The Protective Effects of Alpha-Lipoic Acid and Coenzyme Q10 Combination on Ovarian Ischemia-Reperfusion Injury: An Experimental Study

Abstract

Objective. This study aims to evaluate whether alpha-lipoic acid and/or coenzyme Q10 can protect the prepubertal ovarian tissue from ischemia-reperfusion injury in an experimental rat model of ovarian torsion. Materials and Methods. Forty-two female preadolescent Wistar-Albino rats were divided into 6 equal groups randomly. The sham group had laparotomy without torsion; the other groups had torsion/detorsion procedure. After undergoing torsion, group 2 received saline, group 3 received olive oil, group 4 received alpha-lipoic acid, group 5 received coenzyme Q10, and group 6 received both alpha-lipoic acid and coenzyme Q10 orally. The oxidant-antioxidant statuses of these groups were compared using biochemical measurement of oxidized/reduced glutathione, glutathione peroxidase and malondialdehyde, pathological evaluation of damage and apoptosis within the ovarian tissue, and immunohistochemical assessment of nitric oxide synthase. Results. The left ovaries of the alpha-lipoic acid + coenzyme Q10 group had significantly lower apoptosis scores and significantly higher nitric oxide synthase content than the left ovaries of the control groups. The alpha-lipoic acid + coenzyme Q10 group had significantly higher glutathione peroxidase levels and serum malondialdehyde concentrations than the sham group. Conclusions. The combination of alpha-lipoic acid and coenzyme Q10 has beneficial effects on oxidative stress induced by ischemia-reperfusion injury related to ovarian torsion.

Figure 1

Mean rank of apoptosis.

Figure 2

Slight TUNEL positivity in follicular cells (arrow) in group 1 (a). Moderate TUNEL positivity in follicular cells (arrows) and slight positivity in stroma (yellow arrows) in group 6 (b). Severe TUNEL positivity in follicular cells (arrows) and stroma (yellow arrows) in group 2 (c). ×50. TUNEL method. AEC chromogen. Gill's (I) Hematoxylin.

Figure 3

Mean rank of NOS immunoreactivity.

Figure 4

Slight NOS positivity in follicular cells (lines) (a). Moderate NOS positivity in follicular cells in group 3 (lines) (b). Severe NOS positivity in follicular cells (lines) and stroma (yellow lines) in group 6 (c). ×50. ABC peroxidase. AEC chromogen. Gill's (I) Hematoxylin.

Figure 5

When compared with the left ovaries of the saline and olive oil groups, the left ovaries of the alpha-lipoic acid, coenzyme Q₁₀, and alpha-lipoic acid + coenzyme Q₁₀ groups had significantly lower ovarian damage scores (P = 0.03). The same letters indicated that the difference was statistically insignificant but different letters showed that there was statistical significance between the groups.

Figure 6

When compared with the sham group, the alpha-lipoic acid + coenzyme Q₁₀ group had significantly higher glutathione peroxidase levels and serum malondialdehyde concentrations (P = 0.007 and P = 0.027, resp.). When compared with the control group, the alpha-lipoic acid + coenzyme Q₁₀ group had lower serum malondialdehyde concentrations (P = 0.05). The same letters indicated that the difference was statistically insignificant but different letters showed that there was statistical significance between groups (“a” for glutathione; “1, 2” for malondialdehyde; and “x, y” for glutathione peroxidase).