Platelet-rich plasma enhances post-conditioning recovery from testicular ischemia–reperfusion injury: a novel experimental approach

The present study aimed to investigate the protective effects of platelet-rich plasma combined with post-conditioning on testicular ischemia-reperfusion injury in a rat model. Thirty-two adult male rats were randomly assigned to four groups (n = 8 each): Sham (SH), Ischemia-reperfusion (I/R), post-conditioning (PC), and platelet-rich plasma-post conditioning PRP/PC. Testicular torsion was induced for 3 h, followed by 24 h of reperfusion. After 24 h, blood and testicular tissues were collected for histopathological and immunohistochemical analyses. Ischemia-reperfusion notably increased oxidative stress, apoptosis, and inflammatory markers, as shown by higher levels of malondialdehyde, caspase-3, TNF-α, and IL-6 (p < 0.05). These changes were reduced by PC and more effectively by PRP/PC. Antioxidant markers, including catalase, reduced glutathione (p < 0.0001), eNOS, HSP70, and VEGF (p < 0.0001), were significantly higher in the treated groups than in the I/R group. Histological analysis demonstrated improved testicular structure, with Johnsen's scores of 8-10 (SH), 2-3 (I/R), 6-9 (PC), and 4-9 (PRP/PC). Notably, PRP/PC showed increased expression of Bax and NF-κB. Hematological results revealed significant changes in Hb, RBCs, and HCT, while MCHC and MCH remained unchanged, and MCV showed minor differences. The data of the present study indicated that combined with PC provided partial protection against testicular I/R injury, reducing oxidative stress, apoptosis, and inflammation while preserving testicular architecture. These findings suggest early restorative effects rather than complete functional recovery.