic review aims to analyse the effect of Z. officinale as a sole intervention on these risk factors. Methods: In this PRISMA-based systematic review, we included randomised clinical trials from PubMed, Scopus and Cochrane Database of Systematic Reviews (July 2020) analysing triglycerides, low- and highdensity lipoprotein (LDL, HDL), total cholesterol, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-a), interleukin 1, 6, 10, systolic and/or diastolic blood pressure as outcomes. Quality of studies was evaluated by JADAD and the Cochrane risk-of-bias tools. Results: A total of 24 studies were included, mostly (79.2%) showing low risk of bias. These were based on obesity and cardio-metabolic derangements (33.3%), type 2 diabetes mellitus (37.5%), and miscellaneous conditions (29.2%). While total cholesterol and triglycerides levels mostly improved after Z. officinale, results were inconsistent for other blood lipids markers. Inflammatory markers (CRP, TNF-a) were more consistently reduced by Z. officinale, while only 3 studies reported a non-significant reduction of blood pressure. Conclusions: Although there remains a paucity of studies, Z. officinale may be beneficial for improving dyslipidaemia and inflammation.
A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility
(The world journal of men's health, 2021) Leisegang, Kristian
Globally, infertility impacts 15% of couples trying to conceive. The incidence of male infertility has been increasing over the past several decades, ranging from 20% to 70% worldwide [1,2]. The male partner is found to be solely responsible in 20%–30% of cases, and contributes to couple infertility in approximately 50% of cases [3]. The etiologies and risk factors for male infertility are diverse. In addition to genetic causes, common acquired causes include varicocele, reproductive tract infections/inflammation, endocrine abnormalities, cryptorchidism, medications, malignancy, radiation and chemical or chemotherapy exposure, environmental and lifestyle factors, and underlying medical comorbidities [4].
Impact of body composition analysis on male sexual function : A metabolic age study
(Frontiers in Endocrinology, 2023-01) Leisegang, Kristian; Henkel, Ralf; Majzoub, Ahmad; Elbardisi, Haitham; Madani, Sarah; Mahdi, Mohamed; Agarwal, Ashok; Khalafalla, Kareim; Alsaid, Sami; Arafa, Mohamed
Metabolic Age (MetAge) and body composition analysis may reflect an individual’s metabolic status, which is believed to influence male sexual and gonadal functions. Although erectile dysfunction (ED) and hypogonadism are increasingly prevalent with age, they are also detected among younger men. This study aims to assess the impact of MetAge and body composition on male sexual and gonadal status overall, and particularly in men younger than 40 years of age.
The impact of COVID-19 on the male reproductive tract and fertility: A systematic review
(Informa UK Limited, trading as Taylor & FrancisGroup., 2021) Sengupta, Pallav; Leisegang, Kristian; Agarwal, Ashok
Objective: The COVID-19 pandemic, caused by the acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), remains an ongoing public health challenge. Although males are affected slightly more than females, the impact of SARS-COV-2 on male reproductive system remains unclear. This systematic review aims to provide a concise update on the effects of COVID-19 on male reproductive health, including the presence of viral RNA in semen, and the impact on semen quality, testicular histology, testicular pain and male reproductive hormones. The global health is fronting an immediate as well as impending threat from the novel coronavirus (SARS- CoV-2) causing coronavirus disease (COVID-19), that inflicts more males than females. Evidence suggest that male reproductive system is susceptible to this viral infection. However, there are still several pertinent queries that remain to be fully explained regarding the mechanism in testicular SARS-CoV-2 dynamics and the exact mode of its actions. Thus, the present systematic review aims to provide a concise update on the effects of coronavirus disease 2019 (COVID-19) on male reproduction. Methods: A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines searching the PubMed database. Eligibility for inclusion were original human studies evaluating the impact of COVID-19 on male repro- ductive health. Specific outcomes required for inclusion were at least one of the following: i) seminal detection of mRNA virus, or evaluation of ii) semen analysis, iii) testicular histology or ultrasonography, iv) testicular clinical symptoms and/or v) male reproductive hormones in COVID-19-positive patients. Results: Of 553 retrieved articles, 25 met the inclusion criteria. This included studies primarily investigating the presence of viral RNA in semen (n = 12), semen quality (n = 2), testicular histology (n = 5), testicular pain (n = 2) and male reproductive hormones (n= 4). Results show little evidence for the presence of viral RNA in semen, although COVID-19 seems to affect seminal parameters, induce orchitis, and cause hypogonadism. Mortality cases suggest severe histological disruption of testicular architecture, probably due to a systemic and local reproductive tract inflammatory response and oxidative stress-induced damage. Conclusions: Clinical evaluation of the male reproductive tract, seminal parameters and reproductive hormones is recommended in patients with current or a history of COVID-19,y treatment. Any long-term negative impact on male reproduction remains unexplored and an important future consideration.
The impact of Covid-19 vaccines on male semen parameters: A retrospective cohort study
(University of the Western Cape, 2023) Henkel, Ralf; Leisegang, Kristian; Finelli, Renata
The emergence of SARS-CoV-2 and the subsequent COVID-19 pandemic necessitated the development of adequate vaccines. Despite vaccines being demonstrated to be safe and effective for preventing severe disease and death, vaccine hesitancy remains. Reasons include concerns over adverse effects on male fertility, which have not been widely investigated. Therefore, this study is aimed at determining the impact of COVID-19 vaccination on semen parameters in a retrospective cohort study of South African males undergoing fertility assessment. The patients for this study were adult men who have previously undergone routine semen analysis for fertility assessment at Androcryos Andrology Laboratory (Johannesburg, South Africa) between March 2021 and March 2022. They also received vaccination within 3 months following a semen analysis and underwent a second semen analysis any time post-COVID-19 vaccination. From 277 records analysed, 46 patients met the inclusion criteria, receiving the Pfizer-BioNTech (BNT162b1) (63%), Johnson and Johnson (JNJ-78436735/Ad26.COV2S) (34.8%), and the AstraZeneca (AZD1222) (2.2%) vaccines. Sperm concentration significantly increased postvaccination (P = 0:0001), with no significant changes in semen pH, volume, total sperm count, progressive motility, normal sperm morphology, or chromatin condensation. Results were not influenced by age, type of vaccine received, and the number of days following vaccination, as depicted by multiple regression analysis. In conclusion, there is no evidence of a negative impact of COVID-19 vaccination on male semen parameters, which is consistent with the emerging literature on COVID-19 vaccination and male fertility. COVID-19 vaccinations should not be dismissed based on fear of adverse effects on male fertility parameters.
The impact of male overweight on semen quality and outcome of assisted reproduction
(Medknow Publications, 2014) Leisegang, Kristian; Henkel, Ralf
The impact of obesity on male reproductive health remains a contested topic as evidence is inconclusive and inconsistent. Even more debatable is the effect of male obesity in assisted reproduction. In the manuscript, “the impact of male overweight on semen quality and outcome of assisted reproduction” published in Asian Journal of Andrology, Thomsen et al. investigated the effect of male obesity on fertilization outcomes in intrauterine insemination, in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) programs further contributes to the increasing body of evidence in this field.
The Impact of Storage Time and Seasonal Harvesting on Levels of Sutherlandins and Sutherlandiosides in Lessertia frutescens
(Conference: Faculty of Community and Health Sciences 2nd Research Day, 2013) Leisegang, Kristian; Campbell, J; Weitz, F; Henkel, R.R
In South Africa, an estimate of 70% of the population frequently uses traditional medicine for their health care needs. The use of Lessertia frutescens (Figure 1,2) by various cultural groups dates back to the earlier civilizations and continues to be used today to treat a multitude of ailments. Even in Western countries, L frutescens is used by many people for its anti-proliferative or anti-inflammatory activities. In establishing quality, safety and efficacy of traditional medicine, one would need to ensure that the crude material is of optimal quality.
The in vitro modulation of steroidogenesis by inflammatory cytokines and insulin in TM3 Leydig cells
(BioMed Central, 2018) Leisegang, Kristian; Henkel, Ralf
BACKGROUND: Cytokines and hormones, including insulin, are known to modulate the hypothalamic-pituitary-testes axis and steroidogenesis, both centrally and peripherally. In the context of chronic inflammation and hyperinsulinaemia mediating male hypogonadism associated with obesity, metabolic syndrome and type 2 diabetes mellitus, these mechanisms are poorly understood and the impact of cytokines and insulin on Leydig cell steroidogenesis has not been fully elicited. This study aimed to further investigate the in vitro impact of TNFα, IL1ß, IL6, IL8 and insulin on Leydig cell function and steroidogenesis. METHODS: hCG-stimulated TM3 Leydig cells were exposed to various concentrations of TNFα, IL1ß, IL6, IL8 (100 ng/ ml, 10 ng/ml, 1 ng/ml and 0.1 ng/ml) and insulin (10 ng/ml, 1 ng/ml, 0.1 ng/ml and 0.01 ng/ml) in optimal cell culture conditions over 48 h. Cell viability (XTT) and testosterone and progesterone concentrations (ELISA) were assessed using standardised laboratory techniques. RESULTS: TNFα significantly decreased cell viability and progesterone and testosterone concentrations in a dosedependent relationship. IL1ß and IL6 had a subtle but significant negative effect on cell viability and testosterone concentrations, with a marked significant decrease in progesterone concentration at all concentrations investigated. IL8 showed an increase in cell viability, with no significant effect on testosterone concentrations alongside a significant decrease in progesterone concentrations. Insulin significantly increased cell viability and testosterone concentrations in a dose dependent relationship, but interestingly significantly decreased progesterone concentrations. CONCLUSIONS: The inflammatory cytokines TNFα, IL1β and IL6 cause a dose dependent decline in steroidogenesis in TM3 Leydig cells. These results suggest that chronic inflammation may downregulate steroidogenesis in males via direct modulation of Leydig cell function. However, IL8 may stimulate TM3 Leydig cell growth. Insulin is associated with a dose-dependent increase in testosterone synthesis, with a significant decline in progesterone synthesis. With the phenomenon of insulin resistance, the literature is unclear on the potential role of hyperinsulinaemia in steroidogenesis. Further studies are warranted in order to fully elicit the molecular mechanisms and interactions of these molecules on male steroidogenesis.
An in-depth bibliometric analysis and current perspective on male infertility research
(Korean Society for Sexual Medicine and Andrology, 2019) Baskaran, Saradha; Agarwal, Ashok; Leisegang, Kristian; Peter, Natesan Pushparaj; Selvam, Manesh Kumar Panner; Henkel, Ralf
PURPOSE: Male infertility is emerging as a major, escalating global health problem that imposes the need to investigate research trends in male infertility. The purpose of this study is to analyze male infertility research trends in the past 20 years using the bibliometric database from Scopus. MATERIALS AND METHODS: In order to perform an in-depth bibliometric analysis, we propose a ‘Funnel Model’, which includes several layers representing different sub-areas of male infertility research. Adopting this Funnel Model, using Scopus, we retrieved relevant bibliometric data (articles per year, authors, affiliations, journals, and countries) for various areas of male infertility research and performed descriptive statistics. RESULTS: The bibliometric analysis showed an exponential increase in male infertility research in the last 20 years. USA dominated in research output, with Agarwal, A. as the most prolific researcher. Testicular cancer, obesity and metabolic syndrome, and azoospermia were found to dominate male infertility research, whereas erectile dysfunction and unexplained male infertility had lesser attention. Interestingly, prognostic/diagnostic and mechanistic studies have significantly increased in parallel over the last 20 years. Furthermore, our bibliometric analysis revealed fewer publications in proteomics, transcriptomics and metabolomics when compared to genomics. Also, an increasing trend in publication was seen in assisted reproductive technology (ART) research. CONCLUSIONS: An integrated and steep escalation in the field of omics and ART research appears to be a prerequisite for further development of future diagnostic and therapeutic strategies for male infertility.
Is there plagiarism in the most influential publications in the field of andrology?
(Wiley, 2019) Baskaran, Saradha; Henkel, Ralf; Leisegang, Kristian
Plagiarism is a common form of academic misconduct that extensively jeopardises the quality of scientific publication. The purpose of this study is to determine the extent of plagiarism in the most influential andrology articles. A total of 77 highly cited andrology articles were analysed for their similarity index using iThenticate and Turnitin. The articles were categorised based on the year (before and on/after 2000) and type of publication (review and research articles), and the similarity indices were compared. Furthermore, the analysed articles were categorised based on the level of similarity using an arbitrary similarity index range (low: ≤10, moderate: 11–20, high: 21–50 and very high: >50) and average incidence rate (%) was determined. Our analysis revealed a higher percentage of the similarity indices for reviews than research articles. We noticed a higher similarity index for articles published on/after 2000 than those published before. The majority of the influential articles in the field of andrology showed a low similarity index, while some articles exhibited moderate to high levels of similarity. These findings support the need for the development of similarity index guidelines as a major pre‐requisite for establishing a more transparent and efficient system to address plagiarism in scientific publications.
Male fertility and the COVID-19 pandemic: Systematic review of the literature
(Korean Society for Sexual Medicine and Andrology, 2020) Leisegang, Kristian; Khalili, Mohammad Ali; Majzoub, Ahmad A.
Purpose: Since its discovery in December 2019, the novel coronavirus SARS-CoV-2 has spread globally, causing the current COVID-19 (coronavirus disease-19) pandemic. As there is an increase of infections in the male population, concerns have emerged about the potential impact of COVID-19 on male reproductive organs and male fertility. Therefore, this study systematically investigates the current evidence of SARS-CoV-2 impact on male reproduction and pregnancy outcomes, discussing them in light of the evidence published on other coronaviruses. Materials and Methods: Literature search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 24 original articles were included for the analysis, investigating the effects of the infection on semen parameters, male reproductive hormones, and pregnancy outcomes.
Nutritional value of cooked offal derived from free-range rams reared in South Africa
(Elsevier, 2013) Hoffman, L.C.; Laubscher, L.L.; Leisegang, Kristian
Nutritional value of Dorper (n=10) and Merino (n=10) by-products were evaluated. Proximate composition differed between organs and breeds with Merino heart (68.9 g/100 g), spleen (77.2 g/100 g) and testicles (83.7 g/100 g) having higher moisture contents than their Dorper counterparts. Dorper brain (10.1 g/100 g), heart (15.2 g/100 g), spleen (20.4 g/100 g) and testicles (12.9 g/100 g) had higher protein contents than Merino. Dorper organs also tended to have a lower fat content. Amino acid and fatty acid profiles differed between organs and breeds. Few differences were noted in total SFA and MUFA. Dorper heart (1.8%) had significantly lower total PUFA than Merino heart (7.3%). All the organs showed favourable P:S ratios, with the exception of the tongue, heart and stomach. Dorper and Merino brain, lungs and testicles had favourable n−6/n−3 ratios. Cholesterol content differed between both organs and breeds. The value of offal as food is discussed further.
Obesity and metabolic syndrome associated with systemic inflammation and the impact on the male reproductive system
(John Wiley & Sons Ltd, 2019) Leisegang, Kristian; Henkel, Ralf; Argarwal, Ashok
Obesity and metabolic syndrome (MetS) are global epidemics, driven by an obe‐sogenic environment. This is mediated by complex underlying pathophysiology, in which chronic inflammation is an important aetiological and mechanistic phenom‐enon. A shift towards a subclinical TH1–lymphocyte mediated innate and chronic in‐flammatory response is well defined in obesity and MetS, demonstrated in multiple systems including visceral adiposity, brain (hypothalamus), muscles, vasculature, liver, pancreas, testes, epididymis, prostate and seminal fluid. Inflammatory cytokines dis‐rupt the hypothalamic‐pituitary‐testes axis and steroidogenesis cascades (hypogon‐adotropic hypogonadism), spermatogenesis (poor semen parameters, including DNA fragmentation and detrimental epigenetic modification) and results in subclinical prostatitis and prostate hyperplasia. This review aims to highlight the role of chronic inflammation in obesity and MetS, cytokines in male reproductive physiology and pathophysiology, the impact on steroidogenesis and spermatogenesis, prostate pa‐thology and erectile dysfunction. Currently, it is recommended that clinical assess‐ment of male infertility and reproductive dysfunction in obese and MetS patients includes inflammation assessment (highly sensitive C‐reactive protein), and appro‐priate advice and therapeutic options are incorporated in the management options. However, the mechanisms and therapeutic options remain poorly understood and require significant interdisciplinary research to identify potential novel therapeutic strategies
Obesity is associated with increased seminal insulin and leptin alongside reduced fertility parameters in a controlled male cohort
(BioMed Central, 2014) Leisegang, Kristian; Menkveld, Roelof; Bouic, Patrick J.D.; Henkel, Ralf
Obesity appears to be associated with male reproductive dysfunction and infertility, although this has been inconsistent and inconclusive. Insulin and leptin are known mediators and modulators of the hypothalamus-pituitary-testes axis, contributing to the regulation of male reproductive potential and overall wellbeing. These hormones are also present in semen influencing sperm functions. Although abdominal obesity is closely associated with insulin resistance (hyperinsulinaemia), hyperleptinaemia and glucose dysfunction, changes in seminal plasma concentrations of insulin, leptin and glucose in obese males has not previously been investigated.

Browsing by Author "Leisegang, Kristian"

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