Immunological mechanisms of therapeutic efficacy of oxidized dextran in spermatogenesis disorders of infectious and inflammatory genesis

The article summarizes experimental and clinical data on the immunological properties of oxidized dextran. The study addresses pathophysiological effects of oxidized dextran, in particular, its ability to selectively activate tissue macrophages, including testicular macrophages, which are directly involved in spermatogenesis. In experimental part of the work, a rat model of spermatogenesis disorders was produced by injection of Escherichia coli endotoxin. We have shown that oxidized dextran significantly reduces pathomorphological changes in the testes. At the same time, such effect is associated with the activation of tissue macrophages and release of corresponding cytokines, which exert anti-inflammatory effects and normalize microcirculatory hemodynamics. The presented experimental data correlate with the sufficient results on the high clinical efficacy of oxidized dextran in spermatogenesis disorders and male infertility. Clinical part of this work concerned the effects of rectal administration of oxidized dextran in patients with severe spermatogenesis disorders. It was shown that oxidized dextran significantly increases the volume of ejaculate, the concentration of spermatozoa in the ejaculate, and the total number of spermatozoa. The authors link the data of experimental and clinical studies within the framework of a single concept of tissue macrophage activation and the ability of macrophages to change their phenotype depending on the microenvironment and characteristics of the infectious and inflammatory process. This approach is also confirmed by clinical data on the effect of macrophage phenotypes on drug resistance and severity of intracellular infections, in particular, tuberculosis. Analysis of experimental and clinical data allows the authors to propose a theoretical model for the mechanism of therapeutic effectiveness of oxidized dextran in intracellular infections. The bulk of data presented by the authors allow us to consider oxidized dextran as a quite effective tool for the treatment of intracellular infections, including urogenital infections causing male infertility.