OBJECTIVES An enlargement of the spermatic vein is known as a varicocele. Research studies suggest that immune system mediators such as vascular endothelial growth factor (VEGF) and its receptors including VEGFR1, VEGFR2, and VEGFR3 can play a role in angiogenesis and inhibition of endothelial cell apoptosis and correspondingly suppress spermatogenesis. Thus, the purpose of this study was to measure the expression of VEGF and its receptors in infertile men with varicocele. MATERIALS & METHODS To meet the research objectives, a total number of 30 infertile male patients affected with varicocele (Grade 3) and 30 healthy fertile male subjects without any varicocele or urogenital tract disorder were enrolled in the study. The varicose and normal veins were obtained from the patients along with the blood flowing in these spermatic veins during surgery. Also, peripheral blood samples were collected from the mentioned patients and healthy subjects. The serum levels of VEGF were also measured via enzyme-linked immunosorbent assay (ELISA) and subsequently mRNA level of VEGFR1, VEGFR2, VEGFR3, B Cell Lymphoma-Associated X (Bax), and B-cell lymphoma 2 (Bcl2) genes were measured using the real-time polymerase chain reaction (RT-PCR) technique. RESULTS The findings of this study revealed that VEGFR2 gene expression in varicose veins was significantly increased compared with normal veins in varicocele patients (P < 0.001) and Bax/Bcl2 ratio reduced in varicose veins when compared to normal veins of the patients (P < 0.05). Our findings also showed a significant rise in the serum levels of VEGF in the peripheral blood and varicose vein bloodstream compared with those in healthy subjects (P < 0.0001). Moreover, a significant difference was observed in the serum levels of VEGF in the peripheral blood and varicose vein blood of patients suffering from varicocele (P < 0.001). CONCLUSION According to the results of this study, VEGF/VEGFR2 axis might act in the survival of endothelial cells of varicocele vein through inhibition of apoptosis and stimulation of angiogenesis. Additionally, increased VEGF in the testis can probably play a role in suppressing spermatogenesis and varicocele-based infertility.

中文翻译：

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精索静脉曲张不孕男性血管内皮生长因子及其受体的表达。

目的 精索静脉的扩大被称为精索静脉曲张。研究表明，血管内皮生长因子（VEGF）及其受体包括VEGFR1、VEGFR2和VEGFR3等免疫系统介质可在血管生成和抑制内皮细胞凋亡中发挥作用，并相应地抑制精子发生。因此，本研究的目的是测量 VEGF 及其受体在精索静脉曲张的不育男性中的表达。材料与方法 为了达到研究目标，共有 30 名患有精索静脉曲张（3 级）的不育男性患者和 30 名没有任何精索静脉曲张或泌尿生殖道疾病的健康可育男性受试者参加了研究。静脉曲张和正常静脉与手术期间在这些精索静脉中流动的血液一起从患者身上获得。此外，从上述患者和健康受试者中收集外周血样本。还通过酶联免疫吸附试验 (ELISA) 测量了血清 VEGF 水平，随后测量了 VEGFR1、VEGFR2、VEGFR3、B 细胞淋巴瘤相关 X (Bax) 和 B 细胞淋巴瘤 2 (Bcl2) 基因的 mRNA 水平使用实时聚合酶链反应 (RT-PCR) 技术。结果 本研究结果显示，与正常静脉相比，精索静脉曲张患者的 VEGFR2 基因表达显着增加（P < 0.001），与正常静脉相比，静脉曲张的 Bax/Bcl2 比值降低（P < 0.05）。 ）。我们的研究结果还显示，与健康受试者相比，外周血和静脉曲张血流中 VEGF 的血清水平显着升高（P < 0.0001）。此外，精索静脉曲张患者外周血和静脉曲张血中VEGF的血清水平存在显着差异（P < 0.001）。结论本研究结果表明，VEGF/VEGFR2轴可能通过抑制细胞凋亡和刺激血管生成而影响精索静脉曲张内皮细胞的存活。此外，睾丸中增加的 VEGF 可能在抑制精子发生和精索静脉曲张的不孕症方面发挥作用。精索静脉曲张患者外周血和静脉曲张血中VEGF含量有显着差异（P < 0.001）。结论本研究结果表明，VEGF/VEGFR2轴可能通过抑制细胞凋亡和刺激血管生成而影响精索静脉曲张内皮细胞的存活。此外，睾丸中增加的 VEGF 可能在抑制精子发生和精索静脉曲张的不孕症方面发挥作用。精索静脉曲张患者外周血和静脉曲张血中VEGF含量有显着差异（P < 0.001）。结论本研究结果表明，VEGF/VEGFR2轴可能通过抑制细胞凋亡和刺激血管生成而影响精索静脉曲张内皮细胞的存活。此外，睾丸中增加的 VEGF 可能在抑制精子发生和精索静脉曲张的不孕症方面发挥作用。