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1. Introduction
Testicular torsion is a urologic emergency that occurs frequently in the neonatal and adolescent period [1, 2]. It is characterized by a circulatory failure caused by a testis revolving around the vascular peduncle. This condition is most common in infancy and the beginning of adolescence, but it is seen in almost every age group. Nevertheless, 65% of the cases are seen in the pubertal period, more specifically, at the age of 13 [1–4]. In cases with late diagnoses, this condition can result in function loss and infertility in the testis [1, 3].
Torsion of the spermatic cord first leads to a decrease in the blood stream to the testis. In fact, the basic pathology in testicular torsion is ischemia occurring as a result of the torsion, and tissue damage is done by reactive oxygen species as a result of reperfusion [5, 6]. As a result of the reperfusion of the ischemic tissue, toxic-free oxygen radicals, such as nitric oxide (NO−), superoxide anions (O2−), hydrogen peroxide (H2O2), and hydroxyl radicals (OH−) occur [1, 5, 7].
Moreover, successively occurring cases cause many biochemical and morphological changes in the cells of the testis, which can lead to lipid peroxidation, protein denaturation, DNA damage, and apoptosis [8–10]. Testes are sensitive to free radical damage [5]. Under normal conditions, enzymatic antioxidant defense systems, such as superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT), protect those cells from free radical damage. Malondialdehyde (MDA) is an important indicator of lipid peroxidation.
α-lipoic acid (LA) is an eight-carbon endogenous cofactor with a disulfide structure. It was described as a strong antioxidant in the 1980s, and it works against oxygen radicals. It is known for catching hydroxyl and nitric oxide radicals, peroxynitrite anions, and hydrogen peroxide and extinguishing single oxygen atoms [11–13]. Both the oxidized (LA) and reduced (DHLA) forms of lipoic acid are capable of scavenging hydroxyl and nitric oxide radicals, peroxynitrite anions, and hydrogen peroxide and extinguishing single oxygen atoms. It is a potent metal chelator, an anti-inflammatory...