Immunophenotypic Characteristics of the Fibrous Component of the Blood-Testis Barrier when Using Cell Therapy for Azoospermia Treatment

Objective. Immunohistochemistry testicular tissue collagens evaluation in the treatment of azoospermia with platelet-rich plasma (PRP) and extracorporeal shock wave therapy (ESWT).Materials and methods. We used biopsy material of testicular fragments from 14 patients with an established diagnosis of secretory azoospermia before and after the use of PRP plus ESWT (patent granted RU2738543 from 14.12.2020). The mean age was 33.07 ± 4.64 (28–43 years), the mean duration of the disease – 4,1 ± 2,26 years (1–9 years). All participants received 2 therapy sessions per week during 6 weeks. 1st session included ultrasound-guided PRP injections into testicles and spermatic cords, finally PRP was activated with ESWT (Dornier Aries), 2nd session included ESWT per testicles and epididymis. Immunohistochemistry analysis with antibodies to collagen types I, III and IV of patient’s biopsies with azoospermia were completed on 90 days before treatment and 180 days from last PRP-injection.Results. Before PRP and ESWT therapy: type I collagen was 22.9 ± 4.2 % (p <0.05), type III collagen – 7.3 ± 2.2 % (p <0.05), type IV collagen – 21.4 ± 1.5 % (p <0.05); after combined therapy: type I collagen – 27.3 ± 5.7 % (p <0.05), type III collagen – 7.2 ± 1.5 % (p <0.05), type IV collagen – 32.2 ± 2.6 % (p <0.05).Conclusion. The production of biologically active substances against the background of PRP and ESWT therapy stimulates the collagen various types synthesis, which promotes to the restoration of the fibrous component of the blood-testicular barrier and improves spermatogenesis.