1.Research progress on oxidative stress mechanism and traditional Chinese medicine intervention in varicocele-induced infertility
Shengnan LI ; Hongyan CHEN ; Tengfei CHEN ; Boxian GAO ; Chongfu ZHONG
China Pharmacy 2025;36(12):1536-1541
Varicocele-induced infertility (VCI) is a common andrological disease in clinical practice. Oxidative stress represents the primary mechanism through which varicocele causes male infertility. Traditional Chinese medicine (TCM) treatment, characterized by its multi-target, multi-component, multi-system, and multi-pathway actions, has achieved favorable outcomes in the field of VCI treatment. This paper summarizes the underlying oxidative stress mechanism of VCI and the relevant signaling pathways involved. By reviewing the current research status on how monomers, active fractions, compound formulas, and related preparations of TCM can intervene in oxidative stress through the regulation of these signaling pathways to improve VCI, it is found that the nuclear factor-erythroid 2-related factor 2 (Nrf2) signaling pathway, the mitogen-activated protein kinase (MAPK) signaling pathway, and the hypoxia-inducible factor-1α (HIF-1α) signaling pathway are closely related to the development of VCI. TCM monomers and active fractions (flavonoids from Cuscutae Semen, polysaccharides from Astragali Radix, curcumin, ginsenoside Rg1, hyperin and echinacoside), as well as compound formulas and related preparations of TCM (modified Dahuang zhechong granules, Shengjing huoxue formula, modified Tianxiong san, Tongjingling, Bushen huoxue formula, Mailuoshutong pill, Zishen yutai pill, Danhong tongjing formula) can alleviate oxidative stress, reduce lipid peroxidation damage, improve mitochondrial dysfunction, decrease sperm DNA fragmentation, and inhibit apoptosis by activating the Nrf2 signaling pathways and inhibiting the MAPK and HIF-1α signaling pathways, thereby improving reproductive function.
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